Scholarlink

Background <p>It is not known if there are differences in antipsychotic initiation between migrants and native-born individuals diagnosed with non-affective psychotic disorder. This study aimed to determine (1) potential differences in initiation rate and type of first antipsychotic medication between refugees, non-refugee migrants, second-generation migrants, and Swedish-born young adults with incident non-affective psychosis and (2) which sociodemographic and clinical factors are associated with initiation.</p> Methods <p>This register-based cohort included 12,960 adults aged 18–35 years, residing in Sweden during 2007–2018, with an incident diagnosis of a non-affective psychotic disorder in inpatient or specialised outpatient care. Sociodemographic and clinical factors associated with antipsychotic initiation were determined using modified Poisson regression models yielding Relative Risk, RRs, and 95% Confidence Intervals, CI.</p> Results <p>Initiation of antipsychotic use was slightly less common among refugees (65.6%) compared to non-refugee migrants (70.2%), second-generation migrants (71.0%), and Swedish-born individuals (71.1%). However, after adjustment for sociodemographic and clinical factors, there was no difference in initiation rates between refugees and Swedish-born individuals (adjusted RR 0.96; 95% CI 0.92-1.00). Olanzapine was most common initial antipsychotic in all groups. However, compared to the Swedish-born, refugees (1.47; 1.10–1.97), non-refugee migrants (1.70; 1.26–2.27) and second-generation migrants (1.43; 1.05–1.97) were more likely to initiate the use with long-acting injectable antipsychotics, and also with first-generation antipsychotics, particularly haloperidol. Sociodemographic factors associated with initiation were similar among refugees and Swedish-born individuals, including younger age, higher education and inpatient care.</p> Conclusion <p>Our finding that migrants were more likely to initiate long-acting antipsychotics suggests that clinical teams anticipate medication non-adherence among migrants.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Initiation of antipsychotic medication among refugees, non-refugee migrants, second-generation migrants, and Swedish-born adults with incident non-affective psychotic disorders

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年4月3日

查看全文
  • Daniela Mellin,
  • Ellenor Mittendorfer-Rutz,
  • Christopher J. de Montgomery,
  • Alexis E. Cullen,
  • Heidi Taipale

摘要

Background

It is not known if there are differences in antipsychotic initiation between migrants and native-born individuals diagnosed with non-affective psychotic disorder. This study aimed to determine (1) potential differences in initiation rate and type of first antipsychotic medication between refugees, non-refugee migrants, second-generation migrants, and Swedish-born young adults with incident non-affective psychosis and (2) which sociodemographic and clinical factors are associated with initiation.

Methods

This register-based cohort included 12,960 adults aged 18–35 years, residing in Sweden during 2007–2018, with an incident diagnosis of a non-affective psychotic disorder in inpatient or specialised outpatient care. Sociodemographic and clinical factors associated with antipsychotic initiation were determined using modified Poisson regression models yielding Relative Risk, RRs, and 95% Confidence Intervals, CI.

Results

Initiation of antipsychotic use was slightly less common among refugees (65.6%) compared to non-refugee migrants (70.2%), second-generation migrants (71.0%), and Swedish-born individuals (71.1%). However, after adjustment for sociodemographic and clinical factors, there was no difference in initiation rates between refugees and Swedish-born individuals (adjusted RR 0.96; 95% CI 0.92-1.00). Olanzapine was most common initial antipsychotic in all groups. However, compared to the Swedish-born, refugees (1.47; 1.10–1.97), non-refugee migrants (1.70; 1.26–2.27) and second-generation migrants (1.43; 1.05–1.97) were more likely to initiate the use with long-acting injectable antipsychotics, and also with first-generation antipsychotics, particularly haloperidol. Sociodemographic factors associated with initiation were similar among refugees and Swedish-born individuals, including younger age, higher education and inpatient care.

Conclusion

Our finding that migrants were more likely to initiate long-acting antipsychotics suggests that clinical teams anticipate medication non-adherence among migrants.