The impact of immigration and visible minority status on psychosis symptom profile
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Immigrants have heightened risks of psychotic disorders, and it is proposed that migration influences symptom profiles. The purpose of this study was to investigate if either migration experience and/or visible minority status affected symptom profiles, using a cross-culturally validated five-factor model of the Positive and Negative Syndrome Scale (PANSS), in patients with broadly defined psychotic disorders.
PANSS was assessed in a large catchment area based sample of patients with psychotic disorders verified with the Structured Clinical Interview for DSM-IV (n = 1,081). Symptom profiles based on Wallwork et al. five-factor model were compared for Norwegians (73 %), white immigrants (10.5 %), and visible minority groups (16.5 %).
Visible minorities were significantly younger, had less education, more often a schizophrenia diagnosis and higher PANSS positive, negative and disorganized/concrete factor scores than Norwegians and white immigrants. After controlling for confounders only the items “Delusions” and “Difficulty in abstract thinking” differed between groups. Multivariate analyses indicated that these items were not associated with immigration per se, but rather belonging to a visible minority.
We found mostly similarities in psychotic symptoms between immigrants and Norwegians when using a cross-culturally validated five-factor model of the PANSS. Immigration did not directly influence psychotic symptom profiles but visible minority groups had higher levels of “Delusions” and “Difficulty in abstract thinking”, both symptoms that are partially context dependent.
KeywordsImmigration Ethnic minority Visible minority Psychosis Symptoms Schizophrenia
We would like to thank the participants in the TOP study and the clinicians collaborating in patient recruitment for their contribution. We would also like to thank Thomas Bjella, Eivind Bakken, and Ragnhild Storli. Funding for this study was provided by the Kristian Gerhard Jebsen Foundation, the Research Council of Norway (Grants #181831, 147787/320, 167153/V50) and the Regional Health Authority for South-Eastern Norway Health Authority (Grants #2010-074 and #2006-258). Neither had any role in study design, data collection, analysis and interpretation, writing of the report, or the decision to submit the paper for publication.
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
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