Group-Analytic Contexts, Issue 81, September 2018

Newsletter – Autumn 2018 19
Psychosis and migration: does a correlation exist?
A multitude of retrospective studies since 1930 so far agree that the
impact (and the risk too) of developing psychosis among emigrants,
refugees and asylum seekers is significantly increased in comparison
with the native population, continuing in the second and third
generation (Ødegaard, 1932; Schick M. et al., 2016; Tarricone I. et al.,
2015; Rhodes J.E. et al., 2016; Mandaglio C. & Maierà E., 2014;
Hollander A.C., 2013; Morgan C. et al., 2010; Bradley A.J. & Dinan
T.G., 2010).
The risk of psychosis in first-generation immigrants is almost
three times higher than that of natives (Maltzeberg, 1995). The risk of
psychosis developing among second-generation immigrants is
increased 4-5 times in comparison to the indigenous population
(McGrath, 2004).
Early childhood mental trauma is as much indicative as it is
explanatory for the development of psychosis. Mondelli et al. (2010)
found a significant negative correlation between the number of
stressful life events and cortisol levels in first-episode psychotic
patients, in contrast to the control group. This was attributed to the
excessive load of stressful life events, since 85,7 % of psychotic
patients had experienced a childhood trauma.
A dose-dependent relationship has been described between
traumatic exposure and psychological detriment (Johnson &
Thompson, 2008; Mollica et al., 1998). Stress may be associated with
psychosis by sensitizing people, both at the behavioral and the
neurological level. An example of genes – environment interaction in
psychosis: the vulnerable gene type is more susceptible to the
development of psychosis after environmental exposure in
comparison to the invulnerable type (Moffitt et al. 2005; Winkel et al.
2008). Abuse during childhood correlates with the development of
psychosis during adulthood (Ackner et al. 2013). A number of studies
suggest that emotional abuse and cumulative trauma exposure is
related to psychotic experiences.
Migration related factors potentially associated with
psychopathology are: direct violence, poor living conditions,
humiliation, exclusion and discrimination occurring during the
migration period (violence, lack of water, food, health and basic
services), as well as the pre- (battles, tortures, rape, death or
disappearance of individuals, lack of water, food and health services,
loss of native country and individuals) and post- (racist assaults, gang
violence, retention at refugee camps, exclusion from the host country
infrastructure) migration ones (Migration and health in the European