Discrimination and the incidence of psychotic disorders among ethnic minorities in The Netherlands
Author: Veling W, Selten JP, Susser E, Laan W, Mackenbach JP, Hoek HW
Source:
International journal of epidemiology, 36(4), 761-768.
BACKGROUND: It is well established now that the incidence of schizophrenia is
extremely high for several ethnic minority groups in western Europe, but there is
considerable variation among groups. We investigated whether the increased risk
among these groups depends upon the degree to which they perceive discrimination
based on race or ethnicity. METHODS: We studied the incidence of psychotic
disorders over 7 years in The Hague, a city with a large and diverse population
of ethnic minorities. To compare the incidence of schizophrenic disorders (DSM
IV: schizophrenia, schizophreniform disorder, schizoaffective disorder) in each
ethnic minority group with the incidence in native Dutch, we computed incidence
rate ratios (IRRs). Based on a population study and on rates of reported
incidents of discrimination in The Hague, the degree of perceived discrimination
of ethnic minority groups was rated: high (Morocco), medium
(Netherlands-Antilles, Surinam and 'other non-western countries'), low (Turkey)
or very low ('western or westernized countries'). RESULTS: The age- and
gender-adjusted IRRs of schizophrenic disorders for ethnic minority groups
exposed to high, medium, low, and very low discrimination were 4.00 (95% CI
3.00-5.35), 1.99 (1.58-2.51), 1.58 (1.10-2.27), and 1.20 (0.81-1.90),
respectively. When not only schizophrenic, but all psychotic disorders were
included in the analysis, the results were similar. CONCLUSIONS: These results
suggest that discrimination perceived by ethnic minority groups in western
Europe, or some factor closely related to it, may contribute to their increased
risk of schizophrenia.