The impact of migration on first-episode psychosis clinical presentation at baseline

Objectives: Our primary objective was to examine the clinical presentation and explore differences between migrant and native individuals with first-episode psychosis at baseline. A secondary objective was to explore specific factors contributing to the observed clinical manifestations in first-generation migrant individuals with first-episode psychosis, such as childhood adversities, sex, age, and age at migration. Methods: A naturalistic, observational, prospective, and case-control study was conducted. Statistical analyses included chi-squared tests for categorical variables, t-tests for continuous variables, ANOVA tests for comparisons between multiple groups, and multivariate generalized linear models to explore factors associated with clinical presentation in first-generation migrants. Results were considered statistically significant at p < 0.05. Results: Out of the sample of 363 subjects, 114 were first-generation migrants and 249 were native-born patients. In terms of clinical presentation, first-generation migrants had significantly higher scores on the PANSS Negative subscale compared to natives (p < 0.01). Further analysis showed that this difference was driven by higher average scores in first-generation migrants compared to non-migrants (p < 0.027). First-generation migrants exhibited higher levels of childhood adversity compared to non-migrants. Multivariate analysis revealed that sex was a significant predictor of PANSS Negative scores in first-generation migrants, with men having higher scores than women. Conclusion: In our study, first-generation migrants, particularly men, showed more severe negative symptoms compared to natives. These findings support that the migratory condition should be considered when assessing subjects with first-episode psychosis, as this will help to characterise the pathology precisely and provide personalized clinical treatments.