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Migrant status, clinical symptoms and functional outcome in youth at clinical high risk for psychosis: findings from the NAPLS-3 study

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Abstract

Purpose

Migrant status is a known risk factor for psychosis, but the underlying causes of this vulnerability are poorly understood. Recently, studies have begun to explore whether migrant status predicts transition to psychosis in individuals at clinical high risk (CHR) for psychosis. Results, however, have been inconclusive. The present study assessed the impact of migrant status on clinical symptoms and functional outcome in individuals at CHR for psychosis who took part in the NAPLS-3 study.

Methods

Participants’ migrant status was classified as native-born, first-generation, or second-generation migrant. Clinical symptoms were assessed using the Structured Interview for Psychosis-Risk Syndromes (SIPS); functional outcome was measured using the Global Functioning Scales:Social and Role (GF:S; GF:R). Assessments were conducted at baseline, 12-months, 18-months, and 24-months follow-up. Generalized linear mixed models for repeated measures were used to examine changes over time and differences between groups.

Results

The overall sample included 710 individuals at CHR for psychosis (54.2% males; Age: M = 18.19; SD = 4.04). A mixed model analysis was conducted, and no significant differences between groups in symptoms or functioning were observed at any time point. Over time, significant improvement in symptoms and functioning was observed within each group. Transition rates did not differ across groups.

Conclusion

We discuss potential factors that might explain the lack of group differences. Overall, migrants are a heterogeneous population. Discerning the impact of migration from that of neighborhood ethnic density, social disadvantage or socio-economic status of different ethnic groups could help better understand vulnerability and resilience to psychosis.

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Data availability

The data supporting our study findings can be made available upon reasonable request.

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Acknowledgements

This study was supported by the National Institute of Mental Health (grant U01MH081984 to Dr. Addington; grant U01MH081928 to Dr. Stone; grant U01MH081944 to Dr. Cadenhead; grant U01MH081902 to Drs Cannon and Bearden; grant U01MH082004 to Dr. Perkins; grant U01MH081988 to Dr. Walker; grant U01MH082022 to Dr. Woods; grant U01MH076989 to Dr. Mathalon; grant UO1MH081857 to Dr. Cornblatt).

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Authors and Affiliations

  1. Department of Psychology, College of Natural and Health Sciences, Zayed University, Dubai, UAE

    Mariapaola Barbato

  2. Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada

    Lu Liu & Jean Addington

  3. Departments of Psychiatry and Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA

    Carrie E. Bearden

  4. Department of Psychiatry, UCSD, San Diego, CA, USA

    Kristin S. Cadenhead & Ming T. Tsuang

  5. Department of Psychiatry, Zucker Hillside Hospital, Long Island, NY, USA

    Barbara A. Cornblatt

  6. Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA

    Matcheri Keshavan, Larry J. Seidman & William Stone

  7. Department of Psychiatry, UCSF, and SFVA Medical Center, San Francisco, CA, USA

    Daniel H. Mathalon

  8. Department of Psychiatry, Yale University, New Haven, CT, USA

    Thomas H. McGlashan, Scott W. Woods & Tyrone D. Cannon

  9. Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA

    Diana O. Perkins

  10. Institute of Genomic Medicine, University of California, La Jolla, CA, USA

    Ming T. Tsuang

  11. Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, USA

    Elaine F. Walker

  12. Department of Psychology, Yale University, New Haven, CT, USA

    Tyrone D. Cannon

  13. Mathison Centre for Mental Health Research & Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada

    Jean Addington

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  1. Mariapaola Barbato
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  2. Lu Liu
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  3. Carrie E. Bearden
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Correspondence to Jean Addington.

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Barbato, M., Liu, L., Bearden, C.E. et al. Migrant status, clinical symptoms and functional outcome in youth at clinical high risk for psychosis: findings from the NAPLS-3 study. Soc Psychiatry Psychiatr Epidemiol 58, 559–568 (2023). https://doi.org/10.1007/s00127-022-02383-y

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