Ethnic density, urbanicity and psychosis risk for migrant groups – A population cohort study

Peter Schofield*, Malene Thygesen, Jay Das-Munshi, Laia Becares, Elizabeth Cantor-Graae, Carsten Pedersen, Esben Agerbo

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

45 Citations (Scopus)
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Background Rates of psychotic disorder are raised for many migrant groups. Understanding the role played by the social context in which they live may help explain why. This study investigates the effect of both neighbourhood ethnic density and urbanicity on the incidence of non-affective psychosis for migrant groups. Method Population based cohort of all those born 1965 or later followed from their 15th birthday (2,224,464 people) to 1st July 2013 (37,335,812 person years). Neighbourhood exposures were measured at age 15. Results For all groups incidence of non-affective psychosis was greater in lower ethnic density neighbourhoods. For migrants of African origin there was a 1.94-fold increase (95% CI, 1.17–3.23) comparing lowest and highest density quintiles; with similar effects for migrants from Europe (excluding Scandinavia): incidence rate ratio (IRR) 1.99 (95% CI, 1.56–2.54); Asia: IRR 1.63 (95% CI, 1.02–2.59); and the Middle East: IRR 1.68 (95% CI, 1.19–2.38). This initial analysis found no evidence for an urbanicity effect for migrant groups. Adjusting for ethnic density revealed a positive association between level of urbanicity and psychosis for two groups, with a statistically significant linear trend (average effect of a one quintile increase) for migrants from Europe: IRR 1.09 (95% CI, 1.02–1.16) and the Middle East: IRR 1.12 (95% CI, 1.01–1.23). Conclusions In this first nationwide population-based study of ethnic density, urbanicity and psychosis we show that lower ethnic density is associated with increased incidence of non-affective psychosis for different migrant groups; masking urban/rural differences in psychosis for some groups.

Original languageEnglish
Pages (from-to)82-87
Number of pages6
JournalSchizophrenia Research
Issue number0
Early online date15 Mar 2017
Publication statusPublished - Dec 2017


  • Ethnicity
  • Etiology
  • Psychosis
  • Social determinants


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