Friday, March 25, 2016

Refugee are likely to be schizophrenic?

A study suggesting the risk of schizophrenia for refugees was recently published. According to the result, refugees have three times as likely to experience psychotic episodes than native-born citizens. It has been already known that refugees are exposing high risks of depression and PTSD. But it is for the first time to reveal the relationship between refugees and psychoses.

The Washington Post: For refugees, another risk: Schizophrenia

This survey was conducted in Sweden. The Swedish government has a sophisticated database of the citizens' health. Approximately 1.3 million people were examined in this study. I have never heard such a large amount of samples in other studies with a similar structure.

Large sample size is advantageous to make the results trustworthy. The British Medical Journal, on which this paper was published, is a world-famous academic journal. Nonetheless, this kind of results has to be carefully evaluated.

The BMJ: Refugee migration and risk of schizophrenia and other non-affective psychoses: cohort study of 1.3 million people in Sweden

With looking through this article, I found few flaws in this survey. The author adjusted potential confounders such as socioeconomic status. For excluding the influence of cultural shock, refugees were also compared with non-refugee immigrants. The likelihood to become psychotic was still higher in refugees.

Pre-migratory experiences were not considered in this study, as the author mentioned. It can be influential to the onset of schizophrenia. The cause of schizophrenia has not been identified, but suspected to the internal vulnerability and the external stress. What kind of stress the patients were exposed was crucial is still unclear.

The discrepancy of diagnostic criteria for schizophrenia is under discussion. It is known that cultural background is influential in diagnosing schizophrenia. Some migrants have the complicated background, and therefore, they can be likely to be misidentified as schizophrenic.

It is no doubt that refugees have several risks for deteriorating their physical and mental status. I hope this result will not lead to discrimination against them.

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