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Schizophrenia and migration: a meta-analysis and review
Elizabeth Cantor-Graae1, Jean-Paul Selten
1Department of Community Medicine, Hospital UMAS, Lund University, Malmö, Sweden. elizabeth.cantor-graae@smi.mas.lu.se
The American Journal of Psychiatry
|December 31, 2004
Summary
Migration is a significant risk factor for schizophrenia, increasing the likelihood of developing the condition. This meta-analysis quantifies the elevated risk for both first- and second-generation migrants.
Area of Science:
- Psychiatry
- Epidemiology
- Sociology
Background:
- Migration is increasingly recognized as a potential risk factor for schizophrenia.
- Previous studies suggest a link, but a quantitative synthesis of the effect size is needed.
Purpose of the Study:
- To synthesize findings from previous studies on migration and schizophrenia risk.
- To provide a quantitative index of the effect size associated with migration as a risk factor.
Main Methods:
- A systematic literature search of MEDLINE (1977-2003) for population-based incidence studies of migrants.
- Inclusion criteria required reported numerators and denominators for incidence rates and age correction.
- A mixed-effects meta-analytic model was used due to significant heterogeneity across studies.
Main Results:
- First-generation migrants showed a weighted relative risk of 2.7 for developing schizophrenia.
- Second-generation migrants had a higher relative risk of 4.5.
- Increased risk was observed for migrants from developing countries (RR=3.3) and from predominantly Black populations (RR=4.8).
Conclusions:
- A history of migration is an important risk factor for schizophrenia.
- The varying risk patterns suggest that psychosocial adversity plays a role in schizophrenia etiology.