Do immigrants into a new nation have a greater risk of mood disorders? The standard approach has been to say that this is due to bias of measurement, or institutionalised racism. But minorities do have an increased risk of mood disorders: this may vary somewhat by the immigrant culture and the host culture. There have been a large number of papers that look at these issues, and the most recent meta analysis is in the British Journal.

Since link rot is a real thing, I have put the reference a the bottom of the abstract.

Background

Although there are consistent reports of higher psychosis rates among immigrants, the information on mood disorders is limited.

Aims

To review and quantify the difference in incidence of mood disorders in first- and second-generation immigrant (FGI and SGI) groups v. non-immigrants.

Method

PubMed, EMBASE and PsycINFO were searched for articles from cohort studies reporting incidence of mood disorders among FGIs and SGIs.

Results

Eighteen studies met our inclusion criteria. The summary relative risk (RR) for FGIs was 1.25 (95% CI 1.11–1.41), based on 17 effect sizes and 6120 cases, and 1.16 (95% CI 0.96–1.40) for SGIs based on three effect sizes. Men seemed at higher risk (RR = 1.29, 95% CI 1.06–1.56).

Conclusions

Clinicians should view FGIs as a group at risk of mood disorders, especially men. Further research is needed to understand immigrants’ risk, especially in SGI.

Irina Mindlis, Paolo Boffetta Mood disorders in first- and second-generation immigrants: systematic review and meta-analysisThe British Journal of Psychiatry Jan 2017, bjp.bp.116.181107; DOI: 10.1192/bjp.bp.116.181107

A relative risk under four is unlikely to be causal. This is a correlation: though signficant, it is not that strong. The authors need to consider that there may be publication bias (which is shown n the second diagram, the first is the PRISMA diagram which shows how the papers were selected).

Where the authors are correct is to note that immigration — a known risk for psychosis — needs to be considered as a potential risk for common mental disorders.

From the authors discussion.

Irrespective of the reasons for migration, the process of migrating in itself can be a highly stressful life event, which could lead to a higher risk of mood disorders. Immigrants can be vulnerable populations, with poorer access to the job market, education and employment. With 232 million international migrants in 2013, there is a great need to prevent mental health disorders among this group, not only for the impact that mental disorders can have directly, but also indirectly through its moderating effect on a myriad of health conditions.Although a family history of mental illness and biological factors remain significant risk factors for mood disorders, the main clinical implication of our review is that FGIs – especially men – should be viewed as a group at risk of such disorders. Future research should attempt to study immigrant generations separately, since their stressors are different: whereas FGIs can experience migration and settling in a different country as stressful, SGIs can experience stress due to being bicultural. Greater homogeneity is also needed in respect to region of origin, to be able to understand whether different groups carry different risks. Lastly, although most research regarding the mental health of immigrants has focused on schizophrenia, greater attention should be paid to disorders that are more prevalent and overwhelmingly costly to individuals, their families and the community at large.

The authors are proceeding with some caution. Our rulers and elite are not. For they are following their theory, and to paraphrase Matt Briggs The love of theory is the root of much evil