Migrating during adolescence increases psychosis risk

The findings, published in PLOS Mental Health, add to previous research finding that migrants and people from minority ethnic groups face an elevated risk of psychosis, by now clarifying that migration during adolescence appears to be a particular risk factor.

The researchers analysed data from 2,132 people in England, France, Italy, Spain and the Netherlands, including 937 people who had experienced a first episode of a psychotic disorder, who participated in the EU-GEI (European network of national schizophrenia networks studying gene-environment interactions) study.

The research team found that migration was generally associated with an increased risk of psychosis, but after adjusting for potential confounding factors such as ethnicity, markers of social disadvantage, and parental history of psychosis, only those who had migrated to a new country during adolescence (aged 11 to 17 years) bore a significantly higher risk of psychosis.

First author, PhD candidate Humma Andleeb (UCL Psychology & Language Sciences), said: “Migration at a young age is a particularly stressful life event and can be associated with plenty of factors that may increase the risk of developing psychosis.

“Adolescence is a key developmental period, critical for establishing our sense of self, so any upheaval to an adolescent’s life could pose risks to their mental health.

“Additionally, some young migrants will have experienced traumatic events before their family decided to seek a new life in a different country, and then the migration itself can be very upsetting as they are separated from friends and family. Once people arrive in a new country, they may then face discrimination and language barriers, and adjusting to a new culture and lifestyle can be difficult for an adolescent who is still trying to forge their own identity.”

The researchers found that migrants from Black or North African ethnic groups faced the highest psychosis risk, with North African people who migrated to Europe in adolescence being at least two to three times more likely to develop psychosis, although the researchers caution that the sample sizes of specific subgroups were not large enough to confidently specify the degree of increased risk.

Previous research by UCL Psychiatry researchers has found that social inequalities, language differences, discrimination and isolation can all contribute to the higher psychosis risk in ethnic minority groups.*

Senior author Professor James Kirkbride (UCL Psychiatry) said: “A supportive environment, with good access to education, healthcare, and employment opportunities, while being free of racism and discrimination, could go a long way towards preventing people from developing psychosis after they have arrived in a new country.

“Unfortunately, the reality is that many migrants face barrier after barrier when settling into a new country that can impact their mental health. These barriers are often compounded by further barriers that many people from minoritised ethnic backgrounds face when accessing treatment for psychosis specifically**.”

Humma Andleeb and colleagues are now conducting research with different ethnic groups to better understand what factors are driving the increased risk of psychosis in certain communities.

She said: “We hope that further research into the factors contributing to psychosis risk could help us to develop better mental health support for young migrants, to prevent them from developing a psychotic disorder.”

The research was supported by funding from Wellcome and the European Union.

* UCL News, 2020: Minorities’ higher psychosis risk linked to cultural distance from majority

** People experiencing a psychotic episode for the first time are less likely to receive early psychological interventions in England if they are from an ethnic minority background, according to a 2023 study led by UCL researchers.

Links

• Research paper in PLOS Mental Health
• Professor James Kirkbride’s academic profile
• Humma Andleeb’s academic profile
• UCL Psychology & Language Sciences
• UCL Psychiatry
• PsyLife lab
• Media coverage

Image

• Credit: James Harden, iStock

Media contact

Chris Lane

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E: chris.lane [at] ucl.ac.uk