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Characteristics of Immigrant and Non-Immigrant Patients in a Dual-Diagnosis Psychiatric Ward and Treatment Implications

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Abstract

Two studies were conducted among patients in a male dual diagnosis (severe mental illness [SMI] with substance use) ward. The research examined the following questions: (1) Do immigrant and non-immigrant dual diagnosis patients exhibit similar or different socio-demographic, clinical and criminological characteristics? (2) What are the implications for treatment of immigrant (and non-immigrant) patients? Study one analyzed computerized hospital records of 413 male patients; Study two examined patient files of a subgroup of 141 (70 immigrant) male patients. Alongside similarities, non-immigrant patients reported higher numbers of repeat and involuntary hospitalizations and more drug use while immigrants showed longer hospitalizations, more suicide attempts, more violent suicide attempts, more violent offenses and more alcohol use. Among non-immigrants significant relationships were found between severity of SMI and crime/violence while among immigrants a significant relationship was found between suicidality and crime/violence. Implications for treatment include need for awareness of suicide risk among immigrant dual-diagnosis patients and an understanding of the differential relationship with crime/violence for the two populations.

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Notes

  1. Violent suicide attempts included suicide by hanging, jumping from a high place, cutting of veins.

References

  1. Soyka M, Albus M, Kathmann N, et al. Prevalence of alcohol and drug abuse in schizophrenic inpatients. Eur Arch Psychiatry Clin Neurosci. 1993;242(6):362–72.

    Article  PubMed  CAS  Google Scholar 

  2. Swendsen J, Conway KP, Degenhardt L, et al. Mental disorders as risk factors for substance use, abuse and dependence: results from the 10-year follow-up of the National Comorbidity Survey. Addiction. 2010;105(6):1117–28.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994;51(1):8.

    Article  PubMed  CAS  Google Scholar 

  4. Regier DA, Farmer ME, Rae DS, et al. Comorbidity of mental disorders with alcohol and other drug abuse. JAMA. 1990;264(19):2511–8.

    Article  PubMed  CAS  Google Scholar 

  5. Hasin DS, Stinson FS, Ogburn E, et al. Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry. 2007;64(7):830.

    Article  PubMed  Google Scholar 

  6. Soyka M. Substance misuse, psychiatric disorder and violent and disturbed behaviour. Br J Psychiatry. 2000;176(4):345–50.

    Article  PubMed  CAS  Google Scholar 

  7. Blanchard JJ, Brown SA, Horan WP, et al. Substance use disorders in schizophrenia: review, integration, and a proposed model. Clin Psychol Rev. 2000;20(2):207–34.

    Article  PubMed  CAS  Google Scholar 

  8. Drake RE, Wallach MA, Teague GB, et al. Housing instability and homelessness among rural schizophrenic patients. Am J Psychiatry. 1991;148(3):330–6.

    PubMed  CAS  Google Scholar 

  9. Mueser KT, Yarnold PR, Levinson DF, et al. Prevalence of substance abuse in schizophrenia. Schizophr Bull. 1990;16(1):31–56.

    Article  PubMed  CAS  Google Scholar 

  10. Scheller-Gilkey G, Lewine RRJ, Caudle J, et al. Schizophrenia, substance use, and brain morphology. Schizophr Res. 1999;35(2):113–20.

    Article  PubMed  CAS  Google Scholar 

  11. Mueser KT, Yarnold PR, Rosenberg SD, et al. Substance use disorder in hospitalized severely mentally ill psychiatric patients. Schizophr Bull. 2000;26(1):179–92.

    Article  PubMed  CAS  Google Scholar 

  12. Kessler RC, Nelson CB, McGonagle KA, et al. The epidemiology of co-occurring addictive and mental disorders: implications for prevention and service utilization. Am J Orthopsychiatry. 1996;66(1):17–31.

    Article  PubMed  CAS  Google Scholar 

  13. Minkoff K. Best practices: developing standards of care for individuals with co-occurring psychiatric and substance use disorders. Psychiatric Serv. 2001;52(5):597–9.

