Vulnerability and diagnosis of psychosis among migrant patients in modena

Abstract

Introduction

The risk of psychotic spectrum disorders in Western countries seems to be higher among immigrants than natives. The higher vulnerability may be related to biological, psychological and social factors while cultural and diagnostic difficulties seem to delay an effective therapeutic intervention, with longer DUP (duration of untreated psychosis).

Aim of the study is to analyze the characteristics of psychotic patients of foreign origin with a particular attention to their use of mental health services.

Methods

We studied all migrant patients attended to 3 Community Mental Health Centres (CMHC) and to the Psychiatric Hospital (PH) of Modena over a period of a month.

The socio-demographic and clinical data were collected by means of a structured culturally-oriented form.

Results

63 patients of foreign origin attended to the Services. 46% of all diagnoses is a psychotic disorder (most frequent diagnosis being that of brief psychotic episode: 19.15% in CMHC, 22% in PH).

Psychotic disorders are prevalently present among Asian, South American and Eastern European populations.

Use of second generation antipsychotics is frequent in the CMHC (23.4% of all psychopharmacological treatments, p = 0.003) while combined therapies dominate in PH (42.86%). The DUP is on average 12 weeks in PH, 8 in CMHC.

Conclusion

We would confirm a high incidence of psychosis among migrant subjects, with a tendency to use emergency health services. Often there are difficulties in establishing a continuous and territorial therapeutic relationship, or to intervene in the early stage of onset.