INCIDENCE AND ENVIRONMENTAL RISK FACTORS FOR PSYCHOSIS IN FIRST GENERATION MIGRANTS IN NORTHERN ITALY

Abstract

Whilst the excess of psychosis among migrants is a well defined phenomenon in Northern Europe, it had not been demonstrated in Southern Europe. Moreover : 1) most studies focused on ethnic minorities and not on first generation migrants; 2) there are not studies conducted in contemporary times involving internal migrants; 3)published studies have mostly focused on risk factors in the post migration phase (such as ethnic fragmentation, unemployment, etc).

My PhD project aimed to : 1) Verify whether there was an excess of psychosis among migrants in Italy 2) Understand the role of known environmental risk factors for psychosis (such as substance use, being single/living alone, being unemployed and low level of education) in the development and course of psychosis in migrants.

I used data collected in Bologna West as an incidence of first-episode psychosis (Bo-FEP) study. All first episode psychosis patients (FEP) age 18 to 65 yrs old, presenting to the Bologna Mental Health Centres between January 2002 and December 2010, resident within defined catchment areas in Bologna, and without any previous contact with health services for psychosis, were identified and invited to take part in this project. I also used follow-up data collected 1 year after the first contact of FEP patients with services.

My thesis contains 2 published papers and 1 accepted paper. (Tarricone et al., 2012; Tarricone et al., 2014; Tarricone et al, accepted with revisions), The overall Incidence Rare standardised for age and gender in the Bo-FEP study was 16.4 per 100,000 person-years (95% CI, 13.9- 18.9). The Incidence Rate Ratio was 1.93 (1.19-3.13, p=0.007) for internal migrants and 1.79 (1.06-3.02, p=0.03) for external migrants compared to natives. Substance users had a significantly higher rate of hospitalizations during the 12 months follow-up after adjusting for age, gender and other potential confounders (OR 5.84, 95% CI 2.44-13.97, p≤0.001).

In addition I have reviewed the relevant literature, described the background and overall methodology of the study, discussed the limitations and written a conclusion.

Date of Award	2016
Original language	English
Awarding Institution	King's College London
Supervisor	Jane Boydell (Supervisor) & Craig Morgan (Supervisor)