    Article  CAS  Google Scholar 

  14. Odegaard O. Emigration and insanity: a study of mental disease among the Norwegian-born population of Minnesota. Acta Psychiatr Scand. 1932;7(suppl 4):1–206.

    Google Scholar 

  15. Werbeloff N, Levine SZ, Rabinowitz J. Elaboration on the association between immigration and schizophrenia: a population-based national study disaggregating annual trends, country of origin and sex over 15 years. Soc Psychiatry Psychiatr Epidemiol. 2012;47(2):303–11.

    Article  PubMed  Google Scholar 

  16. Corcoran C, Perrin M, Harlap S, et al. Incidence of schizophrenia among second-generation immigrants in the Jerusalem Perinatal Cohort. Schizophr Bull. 2009;35(3):596–602.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Cooper B. Immigration and schizophrenia: the social causation hypothesis revisited. Br J Psychiatry. 2005;186(5):361–3.

    Article  PubMed  Google Scholar 

  18. Cantor-Graae E, Selten J-P. Schizophrenia and migration: a meta-analysis and review. Am J Psychiatry. 2005;162(1):12–24.

    Article  PubMed  Google Scholar 

  19. Selton JP, Slaets JPJ, Khan RS. Schizophrenia in Surinamese and Dutch Antillean immigrants to the Netherlands: evidence of an increased incidence. Psychol Med. 1997;27(4):807–11.

    Article  Google Scholar 

  20. Bhugra D, Jones P. Migration and mental illness. Adv Psychiatr Treat. 2001;7(3):216–22.

    Article  Google Scholar 

  21. Grove W, Clayton PJ, Endicott J, et al. Immigration and major affective disorder. Acta Psychiatr Scand. 1986;74(6):548–52.

    Article  PubMed  CAS  Google Scholar 

  22. Swinnen SGHA, Selten J-P. Mood disorders and migration meta-analysis. Br J Psychiatry. 2007;190(1):6–10.

    Article  PubMed  Google Scholar 

  23. Ritsner M, Ponizovsky A, Kurs R, et al. Somatization in an immigrant population in Israel: a community survey of prevalence, risk factors, and help-seeking behavior. Am J Psychiatry. 2000;157(3):385–92.

    Article  PubMed  CAS  Google Scholar 

  24. Veen D, Selten JP, Hoek HW, et al. Use of ilicit substances in a psychosis incidence cohort: a comparison among different ethnic groups in the Netherlands. Acta Psychiatr Scand. 2002;105(6):440–3.

    Article  PubMed  CAS  Google Scholar 

  25. Alegria M, Canino G, Shrout PE, et al. Prevalence of mental illness in immigrant and non-immigrant US Latino groups. Am J Psychiatry. 2008;165(3):359.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Grant BF, Stinson FS, Hasin DS, et al. Immigration and lifetime prevalence of DSM-IV psychiatric disorders among Mexican Americans and non-Hispanic whites in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry. 2004;61(12):1226.

    Article  PubMed  Google Scholar 

  27. Oberg K. Culture shock: adjustment to new cultural environments. Pract Anthropol. 1960;7(2):177–82.

    Google Scholar 

  28. Akhtar S. Immigration and identity: turmoil, treatment, and transformation. Northvale: Jason Aronson; 1999.

    Google Scholar 

  29. Garza-Guerrero AC. Culture shock: its mourning and the vicissitudes of identity. J Am Psychoanal Assoc. 1974;22:408–29.

    Article  PubMed  CAS  Google Scholar 

  30. Berry JW. Immigration, acculturation, and adaptation. Appl Psychol. 1997;46(1):5–34.

    Google Scholar 

  31. Berry JW, Kim U. Acculturation and mental health. In: Dasen RP, Berry JW, Sartorius N, editors. Health and cross-cultural psychology: toward applications cross-cultural research and methodology series. Thousand Oaks: Sage Publications; 1988. p. 207–36.

    Google Scholar 

  32. Walsh SD, Edelstein A, Vota D. Suicidal ideation and alcohol use among Ethiopian adolescents in Israel: the relationship with ethnic identity and parental support. Eur Psychol. 2012;17:131–42.

