Christopher Jamil de Montgomery, Amanda Falah Rasmussen, Jakob Bergström, Heidi Taipale, Aemal Akhtar, Allan Krasnik, Marie Nørredam, Ellenor Mittendorfer-Rutz, Alexis E. Cullen
{"title":"丹麦和瑞典年轻人首次精神病发作前的难民移民背景和医疗接触：各国模式一致吗？","authors":"Christopher Jamil de Montgomery, Amanda Falah Rasmussen, Jakob Bergström, Heidi Taipale, Aemal Akhtar, Allan Krasnik, Marie Nørredam, Ellenor Mittendorfer-Rutz, Alexis E. Cullen","doi":"10.1111/eip.70039","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>The objective of this study was to examine group differences in healthcare contacts prior to a first diagnosis of non-affective psychotic disorders (NAPDs) comparing young refugees settled in Denmark and Sweden before turning 18 non-refugee migrants and native-born individuals.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Using nationwide register data, we identified all individuals aged 18–35 who received an NAPD diagnosis during 2006–2018. Healthcare contacts for other psychiatric disorders were categorised as inpatient, outpatient (grouped by discharge diagnosis) or dispensed antidepressant medication. Logistic regression was used in each country to compare contacts within 12 months prior to NAPD diagnosis, yielding odds ratios (OR) and corresponding 95% confidence intervals (CI), while standardised prevalence ratios (SPR), reported in percentages, were used to compare healthcare contact across countries.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>We included 11,679 individuals in Denmark and 11,088 in Sweden. The likelihood of prior contact of any type was lower in both countries for both refugees [Denmark: OR = 0.75(CI: 0.63, 0.90); Sweden: OR = 0.61(CI: 0.55, 0.68)] and non-refugee migrants [Denmark: OR = 0.78(CI: 0.64, 0.95); Sweden: OR = 0.55(CI: 0.49, 0.62)] compared with majority peers. The largest differences were observed for dispensed antidepressants in both countries [Denmark: OR<sub>refugees</sub> = 0.58(CI: 0.47, 0.71); Sweden: OR<sub>refugees</sub> = 0.52(CI: 0.45, 0.61)]. Outpatient contacts in particular were more common in Sweden than in Denmark across all groups [SIR<sub>refugees</sub> = 151% (CI: 125, 180)].</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Young refugees and non-refugee migrants in both Denmark and Sweden were less likely to have healthcare contact for other psychiatric disorders prior to NAPD onset than host populations. As healthcare contacts offer opportunities to identify treatment needs early, these groups may be vulnerable to delays in the pathway to treatment.</p>\n </section>\n </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"19 4","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/eip.70039","citationCount":"0","resultStr":"{\"title\":\"Refugee Migration Background and Healthcare Contacts Prior to First-Episode Psychosis in Young Adults in Denmark and Sweden: Are Patterns Consistent Across Countries?\",\"authors\":\"Christopher Jamil de Montgomery, Amanda Falah Rasmussen, Jakob Bergström, Heidi Taipale, Aemal Akhtar, Allan Krasnik, Marie Nørredam, Ellenor Mittendorfer-Rutz, Alexis E. Cullen\",\"doi\":\"10.1111/eip.70039\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>The objective of this study was to examine group differences in healthcare contacts prior to a first diagnosis of non-affective psychotic disorders (NAPDs) comparing young refugees settled in Denmark and Sweden before turning 18 non-refugee migrants and native-born individuals.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Using nationwide register data, we identified all individuals aged 18–35 who received an NAPD diagnosis during 2006–2018. Healthcare contacts for other psychiatric disorders were categorised as inpatient, outpatient (grouped by discharge diagnosis) or dispensed antidepressant medication. Logistic regression was used in each country to compare contacts within 12 months prior to NAPD diagnosis, yielding odds ratios (OR) and corresponding 95% confidence intervals (CI), while standardised prevalence ratios (SPR), reported in percentages, were used to compare healthcare contact across countries.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>We included 11,679 individuals in Denmark and 11,088 in Sweden. The likelihood of prior contact of any type was lower in both countries for both refugees [Denmark: OR = 0.75(CI: 0.63, 0.90); Sweden: OR = 0.61(CI: 0.55, 0.68)] and non-refugee migrants [Denmark: OR = 0.78(CI: 0.64, 0.95); Sweden: OR = 0.55(CI: 0.49, 0.62)] compared with majority peers. The largest differences were observed for dispensed antidepressants in both countries [Denmark: OR<sub>refugees</sub> = 0.58(CI: 0.47, 0.71); Sweden: OR<sub>refugees</sub> = 0.52(CI: 0.45, 0.61)]. 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Refugee Migration Background and Healthcare Contacts Prior to First-Episode Psychosis in Young Adults in Denmark and Sweden: Are Patterns Consistent Across Countries?
Introduction
The objective of this study was to examine group differences in healthcare contacts prior to a first diagnosis of non-affective psychotic disorders (NAPDs) comparing young refugees settled in Denmark and Sweden before turning 18 non-refugee migrants and native-born individuals.
Methods
Using nationwide register data, we identified all individuals aged 18–35 who received an NAPD diagnosis during 2006–2018. Healthcare contacts for other psychiatric disorders were categorised as inpatient, outpatient (grouped by discharge diagnosis) or dispensed antidepressant medication. Logistic regression was used in each country to compare contacts within 12 months prior to NAPD diagnosis, yielding odds ratios (OR) and corresponding 95% confidence intervals (CI), while standardised prevalence ratios (SPR), reported in percentages, were used to compare healthcare contact across countries.
Results
We included 11,679 individuals in Denmark and 11,088 in Sweden. The likelihood of prior contact of any type was lower in both countries for both refugees [Denmark: OR = 0.75(CI: 0.63, 0.90); Sweden: OR = 0.61(CI: 0.55, 0.68)] and non-refugee migrants [Denmark: OR = 0.78(CI: 0.64, 0.95); Sweden: OR = 0.55(CI: 0.49, 0.62)] compared with majority peers. The largest differences were observed for dispensed antidepressants in both countries [Denmark: ORrefugees = 0.58(CI: 0.47, 0.71); Sweden: ORrefugees = 0.52(CI: 0.45, 0.61)]. Outpatient contacts in particular were more common in Sweden than in Denmark across all groups [SIRrefugees = 151% (CI: 125, 180)].
Conclusion
Young refugees and non-refugee migrants in both Denmark and Sweden were less likely to have healthcare contact for other psychiatric disorders prior to NAPD onset than host populations. As healthcare contacts offer opportunities to identify treatment needs early, these groups may be vulnerable to delays in the pathway to treatment.
期刊介绍：
Early Intervention in Psychiatry publishes original research articles and reviews dealing with the early recognition, diagnosis and treatment across the full range of mental and substance use disorders, as well as the underlying epidemiological, biological, psychological and social mechanisms that influence the onset and early course of these disorders. The journal provides comprehensive coverage of early intervention for the full range of psychiatric disorders and mental health problems, including schizophrenia and other psychoses, mood and anxiety disorders, substance use disorders, eating disorders and personality disorders. Papers in any of the following fields are considered: diagnostic issues, psychopathology, clinical epidemiology, biological mechanisms, treatments and other forms of intervention, clinical trials, health services and economic research and mental health policy. Special features are also published, including hypotheses, controversies and snapshots of innovative service models.
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