Ethnic enclaves and risk of psychiatric disorders among first- and second-generation immigrants in Sweden. 2015

Briana Mezuk, and Xinjun Li, and Klas Cederin, and Jeannie Concha, and Kenneth S Kendler, and Jan Sundquist, and Kristina Sundquist
Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, One Capitol Plaza, Suite 824, PO Box 980212, Richmond, VA, USA. bmezuk@vcu.edu.

OBJECTIVE Some non-Western immigrant groups in Europe have elevated risk of psychosis relative to native-born. It is hypothesized that neighborhood ethnic density moderates this risk. Immigration to Sweden has increased substantially recently, particularly from the Middle East. This study examined the relationship between neighborhood ethnic density (i.e., living in an immigrant enclave) and risk of psychotic and affective disorders among three groups: Iraqi immigrants, immigrants from other nations, and native-born Swedes. METHODS Individuals aged 15-60, without prevalent psychopathology, were drawn from Swedish population-based registries and followed from 2005 to 2010 (N = 950,979). Multi-level logistic regression was used to examine the association between neighborhood ethnic composition and incident psychopathology. RESULTS Cumulative incidence of psychopathology was greater in Iraqi enclaves relative to predominantly Swedish neighborhoods (6.3 vs. 4.5%). Iraqis living in enclaves did not have significantly greater risk of psychosis (Odds Ratio (OR): 1.66, 95% Confidence Interval (CI) 0.92-2.97) or affective disorders (OR: 1.04, 95%CI 0.85-1.27) relative to those in predominantly Swedish neighborhoods. There was no increased risk of psychosis (OR: 0.93, p > 0.05) or affective disorders (OR: 0.93, p > 0.05) for other immigrants living in an enclave. Swedes living in an enclave had elevated risk of both psychosis (OR: 1.37, p < 0.05) and affective disorders (OR: 1.14, p < 0.05) relative to those in predominantly Swedish neighborhoods. Second-generation Iraqis had higher risk of psychotic but not affective disorders relative to first-generation. CONCLUSIONS Neighborhood ethnic density does not moderate risk of psychopathology for immigrants in Sweden. Findings regarding Swedes are consistent with social drift.

UI MeSH Term Description Entries
D007493 Iraq A country bordering the Persian Gulf, between Iran and Kuwait. The capital is Baghdad. Republic of Iraq
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011156 Population Density Number of individuals in a population relative to space. Overpopulation,Population Size,Underpopulation,Densities, Population,Density, Population,Population Densities,Population Sizes
D011618 Psychotic Disorders Disorders in which there is a loss of ego boundaries or a gross impairment in reality testing with delusions or prominent hallucinations. (From DSM-IV, 1994) Psychoses,Psychosis, Brief Reactive,Schizoaffective Disorder,Schizophreniform Disorders,Psychosis,Brief Reactive Psychoses,Brief Reactive Psychosis,Disorder, Psychotic,Disorder, Schizoaffective,Disorder, Schizophreniform,Disorders, Psychotic,Disorders, Schizoaffective,Disorders, Schizophreniform,Psychoses, Brief Reactive,Psychotic Disorder,Reactive Psychoses, Brief,Reactive Psychosis, Brief,Schizoaffective Disorders,Schizophreniform Disorder
D012042 Registries The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers. Parish Registers,Population Register,Parish Register,Population Registers,Register, Parish,Register, Population,Registers, Parish,Registers, Population,Registry
D012111 Residence Characteristics Elements of residence that characterize a population. They are applicable in determining need for and utilization of health services. Community,Domicile,Living Arrangements,Neighborhood,Place of Birth,Residential Selection,Arrangement, Living,Birth Place,Communities,Domiciles,Living Arrangement,Neighborhoods,Residence Characteristic
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths

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