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Refugee Experience Increases Psychosis Risk in Migrants

August 21, 2019

Refugees are at significantly increased risk of developing schizophrenia and other nonaffective psychoses, compared with nonrefugee migrants and native populations, according to a study published online in JAMA Psychiatry.

The systematic review and meta-analysis included 9 studies involving 540,000 refugees in Denmark, Sweden, Norway, and Canada. The study is believed to be the first and most comprehensive review to focus on refugee risk for nonaffective psychoses, such as schizophrenia, schizoaffective disorders, and schizophreniform disorders.

When researchers zeroed in on studies with a low risk of bias, they identified a relative risk of developing nonaffective psychoses of 1.39 for refugees compared with nonrefugee migrants, and 2.41 for refugees compared with the native population.

Cognitive Decline Continues After Onset of Psychosis

“Refugees may be especially vulnerable to developing a psychotic disorder because of a multifactorial combination of pre-, peri-, and postmigratory adversities,” researchers wrote. “These hardships include traumatic life events, human rights violations, social exclusion, poverty, restricted access to medical services, and limited possibilities of participating in society.”

Compared with nonrefugee migrants, the process of migration for refugees is typically forced and, consequently, refugees are often less prepared, researchers continued.

“Refugee experience may thus represent an independent risk factor for nonaffective psychosis in migrants,” they wrote. “We believe that these findings highlight the need for psychiatric prevention strategies and outreach programs for refugees.”

—Jolynn Tumolo


Brandt L, Henssler J, Müller M, Wall S, Gabel D, Heinz A. Risk of psychosis among refugees: a systematic review and meta-analysis. JAMA Psychiatry. 2019 August 14;[Epub ahead of print].

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