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December 30, 2004American Journal of Psychiatry1,244 citations

Schizophrenia and Migration: A Meta-Analysis and Review

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ECElizabeth Cantor‐GraaeJSJean‐Paul Selten

Key Points

  • This research aims to evaluate the relationship between migration and the risk of developing schizophrenia by synthesizing previous studies.
  • Conducted a systematic search of MEDLINE for population-based incidence studies on migrants from 1977 to 2003.
  • Included studies with reported incidence, numerators, and denominators, and performed age corrections where possible.
  • Employed a mixed-effects meta-analytic model to address significant heterogeneity across studies.
  • The mean weighted relative risk for first-generation migrants developing schizophrenia was 2.7 (95% CI=2.3-3.2).
  • Second-generation migrants exhibited a relative risk of 4.5 (95% CI=1.5-13.1).
  • Migrants from developing countries had a larger effect size (relative risk=3.3, 95% CI=2.8-3.9) than those from developed countries.

Abstract

OBJECTIVE: The authors synthesize findings of previous studies implicating migration as a risk factor for the development of schizophrenia and provide a quantitative index of the associated effect size. METHOD: MEDLINE was searched for population-based incidence studies concerning migrants in English-language publications appearing between the years 1977 and 2003. Article bibliographies and an Australian database were cross-referenced. Studies were included if incidence reports provided numerators and denominators and if age correction was performed or could be performed by the authors. Relative risks for migrant groups were extracted or calculated for each study. Significant heterogeneity across studies indicated the need for a mixed-effects meta-analytic model. RESULTS: The mean weighted relative risk for developing schizophrenia among first-generation migrants (40 effect sizes) was 2.7 (95% confidence interval CI=2.3-3.2). A separate analysis performed for second-generation migrants (seven effect sizes) yielded a relative risk of 4.5 (95% CI=1.5-13.1). An analysis performed for studies concerning both first- and second-generation migrants and studies that did not distinguish between generations (50 effect sizes) yielded a relative risk of 2.9 (95% CI=2.5-3.4). Subgroup comparisons yielded significantly greater effect sizes for migrants from developing versus developed countries (relative risk=3.3, 95% CI=2.8-3.9) and for migrants from areas where the majority of the population is black (relative risk=4.8, 95% CI=3.7-6.2) versus white and neither black nor white. CONCLUSIONS: A personal or family history of migration is an important risk factor for schizophrenia. The differential risk pattern across subgroups suggests a role for psychosocial adversity in the etiology of schizophrenia.

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Cite This Study

Cantor‐Graae et al. (2004) studied this question.

synapsesocial.com/papers/6a0f933a92676d5461fcd5b9https://doi.org/10.1176/appi.ajp.162.1.12
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