Antipsychotic treatment patterns in refugees and their Swedish-born peers with first-episode non-affective psychosis: findings from the REMAIN study
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Antipsychotic treatment patterns in refugees and their Swedish-born peers with first-episode non-affective psychosis : findings from the REMAIN study. / Goppers, Julia Spaton; Mittendorfer-Rutz, Ellenor; Cullen, Alexis E.; de Montgomery, Christopher Jamil; Tanskanen, Antti; Norredam, Marie; Taipale, Heidi.
In: BJPsych Open, Vol. 9, No. 3, 57, 2023.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Antipsychotic treatment patterns in refugees and their Swedish-born peers with first-episode non-affective psychosis
T2 - findings from the REMAIN study
AU - Goppers, Julia Spaton
AU - Mittendorfer-Rutz, Ellenor
AU - Cullen, Alexis E.
AU - de Montgomery, Christopher Jamil
AU - Tanskanen, Antti
AU - Norredam, Marie
AU - Taipale, Heidi
PY - 2023
Y1 - 2023
N2 - BackgroundPrevious studies suggest that migrants tend to utilise antipsychotics less often than their native-born peers. However, studies examining antipsychotic use among refugees with psychosis are lacking. AimsTo compare the prevalence of antipsychotic drug use during the first 5 years of illness among refugees and Swedish-born individuals with a newly diagnosed non-affective psychotic disorder, and to identify sociodemographic and clinical factors associated with antipsychotic use. MethodThe study population included refugees (n = 1656) and Swedish-born persons (n = 8908) aged 18-35 years during 2007-2018, with incident diagnosis of non-affective psychotic disorder recorded in the Swedish in-patient or specialised out-patient care register. Two-week point prevalence of antipsychotics use was assessed every 6 months in the 5 years following first diagnosis. Factors associated with antipsychotic use (versus non-use) at 1 year after diagnosis were examined with modified Poisson regression. ResultsRefugees were somewhat less likely to use antipsychotics at 1 year after first diagnosis compared with Swedish-born persons (37.1% v. 42.2%, age- and gender-adjusted risk ratio 0.88, 95% CI 0.82-0.95). However, at the 5-year follow-up, refugees and Swedish-born individuals showed similar patterns of antipsychotic use (41.1% v. 40.4%). Among refugees, higher educational level (>12 years), previous antidepressant use and being diagnosed with schizophrenia/schizoaffective disorder at baseline were associated with an increased risk of antipsychotics use, whereas being born in Afghanistan or Iraq (compared with former Yugoslavia) was associated with decreased risk. ConclusionsOur findings suggest that refugees with non-affective psychotic disorders may need targeted interventions to ensure antipsychotic use during the early phase of illness.
AB - BackgroundPrevious studies suggest that migrants tend to utilise antipsychotics less often than their native-born peers. However, studies examining antipsychotic use among refugees with psychosis are lacking. AimsTo compare the prevalence of antipsychotic drug use during the first 5 years of illness among refugees and Swedish-born individuals with a newly diagnosed non-affective psychotic disorder, and to identify sociodemographic and clinical factors associated with antipsychotic use. MethodThe study population included refugees (n = 1656) and Swedish-born persons (n = 8908) aged 18-35 years during 2007-2018, with incident diagnosis of non-affective psychotic disorder recorded in the Swedish in-patient or specialised out-patient care register. Two-week point prevalence of antipsychotics use was assessed every 6 months in the 5 years following first diagnosis. Factors associated with antipsychotic use (versus non-use) at 1 year after diagnosis were examined with modified Poisson regression. ResultsRefugees were somewhat less likely to use antipsychotics at 1 year after first diagnosis compared with Swedish-born persons (37.1% v. 42.2%, age- and gender-adjusted risk ratio 0.88, 95% CI 0.82-0.95). However, at the 5-year follow-up, refugees and Swedish-born individuals showed similar patterns of antipsychotic use (41.1% v. 40.4%). Among refugees, higher educational level (>12 years), previous antidepressant use and being diagnosed with schizophrenia/schizoaffective disorder at baseline were associated with an increased risk of antipsychotics use, whereas being born in Afghanistan or Iraq (compared with former Yugoslavia) was associated with decreased risk. ConclusionsOur findings suggest that refugees with non-affective psychotic disorders may need targeted interventions to ensure antipsychotic use during the early phase of illness.
KW - Psychotic disorders
KW - refugees
KW - antipsychotics
KW - epidemiology
KW - schizophrenia
KW - ACTING INJECTABLE ANTIPSYCHOTICS
KW - NATIONWIDE COHORT
KW - SCHIZOPHRENIA
KW - MEDICATION
KW - MORTALITY
KW - NONADHERENCE
KW - ADHERENCE
KW - CLOZAPINE
KW - RISK
U2 - 10.1192/bjo.2023.38
DO - 10.1192/bjo.2023.38
M3 - Journal article
C2 - 37013904
VL - 9
JO - BJPsych Open
JF - BJPsych Open
SN - 2056-4724
IS - 3
M1 - 57
ER -
ID: 343284811