Anna?Clara Hollander|Henrik Dal|Glyn Lewis|Cecilia Magnusson|James Kirkbride|Christina Dalman
Refugee migration and risk of schizophrenia and other non-affective psychoses: cohort study of 1.3 million people in Sweden
Karolinska Institutet|Stockholm County Council|University College London|Stockholm County Council|Karolinska Institutet|University College London|Stockholm County Council|Karolinska Institutet
bobjectivebnbspto determine whether refugees elevated risk schizophrenia nonaffective psychotic disorders relative nonrefugee migrants similar regions origin swedishborn population bdesignbnbspcohort study people living sweden born 1 january 1984 followed 14th birthday arrival sweden later diagnosis nonaffective psychotic disorder emigration death 31 december 2011 bsettingbnbsplinked swedish national register data bparticipantsbnbsp1 347 790 people including people born sweden two swedishborn parents 1 191 004 884 refugees 24 123 18 nonrefugee migrants 132 663 98 four major refugee generating regions middle east north africa subsaharan africa asia eastern europe russia bmain outcome measuresbnbspcox regression analysis used estimate adjusted hazard ratios nonaffective psychotic disorders refugee status region origin controlling age risk sex disposable income population density bresultsbnbsp3704 cases nonaffective psychotic disorder identified 89 million person years followup crude incidence rate 385 95 confidence interval 372 399 per 100 000 person years swedishborn population 804 727 889 per 100 000 person years nonrefugee migrants 1264 1031 1548 per 100 000 person years refugees refugees increased risk psychosis compared swedishborn population adjusted hazard ratio 29 95 confidence interval 23 36 nonrefugee migrants 17 13 21 adjustment confounders increased rate refugees compared nonrefugee migrants pronounced men likelihood ratio test interaction sup2sup df2 z135 p0001 present refugees regions except subsaharan africa refugees nonrefugee migrants subsaharan africa similarly high rates relative swedishborn population bconclusionsbnbsprefugees face increased risk schizophrenia nonaffective psychotic disorders compared nonrefugee migrants similar regions origin nativeborn swedish population clinicians health service planners refugee receiving countries aware raised risk psychosis addition mental physical health inequalities experienced refugees