Age at Migration and Future Risk of Psychotic Disorders Among Immigrants in the Netherlands: A 7-Year Incidence Study
Abstract
Objective:
Method:
Results:
Conclusions:
Method
Identification of Case Patients
Classification of Ethnicity
Population Data and Neighborhood Characteristics
Statistical Analyses
Results
Case Patients (N=618)b | Total At-Risk Population (N=1,870,016)c | |||
---|---|---|---|---|
Characteristic | N | % | N | % |
Male | 436 | 70.6 | 951,870 | 50.9 |
Age at the time of migration (years)d | ||||
0–4 | 44 | 18.5 | 53,399 | 7.3 |
5–9 | 36 | 15.1 | 63,663 | 8.6 |
10–14 | 29 | 12.2 | 70,844 | 9.6 |
15–19 | 52 | 21.8 | 105,968 | 14.3 |
20–24 | 34 | 14.3 | 134,551 | 18.3 |
25–29 | 23 | 9.7 | 122,726 | 16.7 |
>29 | 20 | 8.4 | 185,084 | 25.1 |
Ethnicity | ||||
Dutch | 226 | 36.6 | 988,869 | 52.9 |
Surinamese | ||||
Immigrant | 57 | 9.2 | 158,142 | 8.5 |
Second-generation citizen | 37 | 6.0 | 34,714 | 1.9 |
Netherlands Antillean | ||||
Immigrant | 17 | 2.8 | 38,224 | 2.0 |
Second-generation citizen | 4 | 0.6 | 5,500 | 0.3 |
Turkish | ||||
Immigrant | 37 | 6.0 | 100,712 | 5.4 |
Second-generation citizen | 18 | 2.9 | 15,750 | 0.8 |
Moroccan | ||||
Immigrant | 68 | 11.0 | 73,122 | 3.9 |
Second-generation citizen | 23 | 3.7 | 11,054 | 0.6 |
Other non-Western | ||||
Immigrant | 72 | 11.7 | 162,402 | 8.7 |
Second-generation citizen | 25 | 4.0 | 68,429 | 3.7 |
Western | ||||
Immigrant | 22 | 3.6 | 104,740 | 5.6 |
Second-generation citizen | 12 | 1.9 | 108,358 | 5.8 |
Analyses Restricted to Immigrant Groups
Country of Origin | Incidence Rate Ratioa | 95% CI | χ2 (df=1) | p |
---|---|---|---|---|
All countries | 0.96 | 0.95–0.98 | 27.03 | 0.000 |
All non-Western countries | 0.96 | 0.94–0.97 | 28.26 | 0.000 |
Surinam | 0.93 | 0.89–0.97 | 12.00 | 0.001 |
Netherlands Antilles | 0.91 | 0.86–0.97 | 8.18 | 0.004 |
Turkey | 0.93 | 0.88–0.97 | 10.15 | 0.001 |
Morocco | 0.96 | 0.93–1.00 | 4.97 | 0.03 |
Other non-Western countries | 0.98 | 0.95–1.01 | 2.32 | 0.13 |
All Western countriesb | 1.00 | 0.95–1.05 | 0.00 | 0.97 |
Age at First Contact With a Physician (Years) | Number of Case Patients | Incidence Rate Ratioa | 95% CI |
---|---|---|---|
15–19 | 30 | 0.89 | 0.83–0.96 |
20–24 | 73 | 0.95 | 0.92–0.98 |
25–29 | 69 | 0.95 | 0.92–0.97 |
30–34 | 38 | 0.97 | 0.93–1.00 |
35–39 | 39 | 0.97 | 0.94–1.01 |
40–44 | 10 | 1.00 | 0.94–1.06 |
45–49 | 9 | 1.02 | 0.96–1.08 |
50–54 | 5 | 1.01 | 0.92–1.10 |
Analyses of Immigrant Groups and Dutch Citizens
All Non-Western Countries | Surinam | The Netherlands Antilles | Turkey | Morocco | Other Non-Western Countries | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Generation | IRR | 95% CI | IRR | 95% CI | IRR | 95% CI | IRR | 95% CI | IRR | 95% CI | IRR | 95% CI |
Immigrant | 1.95 | 1.63–2.33 | 1.77 | 1.32–2.36 | 1.69 | 1.03–2.76 | 1.38 | 0.98–1.96 | 3.43 | 2.62–4.50 | 1.82 | 1.39–2.37 |
Age at the time of migration (years) | ||||||||||||
0–4 | 2.96b | 2.10–4.17 | 2.76 | 1.63–4.66 | 7.10 | 2.63–19.16 | 2.51 | 1.03–6.12 | 3.57 | 1.93–6.61 | 2.01 | 0.83–4.89 |
5–9 | 2.31 | 1.61–3.29 | 2.47 | 1.46–4.16 | 2.77 | 0.69–11.19 | 2.46 | 1.15–5.23 | 1.91 | 0.85–4.32 | 2.04 | 0.90–4.60 |
10–14 | 1.51 | 1.02–2.25 | 0.74 | 0.27–1.98 | c | c | 1.15 | 0.47–2.80 | 2.40 | 1.18–4.87 | 2.49 | 1.35–4.60 |
15–19 | 1.85 | 1.35–2.53 | 1.63 | 0.80–3.30 | 1.11 | 0.35–3.48 | 0.87 | 0.39–1.96 | 5.38 | 3.37–8.60 | 1.47 | 0.83–2.58 |
20–24 | 1.40 | 0.96–2.03 | 0.43 | 0.11–1.74 | 1.39 | 0.52–3.74 | 1.44 | 0.71–2.92 | 3.16 | 1.62–6.16 | 1.26 | 0.62–2.56 |
25–29 | 1.14 | 0.71–1.83 | 0.77 | 0.19–3.13 | 1.76 | 0.44–7.09 | 0.63 | 0.16–2.55 | 1.71 | 0.63–4.60 | 1.22 | 0.63–2.38 |
>29 | 1.00 | 0.58–1.72 | 0.80 | 0.20–3.26 | c | c | c | c | 1.19 | 0.29–4.84 | 1.49 | 0.80–2.78 |
Second-generation citizen | 1.82 | 1.43–2.32 | 2.34 | 1.63–3.34 | 1.92 | 0.71–5.17 | 2.39 | 1.47–3.89 | 4.11 | 2.65–2.38 | 0.91 | 0.60–1.38 |
Discussion
Selective Migration
Potential Confounding Factors
Ascertainment of Case Patients
Prior Research on Age at the Time of Migration
Possible Mechanisms
Implications and Future Research
Footnote
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