By Dr. Minal Mistry, Psychiatrist
Psychosis and immigration
We are currently seeing the highest rates of immigration than ever in society, which is likely to increase with more migrants entering western countries looking for a better quality of life for themselves and their families. However, there is another side to immigration that has attracted mental health research: the known association of migration with certain psychiatric conditions. For instance, a psychotic condition such as schizophrenia has been known have a higher incidence amongst immigrants compared with nonimmigrants. This finding is particularly well established in some European countries – the Netherlands, Denmark, Germany, the United Kingdom (UK) – and Canada.
The missing part of this jigsaw – the missing link – is whether the psychosis seen with those who migrate are associated with actual biochemical abnormalities i.e. does the social mobility seen in migration, a risk factor for psychosis, manifest with biological changes in the brain?
We may finally have an answer to the question of whether the migration-induced psychosis plays out with biochemical brain changes. We already know that dopamine is the key neurotransmitter implicated in people with a psychosis – increased dopamine function in an area of the brain called the “Striatum”. Alice Egerton at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK, has conducted research in this area (see “Dopamine and schizophrenia research paper” in “useful information” section of this blog).
Alice Egerton has now published a new paper, thanks to her collaboration with colleagues in UK and Toronto (Canada), to show that dopamine function is indeed elevated in those who migrate (and similar findings were found in the children of those who have migrated).
“These data provide the first evidence that the effect of migration on the risk of developing psychosis may be mediated by an elevation in brain dopamine function.” (see Dopamine and immigration research paper)
Why does migration increase the risk of Schizophrenia?
We do not really know the answer to this question, but there are theories regarding contributing factors, as Alice Egerton goes on to explain in her UK-Canadian study paper that it is the role of stress brought about by migrants being at increased risk of:
What is the significance of this study?
Firstly, I am excited by the findings of this paper as it unearths an interesting connection between social and biological components of mental illness especially with respect to the “stress-vulnerability model”. As the authors of the study remark:
“This suggests that adverse psychological, social, and environmental experiences associated with immigration may increase the risk of schizophrenia by influencing brain dopamine function, a key pathophysiological component of psychosis.”
Secondly, and more importantly for me, it highlights the strong social component of mental illness especially as a mediating factor in determining the risk of developing biological abnormalities in our brains that increase risk of developing a serious psychiatric condition. Why is this part so important? It is important because psychosocial factors can be remedied. For instance, we can intervene to reduce the problems of social isolation and discrimination that migrants may endure – by intervening in this way we help reduce mental illness as well as practicing kindness in welcoming those to come to our country looking for a fresh start in life.
Egerton A Chaddock CA Winton-Brown TT et al. Presynaptic striatal dopamine dysfunction in people at ultra-high risk for psychosis: findings in a second cohort. Biol Psychiatry. 2013;74:106–112.
Egerton A, Howes OD, Houle S, McKenzie K, Valmaggia LR, Bagby MR et al. Elevated Striatal Dopamine Function in Immigrants and Their Children: A Risk Mechanism for Psychosis. Schizophrenia Bulletin. 2017 Jan 5. Available from, DOI: 10.1093/schbul/sbw181
Cite this article as:
Minal Mistry (2017). The social-biological connection in immigration and psychosis: The missing link. The Beautiful Space-A journal of Mind, Art and Poetry. July 2017: TBSB120
Please check author names highlighted with each article.
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