Elsevier

Schizophrenia Research

Volume 86, Issues 1–3, September 2006, Pages 189-193
Schizophrenia Research

Incidence of schizophrenia among ethnic minorities in the Netherlands: A four-year first-contact study

https://doi.org/10.1016/j.schres.2006.06.010Get rights and content

Abstract

There is only one previous report on the first-contact incidence of schizophrenia among immigrants in the Netherlands, which was based on a small number of cases, particularly for second generation immigrants. We conducted another two-year first-contact incidence study in the same geographical area, combined the data of both studies and compared risks over all four years. The incidence of schizophrenia was increased for all first generation non-Western immigrants. The risk was particularly high for second generation immigrants: the age- and gender-adjusted incidence rate ratio was 5.8 (95% CI, 2.9–11.4) for Moroccans, 2.9 (1.6–5.0) for Surinamese, 2.3 (1.0–5.4) for Turks, and 3.5 (1.8–6.8) for immigrants from other non-Western countries.

Introduction

Studies from the United Kingdom and Scandinavia have reported a very high incidence of schizophrenia among several immigrant groups (Cantor-Graae and Selten, 2005, Kirkbride et al., 2006). A two-year first-contact study in The Hague, the Netherlands, found an increased incidence of schizophrenia among immigrants from Surinam and among male immigrants from Morocco (Selten et al., 2001). The risks were not significantly increased for Moroccan or Turkish women, or for immigrants from Western countries. However, these results were difficult to interpret, because the number of cases was small, particularly for the second generation.

As the high schizophrenia incidence rates among immigrants are still poorly understood (Sharpley et al., 2001) and have been questioned (Strakowski et al., 1996, Fernando, 2003, Arnold et al., 2004), it is important to clarify which immigrant groups are at higher risk, and to what extent second generation immigrants are affected. We therefore conducted a second two-year first-contact incidence study in The Hague and combined the results of both studies. We compared the risks of schizophrenic disorders (DSM IV: schizophrenia, schizophreniform disorder, schizoaffective disorder) in immigrants with those in native Dutch persons.

Section snippets

Classification of ethnicity

The municipality of The Hague classifies ethnicity according to citizens' country of birth and to that of their parents. Immigrants include both those who are foreign-born (first generation) and those who have at least one foreign-born parent (second generation). Seven categories of ethnicity are used: (1) Morocco, (2) Surinam, (3) Turkey, (4) the Netherlands Antilles, (5) other non-Western countries, (6) Western or westernised countries (Western or Northern Europe, the former Yugoslavia, the

First period, 1997–1999

The results of the first period have been reported previously (Selten et al., 2001).

Second period, 2000–2002

One hundred ninety-seven subjects made first contact during this two-year period. Diagnostic interviews were conducted in 155 cases (78.7%) and interviews with key informants in 132 cases (67.0%). A consensus DSM-IV diagnosis could be made for all but one subject. One hundred nineteen subjects (87 men, 32 women) were diagnosed with a schizophrenic disorder. Among these 119 subjects, the mean age at first contact

Discussion

The risk of schizophrenic disorders was increased for first and second generation immigrants from Morocco, Surinam, and other non-Western countries. Second generation immigrants from these groups had higher risks than those of the first generation.

Remarkably, whereas the risk was very high for first and second generation Moroccan males, the risk for Moroccan females, first or second generation, was not significantly increased. We have no ready explanation for the low number of Moroccan women

Acknowledgments

This study was supported in part by the Theodore and Vada Stanley Foundation.

References (16)

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