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Risk of psychosis among refugees: A systematic review and meta-analysis

JAMA Aug 22, 2019

Brandt L, et al. - Via a systematic review and meta-analysis of six studies, 4,358 screened articles, and 540,000 refugees in Denmark, Sweden, Norway, and Canada, researchers evaluated the relative risk (RR) of incidence of non–affective psychosis in refugees in comparison with the RR in the native population and nonrefugee migrants. The RR was 1.43 for non–affective psychoses in refugees vs nonrefugee migrants. An RR of 1.39 was observed in analyses that were restricted to studies with low risk of bias for refugees vs nonrefugee migrants, 2.41 for refugees vs native population, and 1.92 for nonrefugee migrants vs the native group. Exclusion of studies that defined refugee status not individually but only by country of origin led to an RR of 2.24 for refugees in comparison with nonrefugee migrants and an RR of 3.26 for refugees in contrast with the native group. In general, the RR of non–affective psychosis was raised in refugees and nonrefugee migrants when compared with the native population. Hence, among refugees in Denmark, Sweden, Norway, and Canada, refugee experience seemed to be an independent risk factor in developing non–affective psychosis. Moreover, applying the findings to non-Scandinavian countries should involve a consideration of the features of the native society and its specific interaction with the refugee population.
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