Characteristics associated with the risk of psychosis among immigrants and their descendants in France

Housing inequalities and health outcomes among migrant and refugee populations in high-income countries: a mixed-methods systematic review

BACKGROUND

Migrant and refugee populations are disproportionately affected by the housing crises reportedly impacting high-income countries around the globe. However, the health implications of housing inequalities within these communities and contexts remain relatively understudied. This review aimed to synthesise the evidence on housing and health inequalities prevalent among migrant and refugee populations in high-income countries, and to identify the pathways linking housing inequalities and health outcomes.

METHODS

This systematic review employed the Joanna Briggs Institute (JBI) methodology for mixed-methods systematic reviews using a convergent integrated approach to synthesis and integration. Electronic database searches were conducted using Medline (OVID), Web of Science (ISI), Embase (OVID), PsycInfo (OVID), Scopus, and CINAHL (EBSCO), supplemented by grey literature searches on Google Scholar, MedNar, and WHOLIS. Eligible studies included quantitative, qualitative, and mixed methods designs focused on understanding how housing inequalities are associated with physical and mental health outcomes.

RESULTS

A total of 65 studies published between 1995 and 2024 were included in this review, comprising 38 quantitative and 27 qualitative studies. Substandard housing conditions, such as overcrowding and poor ventilation, were consistently associated with adverse physical and mental health outcomes, including respiratory illnesses and experiences of anxiety and depression. The type of housing tenure also impacted both physical and mental health, specifically living in inadequate rental housing as opposed to self-owned homes, was linked with poorer physical health and increased risk of mental health issues. Similarly, housing insecurity stemming from unstable housing situations and insecure tenancy, as well as neighbourhood conditions such as safety concerns and living in deprived neighbourhoods, led to the exacerbation of both physical and mental health issues. Furthermore, housing affordability challenges and decreased housing satisfaction were linked with poor mental health outcomes such as experiences of depression and psychological distress.

CONCLUSIONS

This review highlights the critical role of housing as a social determinant of health and wellbeing for migrant and refugee populations in high-income countries, along with highlighting the potential pathways through which housing inequalities impact physical and mental health outcomes. Ensuring access to adequate, affordable, and secure housing, while also improving neighbourhood conditions, is essential for improving the health and wellbeing of migrant and refugee populations.

Schizotypal dimensions by migrant status in the general population: An exploratory study

Migrant status and ethnic minority background have been associated with increased risk for psychosis. However, it remains unclear if such association exists with subclinical forms of psychosis. In two general population samples, totaling 460 subjects, we investigated whether migrant status and/or ethnicity predict self-reported positive, negative and/or disorganized dimensions of psychosis (as measured by the SPQ-B). In comparison to the reference population, we observed higher scores in the negative dimension among both first and second-generation migrants as well as in some ethnic minority groups (particularly North Africa and French overseas). Our findings highlight the need to understand the mechanisms underlying this association between negative schizotypal traits and migrant/ethnic minority status. The fact that migration/ethnicity are associated with both psychotic disorders and subclinical manifestations of psychosis also support the psychosis continuum theory. The higher rates of negative schizotypal traits in these populations underscores the necessity for tailored policies and interventions to enhance mental health and prevent the transition to psychosis in these subgroups.

Characteristics associated with the risk of psychosis among immigrants and their descendants in France

OBJECTIVE

To explore the sociodemographic characteristics that might explain the increased incidence of psychosis among immigrants and their descendants in France.

METHODS

Data were collected for all subjects with first contact for psychosis aged between 18 and 64 years, in two catchment areas in the Paris region. Incidence rates (IR) and incidence rate ratios (IRR) were adjusted for gender and age.

RESULTS

During 805,396 persons-year at risk, we identified 321 cases of first-episode psychosis, of which 129 were immigrants and 78 descendants of immigrants. We found that the geographic origin was associated with the risk of psychosis although generation has little impact. Sub-Saharan African immigrants and their descendants showed the highest risk (IRR = 3.1 and IRR = 2.9, respectively). We observed that living in deprived areas increased the incidence of psychosis (IRR = 1.3, 95CI%: 1.0-1.6), particularly among immigrants (IRR = 1.6; 95% CI: 1.1-2.5). Finally, our study showed that subjects having unstable housing (a proxy for "hard to count population") could inflate the incidence rates among immigrants.

CONCLUSION

The current study shows that the increased risk of psychosis in groups with an immigration background in France is associated with their origin and highlights the importance of socioeconomic factors in modulating this risk.