Child maltreatment, migration and risk of first-episode psychosis: results from the multinational EU-GEI study

Giuseppe D'Andrea^{1

2}, Jatin Lal¹, Sarah Tosato³, Charlotte Gayer-Anderson⁴, Hannah E Jongsma^{5

6}, Simona A Stilo^{7

8}, Els van der Ven⁹, Diego Quattrone¹⁰, Eva Velthorst^{11

12}, Domenico Berardi¹³, Paulo Rossi Menezes¹⁴, Celso Arango¹⁵, Mara Parellada¹⁵, Antonio Lasalvia³, Caterina La Cascia¹⁶, Laura Ferraro¹⁶, Daniele La Barbera¹⁶, Lucia Sideli¹⁷, Julio Bobes¹⁸, Miguel Bernardo¹⁹, Julio Sanjuán²⁰, Jose Luis Santos²¹, Manuel Arrojo²², Cristina Marta Del-Ben²³, Giada Tripoli^{8

16

24}, Pierre-Michel Llorca²⁵, Lieuwe de Haan²⁶, Jean-Paul Selten²⁷, Andrea Tortelli²⁸, Andrei Szöke²⁹, Roberto Muratori³⁰, Bart P Rutten³¹, Jim van Os^{8

31}, Peter B Jones³², James B Kirkbride³³, Robin M Murray⁸, Marta di Forti¹⁰, Ilaria Tarricone^{1

30}, Craig Morgan⁴

Affiliations

¹ Department of Medical and Surgical Sciences, Bologna Transcultural Psychosomatic Team (BoTPT), University of Bologna, Bologna, Italy.
² Community Mental Health Center of Sassuolo, Department of Mental Health and Drug Abuse, AUSL Modena, Modena, Italy.
³ Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy.
⁴ ESRC Center for Society and Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
⁵ Centre for Transcultural Psychiatry 'Veldzicht', Balkbrug, The Netherlands.
⁶ University Centre for Psychiatry, University Medical Centre Groningen, Groningen, The Netherlands.
⁷ Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy.
⁸ Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁹ Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
¹⁰ Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.
¹¹ Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
¹² Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA.
¹³ Department of Biomedical and Neuromotor Sciences (DIBINEM), Section of Psychiatry, University of Bologna, Bologna, Italy.
¹⁴ University Hospital, Section of Epidemiology, University of São Paulo, São Paulo, Brazil.
¹⁵ Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.
¹⁶ Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy.
¹⁷ Department of Human Science, LUMSA University, Rome, Italy.
¹⁸ Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, ISPA, Ineuropa, CIBERSAM, Oviedo, Spain.
¹⁹ Barcelona Clinic Schizophrenia Unit, Department of Medicine, Neuroscience Institute, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain.
²⁰ Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental, Valencia, Spain.
²¹ Department of Psychiatry, Servicio de Psiquiatría Hospital "Virgen de la Luz", Cuenca, Spain.
²² Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain.
²³ Neuroscience and Behavior Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
²⁴ Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Piazza delle Cliniche, 290127 Palermo, Italy.
²⁵ Université Clermont Auvergne, EA 7280 Npsydo, Clermont-Ferrand, France.
²⁶ Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands.
²⁷ School for Mental Health and Neuroscience, University of Maastricht, Maastricht, The Netherlands.
²⁸ Etablissement Public de Santé Maison Blanche, Paris, France.
²⁹ Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, Fondation Fondamental, F-94010 Créteil, France.
³⁰ Department of Mental Health and Pathological Addiction, Local Health Authority, Bologna, Italy.
³¹ Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands.
³² Department of Psychiatry, University of Cambridge, Cambridge, UK.
³³ PsyLife Group, Division of Psychiatry, UCL, London, UK.

PMID: 36305570
PMCID: PMC10520604
DOI: 10.1017/S003329172200335X

Child maltreatment, migration and risk of first-episode psychosis: results from the multinational EU-GEI study

Giuseppe D'Andrea et al. Psychol Med. 2023 Oct.

. 2023 Oct;53(13):6150-6160.

doi: 10.1017/S003329172200335X. Epub 2022 Oct 28.

