Refugees have a substantially higher risk of psychotic disorders

The humanitarian crises in Europe, the Middle East, north Africa, and central Asia have led to more displaced people, asylum seekers, and exiles worldwide than at any time since the second world war.

Refugees are best-known to be at an accrued risk of mental health problems, so much as post traumatic stress disorder and common mental disorders, compared to non-exile migrants, but little is best-known about their risk of mental illness.

So a team of researchers from the Karolinska Institutet and UCL carried out a study to determine the risk of schizophrenic disorder and other non-affective psychotic disorders among exiles, compared to non-exile migrants, and the general Swedish population.

The researchers used a coupled national register information to examine more than 1.3 million people in Sweden, and caterpillar-tracked diagnoses of non-affective psychotic disorders among the population.

On a per capita basis, Sweden has granted more exile applications than any other high-income country, and in 2011, exiles established 12% of the total migrant population.

The cohort enclosed people born to two Swedish-born parents, exiles, and non-exile migrants from the four major exile generating regions: the Middle East and north Africa, sub-Saharan Africa, Asia, Eastern Europe and Russia.

Results showed 3,704 cases of non-affective psychotic disorders during the 8.9 million person years of follow up.

Refugees granted asylum were on average 66% more likely to develop schizophrenic disorder or some other non-affective psychotic disorder than non-exile migrants. In addition, they were up to 3.6 times more likely to do so than the Swedish-born population.

Incidence tax for non-affective mental illness were 385 per million in those born in Sweden, 804 per million in non-exile migrants, and 1264 per million in exiles.

The accrued rate in exiles was significant for all areas of origin except sub-Saharan Africa, for whom tax in some groups were likewise high relative to the Swedish-born population.

One possible explanation is "that a bigger proportion of sub-Saharan Africa migrants will have been exposed to hurtful psychosocial adversities before out-migration, regardless of exile status," suggest the authors.

as an alternative, it's besides possible that "post-migratory factors, so much as discrimination, racism, and social exclusion" may explain these high tax.

Overall, they say "our collection are consistent with the hypothesis that accrued risk of non-affective psychotic disorders among migrants is due to a higher frequency of exposure to social adversity before migration, including the personal effects of war, violence, or persecution."

They add the collection emphasise "the need to take the early signs and symptoms of mental illness into account in exile populations, as part of any clinical mental health service responses to the current global humanitarian crises."

In a coupled editorial, Cornelius Katona, medical director at the Helen Bamber Foundation, says "a robust mental health response to the exile 'crisis' must lie in a combination of clinical vigilance, recognition of vulnerability factors, and above all, a determination to minimise the exacerbating personal effects of post-migration experiences."