    Article  Google Scholar 

  33. Kposowa AJ, McElvain JP, Breault KD. Immigration and suicide: the role of marital status, duration of residence, and social integration. Arch Suicide Res. 2008;12(1):82–92.

    Article  PubMed  Google Scholar 

  34. Isralowitz RE, Reznik A. Former Soviet Union immigrant and native-born adolescents in Israel: substance use and related problem behavior. J Ethn Subst Abuse. 2007;6(1):8.

    Article  Google Scholar 

  35. Rumbaut RG. Assimilation and its discontents: Between rhetoric and reality. Int Migr Rev 1997:923–960.

  36. Garcia-Coll C, Marks AK. The immigrant paradox in children and adolescents: Is becoming American a developmental risk?. Washington, DC: American Psychological Association; 2012.

    Book  Google Scholar 

  37. Turner RJ, Gil AG. Psychiatric and substance use disorders in South Florida: racial/ethnic and gender contrasts in a young adult cohort. Arch Gen Psychiatry. 2002;59(1):43.

    Article  PubMed  Google Scholar 

  38. Blake SM, Ledsky R, Goodenow C, et al. Recency of immigration, substance use, and sexual behavior among Massachusetts adolescents. Am J Public Health. 2001;91(5):794.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  39. Gfroerer JC, Tan LL. Substance use among foreign-born youths in the United States: does the length of residence matter? Am J Public Health. 2003;93(11):1892.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Kwak K. Adolescents and their parents: a review of intergenerational family relations for immigrant and non-immigrant families. Hum Dev. 2003;46:115–36.

    Article  Google Scholar 

  41. Jimenez-Castro L, Hare E, Medina R, et al. Substance use disorder comorbidity with schizophrenia in families of Mexican and Central American Ancestry. Schizophr Res. 2010;120(1):87–94.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Vega WA, Sribney WM, Achara-Abrahams I. Co-occurring alcohol, drug, and other psychiatric disorders among Mexican-origin people in the United States. Journal Information 2003;93(7).

  43. Vega WA, Canino G, Cao Z, et al. Prevalence and correlates of dual diagnoses in US Latinos. Drug Alcohol Depend. 2009;100(1/2):32–8.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Stueve A, Link BG. Violence and psychiatric disorders: results from an epidemiological study of young adults in Israel. Psychiatr Q. 1997;68(4):327–42.

    Article  PubMed  CAS  Google Scholar 

  45. Swanson JW, Holzer CE, Ganju VK, et al. Violence and psychiatric disorder in the community: evidence from the epidemiologic catchment area surveys. Hosp Community Psychiatry. 1990;41(7):761–70.

    PubMed  CAS  Google Scholar 

  46. Wallace C, Mullen P, Burgess P, et al. Serious criminal offending and mental disorder. Case linkage study. Br J Psychiatry. 1998;172(6):477–84.

    Article  PubMed  CAS  Google Scholar 

  47. Walsh E, Buchanan A, Fahy T. Violence and schizophrenia: examining the evidence. Br J Psychiatry. 2002;180(6):490–5.

    Article  PubMed  Google Scholar 

  48. Link BG, Stueve A, Phelan J. Psychotic symptoms and violent behaviors: probing the components of “threat/control-override” symptoms. Soc Psychiatry Psychiatr Epidemiol. 1998;33(1):S55–60.

    Article  PubMed  Google Scholar 

  49. Lindqvist P, Allebeck P. Schizophrenia and assaultive behaviour: the role of alcohol and drug abuse. Acta Psychiatr Scand. 1990;82(3):191–5.

    Article  PubMed  CAS  Google Scholar 

  50. Rasanen P, Tiihonen J, Isohanni M, et al. Schizophrenia, alcohol abuse, and violent behavior: a 26-year followup study of an unselected birth cohort. Schizophr Bull. 1998;24(3):437–41.

