Philippe Golay1, Philipp Baumann1, Laure Jaton1, Romeo Restellini1, Nadir Mebdouhi1, Philippe Conus1; 1TIPP program, Département de Psychiatrie CHUV, Lausanne University, Switzerland
Aim: Most early psychosis programs treat high ratios of migrants, given they display higher rates of psychosis than the indigenous population. There are however limited studies on this topic in early psychosis programs (EP) and less is known about outcomes. The aim of this study was to compare the premorbid, baseline and outcome profile of patients according to migration (M) and migration in psychosocial adversity (MIA) in order to explore if there were differences suggesting particular needs in terms of treatment in these patients group. Methods: 257 early psychosis patients aged 18-35 years old were followed-up prospectively over 36 months. MIA (29.6%) and M (17.9%) were compared to patients who were born in Switzerland (NM). Results: The profile of MIA was characterized by lower socio-economical level for equal level of education, higher unemployment and forensic history rates, high prevalence of trauma and worse functioning at baseline. MIA patients also had lower global functioning during the follow-up. M patients had a better premorbid adjustment and experienced similar outcomes as the NM group. Conclusions: Results are compatible with the hypothesis that migration in adversity is a potential determinant of functional impairment in early psychosis. The fact that patients who migrated in other contexts have a better outcome is consistent with evidence showing that some migrants are more resilient. Patients who experienced migration in adversity may have specific needs in terms of intervention considering they are more vulnerable, less integrated and have a higher likelihood to have been exposed to trauma.
