Perceived major experiences of discrimination, ethnic group, and risk of psychosis in a six-country case−control study
- 2 March 2021
- journal article
- research article
- Published by Cambridge University Press (CUP) in Psychological Medicine
- Vol. 52 (15), 3668-3676
- https://doi.org/10.1017/s0033291721000453
Abstract
Background: Perceived discrimination is associated with worse mental health. Few studies have assessed whether perceived discrimination (i) is associated with the risk of psychotic disorders and (ii) contributes to an increased risk among minority ethnic groups relative to the ethnic majority.Methods: We used data from the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions Work Package 2, a population-based case−control study of incident psychotic disorders in 17 catchment sites across six countries. We calculated odds ratios (OR) and 95% confidence intervals (95% CI) for the associations between perceived discrimination and psychosis using mixed-effects logistic regression models. We used stratified and mediation analyses to explore differences for minority ethnic groups.Results: Reporting any perceived experience of major discrimination (e.g. unfair treatment by police, not getting hired) was higher in cases than controls (41.8% v. 34.2%). Pervasive experiences of discrimination (≥3 types) were also higher in cases than controls (11.3% v. 5.5%). In fully adjusted models, the odds of psychosis were 1.20 (95% CI 0.91–1.59) for any discrimination and 1.79 (95% CI 1.19–1.59) for pervasive discrimination compared with no discrimination. In stratified analyses, the magnitude of association for pervasive experiences of discrimination appeared stronger for minority ethnic groups (OR = 1.73, 95% CI 1.12–2.68) than the ethnic majority (OR = 1.42, 95% CI 0.65–3.10). In exploratory mediation analysis, pervasive discrimination minimally explained excess risk among minority ethnic groups (5.1%).Conclusions: Pervasive experiences of discrimination are associated with slightly increased odds of psychotic disorders and may minimally help explain excess risk for minority ethnic groups.This publication has 43 references indexed in Scilit:
- The EUropean Network of National Schizophrenia Networks Studying Gene–Environment Interactions (EU-GEI): Incidence and First-Episode Case–Control ProgrammeSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2020
- Psychological correlates of perceived ethnic discrimination in Europe: A meta-analysis.Psychology of Violence, 2018
- Psychoses sans Frontieres: towards an interdisciplinary understanding of psychosis risk amongst migrants and their descendantsEpidemiology and Psychiatric Sciences, 2018
- “More than skin deep”: stress neurobiology and mental health consequences of racial discriminationStress, 2014
- From adversity to psychosis: pathways and mechanisms from specific adversities to specific symptomsSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2014
- The Psychosis High-Risk StateJAMA Psychiatry, 2013
- Does the Concept of "Sensitization" Provide a Plausible Mechanism for the Putative Link Between the Environment and Schizophrenia?Schizophrenia Bulletin, 2007
- Inventorying stressful life events as risk factors for psychopathology: Toward resolution of the problem of intracategory variability.Psychological Bulletin, 2006
- Life events, ethnicity and perceptions of discrimination in patients with severe mental illness.Social psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1999
- Is research into ethnicity and health racist, unsound, or important science?BMJ, 1997