Perceived major experiences of discrimination, ethnic group, and risk of psychosis in a six-country case-control study

Daniele La Barbera, Caterina La Cascia, Giada Tripoli, Laura Ferraro, Ilaria Tarricone, Bizu Gelaye, David R. Williams, Craig Morgan, Manuel Arrojo, Julio Sanjuán, Peter B. Jones, Jose Luis Santos, Eva Velthorst, Supriya Misra, Jim Van Os, Bart P.F. Rutten, Antonio Lasalvia, Hannah E. Jongsma, Charlotte Gayer-Anderson, Cristina Marta Del-BenDomenico Berardi, Sarah Tosato, Antonio Lasalvia, James B. Kirkbride, Robin M. Murray, Paulo Rossi Menezes, Marta Di Forti, Andrea Tortelli, Celso Arango, Christina P.C. Borba, Karestan C. Koenen, Pierre-Michel Llorca, Jean-Paul Selten, Lieuwe De Haan, Julio Bobes, Andrei Szöke, Miguel Bernardo, Diego Quattrone

Research output: Contribution to journalArticlepeer-review

Abstract

Background Perceived discrimination is associated with worse mental health. Few studies have assessed whether perceived discrimination (i) is associated with the risk of psychotic disorders and (ii) contributes to an increased risk among minority ethnic groups relative to the ethnic majority. Methods We used data from the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions Work Package 2, a population-based case-control study of incident psychotic disorders in 17 catchment sites across six countries. We calculated odds ratios (OR) and 95% confidence intervals (95% CI) for the associations between perceived discrimination and psychosis using mixed-effects logistic regression models. We used stratified and mediation analyses to explore differences for minority ethnic groups. Results Reporting any perceived experience of major discrimination (e.g. unfair treatment by police, not getting hired) was higher in cases than controls (41.8% v. 34.2%). Pervasive experiences of discrimination (≥3 types) were also higher in cases than controls (11.3% v. 5.5%). In fully adjusted models, the odds of psychosis were 1.20 (95% CI 0.91-1.59) for any discrimination and 1.79 (95% CI 1.19-1.59) for pervasive discrimination compared with no discrimination. In stratified analyses, the magnitude of association for pervasive experiences of discrimination appeared stronger for minority ethnic groups (OR = 1.73, 95% CI 1.12-2.68) than the ethnic majority (OR = 1.42, 95% CI 0.65-3.10). In exploratory mediation analysis, pervasive discrimination minimally explained excess risk among minority ethnic groups (5.1%). Conclusions Pervasive experiences of discrimination are associated with slightly increased odds of psychotic disorders and may minimally help explain excess risk for minority ethnic groups.
Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalPsychological Medicine
Publication statusPublished - 2021

All Science Journal Classification (ASJC) codes

  • Applied Psychology
  • Psychiatry and Mental health

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