    Article  PubMed  CAS  Google Scholar 

  51. Vinokur D, Levine SZ, Roe D, et al. Age of onset group characteristics in forensic patients with schizophrenia. European Psychiatry in press.

  52. Levine S. Population-based examination of the relationship between type of first admission for schizophrenia and outcomes. Psychiatric Ser. 2008;59(12):1470–3.

    Article  Google Scholar 

  53. Volavka J, Laska E, Baker S, et al. History of violent behaviour and schizophrenia in different cultures. Analyses based on the WHO study on determinants of outcome of severe mental disorders. Br J Psychiatry. 1997;171(1):9–14.

    Article  PubMed  CAS  Google Scholar 

  54. Mullen PE. A reassessment of the link between mental disorder and violent behaviour, and its implications for clinical practice. Aust N Z J Psychiatry. 1997;31(1):3–11.

    Article  PubMed  CAS  Google Scholar 

  55. Hodgins S. Epidemiological investigations of the associations between major mental disorders and crime: methodological limitations and validity of the conclusions. Soc Psychiatry Psychiatr Epidemiol. 1998;33(13):S29–37.

    Article  PubMed  Google Scholar 

  56. Levav I, Lipshitz I, Novikov I, et al. Cancer risk among parents and siblings of patients with schizophrenia. Br J Psychiatry. 2007;190(2):156–61.

    Article  PubMed  CAS  Google Scholar 

  57. Weiser M, Kanyas K, Malaspina D, et al. Sensitivity of ICD-10 diagnosis of psychotic disorders in the Israeli National Hospitalization Registry compared with RDC diagnoses based on SADS-L. Compr Psychiatry. 2005;46(1):38–42.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Rabinowitz J, Slyuzberg M, Ritsner M, et al. Changes in diagnosis in a 9-year national longitudinal sample. Compr Psychiatry. 1994;35(5):361–5.

    Article  PubMed  CAS  Google Scholar 

  59. Weiser M, Werbeloff N, Dohrenwend BP, et al. Do psychiatric registries include all persons with schizophrenia in the general population? A population-based longitudinal study. Schizophrenia Res. 2012;135(1):187–91.

    Article  Google Scholar 

  60. Reichenberg A, Weiser M, Rapp MA, et al. Premorbid intra-individual variability in intellectual performance and risk for schizophrenia: a population-based study. Schizophr Res. 2006;85(1):49–57.

    Article  PubMed  Google Scholar 

  61. Davidson M, Reichenberg A, Rabinowitz J, et al. Behavioral and intellectual markers for schizophrenia in apparently healthy male adolescents. Am J Psychiatry. 1999;156(9):1328–35.

    PubMed  CAS  Google Scholar 

  62. Levine SZ, Bakst S, Rabinowitz J. Suicide attempts at the time of first admission and during early course schizophrenia: a population based study. Psychiatry Res. 2010;177(1):55–9.

    Article  PubMed  Google Scholar 

  63. Levine SZ, Lurie I, Kohn R, et al. Trajectories of the course of schizophrenia: from progressive deterioration to amelioration over three decades. Schizophr Res. 2011;126(1):184–91.

    Article  PubMed  Google Scholar 

  64. Weiser M, Reichenberg A, Rabinowitz J, et al. Gender differences in premorbid cognitive performance in a national cohort of schizophrenic patients. Schizophr Res. 2000;45(3):185–90.

    Article  PubMed  CAS  Google Scholar 

  65. Azfar O, Murrell P. Identifying reticent respondents: assessing the quality of survey data on corruption and values. Econ Dev Cult Change. 2009;57(2):387–412.

    Article  Google Scholar 

  66. Remennick L. Identity quest among Russian Jews of the 1990’2: before and after emigration. In: Krausz E, Tulea G, editors. Jewish survival: the identity problem at the close of the twentieth century. New Brunswikck: Transaction Publishers; 1998.

    Google Scholar 

  67. Oppedal B, Roysamb E, Sam DL. The effect of acculturation and social support on change in mental health among young immigrants. Int J Behav Dev. 2004;28(6):481–94.

