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Cognitive deficits and ethnicity: a cohort study of early psychosis patients in The Netherlands

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Abstract

Purpose

Incidence rates of psychotic disorders are higher in immigrant groups compared to native populations. This increased risk may partly be explained by misdiagnosis. Neurocognitive deficits are a core feature of psychotic disorders, but little is known about the relationship between migration and cognition in psychotic disorders. We examined whether immigrant patients have cognitive deficits similar to non-immigrant patients, in order to investigate the plausibility of misdiagnosis as explanation for increased incidence rates.

Methods

Patients who made first contact for non-affective psychotic disorder were assessed in the cognitive domains sustained attention, immediate recall and delayed recall. Immigrant patients were compared to Dutch patients on cognitive performance.

Results

407 Patients diagnosed with a non-affective psychotic disorder completed cognitive assessment (157 Dutch, 250 immigrants). Both Dutch and immigrant patients showed large cognitive deficits. Between-subgroup comparisons revealed large cognitive deficits for immigrants compared to Dutch, especially for immigrants from Morocco, Turkey and other non-Western countries.

Conclusions

These results indicate that immigrant status is associated with poorer cognitive functioning in early psychosis. The findings argue against diagnostic bias as an explanation for the increased incidence of psychotic disorders in immigrants.

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Acknowledgments

We thank Jurre Wiersma, who kindly assisted in pre-structuring our data and Niels Smits, for his valuable feedback on the statistical analysis. We also thank Johanna Stouten and Myrle Kemperman for their assistance with the proof-reading of the manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Centre for Early Psychosis, Parnassia Psychiatric Institute, Lijnbaan 4, 2512 VA, The Hague, The Netherlands

    Luyken H. Stouten, Wim Veling, Mischa van der Helm, Winfried Laan & Mark van der Gaag

  2. Department of Clinical Psychology, VU University, Amsterdam, The Netherlands

    Mark van der Gaag

Authors
  1. Luyken H. Stouten
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  2. Wim Veling
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  3. Mischa van der Helm
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  4. Winfried Laan
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Correspondence to Luyken H. Stouten.

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Stouten, L.H., Veling, W., van der Helm, M. et al. Cognitive deficits and ethnicity: a cohort study of early psychosis patients in The Netherlands. Soc Psychiatry Psychiatr Epidemiol 48, 37–47 (2013). https://doi.org/10.1007/s00127-012-0521-x

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  • DOI: https://doi.org/10.1007/s00127-012-0521-x

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