Social disadvantage, linguistic distance, ethnic minority status and first-episode psychosis: Results from the EU-GEI case-control study

Caterina La Cascia, Marta Di Forti, Ilaria Tarricone, Robin M. Murray, Els Van Der Ven, Charlotte Gayer-Anderson, Craig Morgan, Manuel Arrojo, Julio Sanjuán, James B. Kirkbride, Peter B. Jones, Jose Luis Santos, Eva Velthorst, Jim Van Os, Miguel Bernardo, Antonio Lasalvia, Hannah E. Jongsma, Charlotte Gayer-Anderson, Robin M. Murray, Christina Marta Del-BenPeter B. Jones, Peter B. Jones, Domenico Berardi, Christina Marta Del-Ben, Paulo Rossi Menezes, James B. Kirkbride, Robin M. Murray, Andrea Tortelli, Celso Arango, Caterina La Cascia, Bart P. Rutten, Paulo Rossi Menezes, Lieuwe De Haan, Julio Bobes, Andrei Szöke, Jim Van Os, Miguel Bernardo, Diego Quattrone

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10 Citations (Scopus)


BackgroundEthnic minority groups in Western countries face an increased risk of psychotic disorders. Causes of this long-standing public health inequality remain poorly understood. We investigated whether social disadvantage, linguistic distance and discrimination contributed to these patterns.MethodsWe used case-control data from the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study, carried out in 16 centres in six countries. We recruited 1130 cases and 1497 population-based controls. Our main outcome measure was first-episode ICD-10 psychotic disorder (F20-F33), and exposures were ethnicity (white majority, black, mixed, Asian, North-African, white minority and other), generational status, social disadvantage, linguistic distance and discrimination. Age, sex, paternal age, cannabis use, childhood trauma and parental history of psychosis were included as a priori confounders. Exposures and confounders were added sequentially to multivariable logistic models, following multiple imputation for missing data.ResultsParticipants from any ethnic minority background had crude excess odds of psychosis [odds ratio (OR) 2.03, 95% confidence interval (CI) 1.69-2.43], which remained after adjustment for confounders (OR 1.61, 95% CI 1.31-1.98). This was progressively attenuated following further adjustment for social disadvantage (OR 1.52, 95% CI 1.22-1.89) and linguistic distance (OR 1.22, 95% CI 0.95-1.57), a pattern mirrored in several specific ethnic groups. Linguistic distance and social disadvantage had stronger effects for first- A nd later-generation groups, respectively.ConclusionSocial disadvantage and linguistic distance, two potential markers of sociocultural exclusion, were associated with increased odds of psychotic disorder, and adjusting for these led to equivocal risk between several ethnic minority groups and the white majority.
Original languageEnglish
Pages (from-to)1-13
Number of pages13
JournalPsychological Medicine
Publication statusPublished - 2020

All Science Journal Classification (ASJC) codes

  • Applied Psychology
  • Psychiatry and Mental health

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