    Article  Google Scholar 

  68. Finch BK, Vega WA. Acculturation stress, social support, and self-rated health among Latinos in California. J Immigr Health. 2003;5(3):109–17.

    Article  PubMed  Google Scholar 

  69. Appleby L, Desai PN, Luchins DJ, et al. Length of stay and recidivism in schizophrenia: a study of public psychiatric hospital patients. Am J Psychiatry. 1993;150:72.

    PubMed  CAS  Google Scholar 

  70. Foster RP. When immigration is trauma: guidelines for the individual and family clinician. Am J Orthopsychiatry. 2001;71(2):153–70.

    Article  PubMed  CAS  Google Scholar 

  71. Danielson KK, Moffitt TE, Caspi A, et al. Comorbidity between abuse of an adult and DSM-III-R mental disorders: evidence from an epidemiological study. Am J Psychiatry. 1998;155(1):131–3.

    PubMed  CAS  PubMed Central  Google Scholar 

  72. Sorenson SB, Golding JM. Prevalence of suicide attempts in a Mexican-American population: prevention implications of immigration and cultural issues. Suicide Life Threat Behav. 1988;18(4):322–33.

    PubMed  CAS  Google Scholar 

  73. Stack S. Comparative analysis of immigration and suicide. Psychol Rep. 1981;49(2):509–10.

    Article  PubMed  CAS  Google Scholar 

  74. Ponizovsky AM, Ritsner MS. Suicide ideation among recent immigrants to Israel from the former Soviet Union: an epidemiological survey of prevalence and risk factors. Suicide Life Threat Behav. 1999;29(4):376–92.

    PubMed  CAS  Google Scholar 

  75. Shoval G, Schoen G, Vardi N, et al. Suicide in Ethiopian immigrants in Israel: a case for study of the genetic-environmental relation in suicide. Arch Suicide Res. 2007;11(3):247–53.

    Article  PubMed  Google Scholar 

  76. Wadsworth T, Kubrin CE. Hispanic suicide in US metropolitan areas: examining the effects of immigration, assimilation, affluence, and disadvantage. Am J Sociol. 2007;112(6):1848–85.

    Article  Google Scholar 

  77. Hovey JD. Acculturative stress, depression, and suicidal ideation in Mexican immigrants. Cultur Divers Ethnic Minor Psychol. 2000;6(2):134.

    Article  PubMed  CAS  Google Scholar 

  78. Hasin D, Rahav G, Meydan J, et al. The drinking of earlier and more recent Russian immigrants to Israel: comparison to other Israelis. J Subst Abuse. 1998;10(4):341–53.

    Article  PubMed  CAS  Google Scholar 

  79. Rahav G, Hasin D, Paykin A. Drinking patterns of recent Russian immigrants and other Israelis: 1995 national survey results. Am J Public Health. 1999;89(8):1212–6.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  80. Lecrubier Y, Sheehan DV, Weiller E, et al. The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. Eur Psychiatry. 1997;12(5):224–31.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Criminology, Bar Ilan University, Ramat Gan, 52900, Israel

    Sophie D. Walsh, Meital Bensimon-Braverman & Lee Topaz Barak

  2. Abarbanel Mental Health Center, Bat Yam, Israel

    David Blass, Meital Bensimon-Braverman & Yael Delayahu

  3. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Yael Delayahu

  4. Department of Psychiatry and Behavioral Sciences, The Johns Hopkins Medical Institutions, Baltimore, MD, USA

    David Blass

  5. The Phoebe R. Berman Bioethics Institute, The Johns Hopkins Medical Institutions, Baltimore, MD, USA

    David Blass

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  1. Sophie D. Walsh
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  2. David Blass
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Correspondence to Sophie D. Walsh.

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Walsh, S.D., Blass, D., Bensimon-Braverman, M. et al. Characteristics of Immigrant and Non-Immigrant Patients in a Dual-Diagnosis Psychiatric Ward and Treatment Implications. J Immigrant Minority Health 16, 1045–1054 (2014). https://doi.org/10.1007/s10903-014-9982-1

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