Authors

Affiliations

¹ Department of Medical and Surgical Sciences, Bologna Transcultural Psychosomatic Team (BoTPT), University of Bologna, Bologna, Italy.
² Community Mental Health Center of Sassuolo, Department of Mental Health and Drug Abuse, AUSL Modena, Modena, Italy.
³ Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy.
⁴ ESRC Center for Society and Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
⁵ Centre for Transcultural Psychiatry 'Veldzicht', Balkbrug, The Netherlands.
⁶ University Centre for Psychiatry, University Medical Centre Groningen, Groningen, The Netherlands.
⁷ Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy.
⁸ Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁹ Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
¹⁰ Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.
¹¹ Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
¹² Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA.
¹³ Department of Biomedical and Neuromotor Sciences (DIBINEM), Section of Psychiatry, University of Bologna, Bologna, Italy.
¹⁴ University Hospital, Section of Epidemiology, University of São Paulo, São Paulo, Brazil.
¹⁵ Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.
¹⁶ Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy.
¹⁷ Department of Human Science, LUMSA University, Rome, Italy.
¹⁸ Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, ISPA, Ineuropa, CIBERSAM, Oviedo, Spain.
¹⁹ Barcelona Clinic Schizophrenia Unit, Department of Medicine, Neuroscience Institute, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain.
²⁰ Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental, Valencia, Spain.
²¹ Department of Psychiatry, Servicio de Psiquiatría Hospital "Virgen de la Luz", Cuenca, Spain.
²² Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain.
²³ Neuroscience and Behavior Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
²⁴ Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Piazza delle Cliniche, 290127 Palermo, Italy.
²⁵ Université Clermont Auvergne, EA 7280 Npsydo, Clermont-Ferrand, France.
²⁶ Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands.
²⁷ School for Mental Health and Neuroscience, University of Maastricht, Maastricht, The Netherlands.
²⁸ Etablissement Public de Santé Maison Blanche, Paris, France.
²⁹ Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, Fondation Fondamental, F-94010 Créteil, France.
³⁰ Department of Mental Health and Pathological Addiction, Local Health Authority, Bologna, Italy.
³¹ Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands.
³² Department of Psychiatry, University of Cambridge, Cambridge, UK.
³³ PsyLife Group, Division of Psychiatry, UCL, London, UK.

PMID: 36305570
PMCID: PMC10520604
DOI: 10.1017/S003329172200335X

Abstract

Background: Child maltreatment (CM) and migrant status are independently associated with psychosis. We examined prevalence of CM by migrant status and tested whether migrant status moderated the association between CM and first-episode psychosis (FEP). We further explored whether differences in CM exposure contributed to variations in the incidence rates of FEP by migrant status.

Methods: We included FEP patients aged 18-64 years in 14 European sites and recruited controls representative of the local populations. Migrant status was operationalized according to generation (first/further) and region of origin (Western/non-Western countries). The reference population was composed by individuals of host country's ethnicity. CM was assessed with Childhood Trauma Questionnaire. Prevalence ratios of CM were estimated using Poisson regression. We examined the moderation effect of migrant status on the odds of FEP by CM fitting adjusted logistic regressions with interaction terms. Finally, we calculated the population attributable fractions (PAFs) for CM by migrant status.

Results: We examined 849 FEP cases and 1142 controls. CM prevalence was higher among migrants, their descendants and migrants of non-Western heritage. Migrant status, classified by generation (likelihood test ratio:χ² = 11.3, p = 0.004) or by region of origin (likelihood test ratio:χ² = 11.4, p = 0.003), attenuated the association between CM and FEP. PAFs for CM were higher among all migrant groups compared with the reference populations.

Conclusions: The higher exposure to CM, despite a smaller effect on the odds of FEP, accounted for a greater proportion of incident FEP cases among migrants. Policies aimed at reducing CM should consider the increased vulnerability of specific subpopulations.

Keywords: Child adversity; childhood trauma; first-episode psychosis; migrants.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

**Fig. 1.**
Predicted probabilities of FEP by CM and migrant status. (a) represents predicted probabilities of psychosis by CM and migrant generational status. (b) represent predicted probabilities of psychosis by CM and Western/non-Western migrant status.

See this image and copyright information in PMC

References

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Child maltreatment, migration and risk of first-episode psychosis: results from the multinational EU-GEI study

Affiliations

Child maltreatment, migration and risk of first-episode psychosis: results from the multinational EU-GEI study

Authors

Affiliations

Abstract

Conflict of interest statement

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References

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LinkOut - more resources

Full Text Sources