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New ResearchFull Access

Age at Migration and Future Risk of Psychotic Disorders Among Immigrants in the Netherlands: A 7-Year Incidence Study

Objective:

The purpose of this study was to examine whether the increased risk for developing a psychotic disorder among immigrants is related to their age at the time of migration.

Method:

In a 7-year first-contact incidence study, immigrants to the Netherlands and Dutch citizens, ages 15–54 years, who made a first contact with a physician for a suspected psychotic disorder were identified. Diagnostic interviews were administered, and DSM-IV diagnoses were determined by consensus between two psychiatrists. A comprehensive municipal registration system provided the denominator, including information on ethnicity and age at the time of migration.

Results:

Lower age at the time of migration was associated with a higher incidence of psychotic disorders among immigrants. People who migrated between the ages of 0 and 4 years had the most elevated risk for psychotic disorders compared with the risk among Dutch citizens (age- and sex-adjusted incidence rate ratio=2.96, 95% confidence interval [CI]=2.10–4.17), and the risk gradually decreased with older age at migration (adjusted incidence rate ratio for migration at 5–9 years, 10–14 years, and >29 years, respectively: 2.31 [CI=1.61–3.29], 1.51 [CI=1.02–2.25], and 1.00 [CI=0.58–1.72]).

Conclusions:

The adverse influence of migration on the risk for psychotic disorders is most prominent in early life, suggesting that this is an important period in the etiology of the illness.