Back to all available

Not all migrants are the same: geographic origin and long-term outcomes after first-episode psychosis

epidemiology
global-health
psychiatry-and-psychology
public-health
mental-health

Abstract

Background: Migration is a well-established risk factor for psychosis, yet limited research has examined long-term clinical trajectories following first-episode psychosis (FEP) in migrant populations within Southern European settings. This study investigates how country of origin and time since migration influence psychiatric outcomes in a naturalistic FEP cohort.

Methods: A five-year longitudinal study was conducted on 184 patients with FEP attending the Early Intervention Service from Hospital Universitari de Mataró. Patients were grouped by geographic origin (Spanish, Latin American, Maghrebi, Sub-Saharan) and migration recency (≤5 years vs. >5 years). Primary outcomes included treatment adherence, use of long-acting injectable (LAI) antipsychotics, relapse, and service disengagement. Logistic regression and survival analyses were used to identify associations.

Results: Maghrebi origin was associated with lower treatment adherence (OR = 0.32, 95% CI: 0.12–0.89, p = 0.030) and higher risk of service disengagement (OR = 3.00, 95% CI: 1.11–8.33, p = 0.032). Recent migrants (≤5 years in Spain) showed a significantly increased risk of disengagement (OR = 4.00, 95% CI: 1.42–12.68, p = 0.009). Sub-Saharan patients had markedly higher odds of receiving LAIs (OR = 10.00, 95% CI: 1.93–55.56, p = 0.006) and earlier initiation. No significant differences were found in relapse rates across groups.

Conclusions: Both migrant origin and recent arrival are associated with adverse psychiatric care trajectories following FEP, likely driven by a complex interplay of cultural, structural, and systemic factors. These findings underscore the need for culturally competent, equity-oriented interventions to improve long-term outcomes for migrant patients with psychosis.

Ask to review this manuscript

Notes for potential reviewers

  • Volunteering is not a guarantee that you will be asked to review. There are many reasons: reviewers must be qualified, there should be no conflicts of interest, a minimum of two reviewers have already accepted an invitation, etc.
  • This is NOT OPEN peer review. The review is single-blind, and all recommendations are sent privately to the Academic Editor handling the manuscript. All reviews are published and reviewers can choose to sign their reviews.
  • What happens after volunteering? It may be a few days before you receive an invitation to review with further instructions. You will need to accept the invitation to then become an official referee for the manuscript. If you do not receive an invitation it is for one of many possible reasons as noted above.
  • PeerJ does not judge submissions based on subjective measures such as novelty, impact or degree of advance. Effectively, reviewers are asked to comment on whether or not the submission is scientifically and technically sound and therefore deserves to join the scientific literature. Our Peer Review criteria can be found on the "Editorial Criteria" page - reviewers are specifically asked to comment on 3 broad areas: "Basic Reporting", "Experimental Design" and "Validity of the Findings".
  • Reviewers are expected to comment in a timely, professional, and constructive manner.
  • Until the article is published, reviewers must regard all information relating to the submission as strictly confidential.
  • When submitting a review, reviewers are given the option to "sign" their review (i.e. to associate their name with their comments). Otherwise, all review comments remain anonymous.
  • All reviews of published articles are published. This includes manuscript files, peer review comments, author rebuttals and revised materials.
  • Each time a decision is made by the Academic Editor, each reviewer will receive a copy of the Decision Letter (which will include the comments of all reviewers).

If you have any questions about submitting your review, please email us at [email protected].