Antipsychotic treatment patterns in refugees and their Swedish-born peers with first-episode non-affective psychosis: findings from the REMAIN study
Background Previous studies suggest that migrants tend to utilise antipsychotics less often than their native-born peers. However, studies examining antipsychotic use among refugees with psychosis are lacking. Aims To compare the prevalence of antipsychotic drug use during the first 5 years of illn...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2023-05-01
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| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472423000388/type/journal_article |
| _version_ | 1827973488859676672 |
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| author | Julia Spaton Goppers Ellenor Mittendorfer-Rutz Alexis E. Cullen Christopher Jamil de Montgomery Antti Tanskanen Marie Norredam Heidi Taipale |
| author_facet | Julia Spaton Goppers Ellenor Mittendorfer-Rutz Alexis E. Cullen Christopher Jamil de Montgomery Antti Tanskanen Marie Norredam Heidi Taipale |
| author_sort | Julia Spaton Goppers |
| collection | DOAJ |
| description | Background
Previous studies suggest that migrants tend to utilise antipsychotics less often than their native-born peers. However, studies examining antipsychotic use among refugees with psychosis are lacking.
Aims
To compare the prevalence of antipsychotic drug use during the first 5 years of illness among refugees and Swedish-born individuals with a newly diagnosed non-affective psychotic disorder, and to identify sociodemographic and clinical factors associated with antipsychotic use.
Method
The study population included refugees (n = 1656) and Swedish-born persons (n = 8908) aged 18–35 years during 2007–2018, with incident diagnosis of non-affective psychotic disorder recorded in the Swedish in-patient or specialised out-patient care register. Two-week point prevalence of antipsychotics use was assessed every 6 months in the 5 years following first diagnosis. Factors associated with antipsychotic use (versus non-use) at 1 year after diagnosis were examined with modified Poisson regression.
Results
Refugees were somewhat less likely to use antipsychotics at 1 year after first diagnosis compared with Swedish-born persons (37.1% v. 42.2%, age- and gender-adjusted risk ratio 0.88, 95% CI 0.82–0.95). However, at the 5-year follow-up, refugees and Swedish-born individuals showed similar patterns of antipsychotic use (41.1% v. 40.4%). Among refugees, higher educational level (>12 years), previous antidepressant use and being diagnosed with schizophrenia/schizoaffective disorder at baseline were associated with an increased risk of antipsychotics use, whereas being born in Afghanistan or Iraq (compared with former Yugoslavia) was associated with decreased risk.
Conclusions
Our findings suggest that refugees with non-affective psychotic disorders may need targeted interventions to ensure antipsychotic use during the early phase of illness.
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| first_indexed | 2024-04-09T19:36:49Z |
| format | Article |
| id | doaj.art-9d748bd1058941168ef962bfa70b7e2e |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-04-09T19:36:49Z |
| publishDate | 2023-05-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-9d748bd1058941168ef962bfa70b7e2e2023-04-04T10:01:04ZengCambridge University PressBJPsych Open2056-47242023-05-01910.1192/bjo.2023.38Antipsychotic treatment patterns in refugees and their Swedish-born peers with first-episode non-affective psychosis: findings from the REMAIN studyJulia Spaton Goppers0Ellenor Mittendorfer-Rutz1Alexis E. Cullen2https://orcid.org/0000-0002-3178-3920Christopher Jamil de Montgomery3Antti Tanskanen4Marie Norredam5Heidi Taipale6https://orcid.org/0000-0002-3281-934XDepartment of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SwedenDepartment of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SwedenDepartment of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden; and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UKDepartment of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden; and Department of Public Health, Danish Research Centre for Migration, Ethnicity and Health (MESU), University of Copenhagen, DenmarkDepartment of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden; and Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, FinlandDepartment of Public Health, Danish Research Centre for Migration, Ethnicity and Health (MESU), University of Copenhagen, DenmarkDepartment of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden; and Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, FinlandBackground Previous studies suggest that migrants tend to utilise antipsychotics less often than their native-born peers. However, studies examining antipsychotic use among refugees with psychosis are lacking. Aims To compare the prevalence of antipsychotic drug use during the first 5 years of illness among refugees and Swedish-born individuals with a newly diagnosed non-affective psychotic disorder, and to identify sociodemographic and clinical factors associated with antipsychotic use. Method The study population included refugees (n = 1656) and Swedish-born persons (n = 8908) aged 18–35 years during 2007–2018, with incident diagnosis of non-affective psychotic disorder recorded in the Swedish in-patient or specialised out-patient care register. Two-week point prevalence of antipsychotics use was assessed every 6 months in the 5 years following first diagnosis. Factors associated with antipsychotic use (versus non-use) at 1 year after diagnosis were examined with modified Poisson regression. Results Refugees were somewhat less likely to use antipsychotics at 1 year after first diagnosis compared with Swedish-born persons (37.1% v. 42.2%, age- and gender-adjusted risk ratio 0.88, 95% CI 0.82–0.95). However, at the 5-year follow-up, refugees and Swedish-born individuals showed similar patterns of antipsychotic use (41.1% v. 40.4%). Among refugees, higher educational level (>12 years), previous antidepressant use and being diagnosed with schizophrenia/schizoaffective disorder at baseline were associated with an increased risk of antipsychotics use, whereas being born in Afghanistan or Iraq (compared with former Yugoslavia) was associated with decreased risk. Conclusions Our findings suggest that refugees with non-affective psychotic disorders may need targeted interventions to ensure antipsychotic use during the early phase of illness. https://www.cambridge.org/core/product/identifier/S2056472423000388/type/journal_articlePsychotic disordersrefugeesantipsychoticsepidemiologyschizophrenia |
| spellingShingle | Julia Spaton Goppers Ellenor Mittendorfer-Rutz Alexis E. Cullen Christopher Jamil de Montgomery Antti Tanskanen Marie Norredam Heidi Taipale Antipsychotic treatment patterns in refugees and their Swedish-born peers with first-episode non-affective psychosis: findings from the REMAIN study BJPsych Open Psychotic disorders refugees antipsychotics epidemiology schizophrenia |
| title | Antipsychotic treatment patterns in refugees and their Swedish-born peers with first-episode non-affective psychosis: findings from the REMAIN study |
| title_full | Antipsychotic treatment patterns in refugees and their Swedish-born peers with first-episode non-affective psychosis: findings from the REMAIN study |
| title_fullStr | Antipsychotic treatment patterns in refugees and their Swedish-born peers with first-episode non-affective psychosis: findings from the REMAIN study |
| title_full_unstemmed | Antipsychotic treatment patterns in refugees and their Swedish-born peers with first-episode non-affective psychosis: findings from the REMAIN study |
| title_short | Antipsychotic treatment patterns in refugees and their Swedish-born peers with first-episode non-affective psychosis: findings from the REMAIN study |
| title_sort | antipsychotic treatment patterns in refugees and their swedish born peers with first episode non affective psychosis findings from the remain study |
| topic | Psychotic disorders refugees antipsychotics epidemiology schizophrenia |
| url | https://www.cambridge.org/core/product/identifier/S2056472423000388/type/journal_article |
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