ABSTRACT
BACKGROUND: We examined whether cannabis use contributes to the increased risk of psychotic disorder for non-western minorities in Europe. METHODS: We used data from the EU-GEI study (collected at sites in Spain, Italy, France, the United Kingdom, and the Netherlands) on 825 first-episode patients and 1026 controls. We estimated the odds ratio (OR) of psychotic disorder for several groups of migrants compared with the local reference population, without and with adjustment for measures of cannabis use. RESULTS: The OR of psychotic disorder for non-western minorities, adjusted for age, sex, and recruitment area, was 1.80 (95% CI 1.39-2.33). Further adjustment of this OR for frequency of cannabis use had a minimal effect: OR = 1.81 (95% CI 1.38-2.37). The same applied to adjustment for frequency of use of high-potency cannabis. Likewise, adjustments of ORs for most sub-groups of non-western countries had a minimal effect. There were two exceptions. For the Black Caribbean group in London, after adjustment for frequency of use of high-potency cannabis the OR decreased from 2.45 (95% CI 1.25-4.79) to 1.61 (95% CI 0.74-3.51). Similarly, the OR for Surinamese and Dutch Antillean individuals in Amsterdam decreased after adjustment for daily use: from 2.57 (95% CI 1.07-6.15) to 1.67 (95% CI 0.62-4.53). CONCLUSIONS: The contribution of cannabis use to the excess risk of psychotic disorder for non-western minorities was small. However, some evidence of an effect was found for people of Black Caribbean heritage in London and for those of Surinamese and Dutch Antillean heritage in Amsterdam.
ABSTRACT
BACKGROUND: Ethnic minorities in the Netherlands face an excess psychosis risk, and understanding of causality remains limited. Linguistic disadvantage and other indicators of societal exclusion might play a role, and offer potential targets for public health interventions. AIM: To establish the contribution of linguistic disadvantage, indicators of social distance and perceived discrimination to the increased risk of psychoses in migrants and ethnic minorities. METHODS: We used the Dutch data from an international case-control study into psychotic disorders (the EU-GEI study). A first episode of psychosis was our outcome variable, and we used well-defined data on established confounders (e.g. age and sex) and indicators of ethnicity, social distance, linguistic disadvantage and perceived discrimination as our predictor variables. RESULTS: Ethnic minorities face an increased psychosis risk. This appears to be the case for both first- and second- generation migrants and so-called ‘Western’ and non-Western migrants. Though confounders and social distance appear to contribute, linguistic disadvantage appears to play a role in the excess psychosis risk in first-generation migrants. CONCLUSION: Reducing the social consequences of linguistic disadvantage or social distance might be a starting point for concrete public health interventions aimed at preventing the increased psychosis risk faced by first-generation migrants.
Subject(s)
Ethnic and Racial Minorities , Psychotic Disorders , Humans , Case-Control Studies , Ethnicity , NetherlandsABSTRACT
To assess the food intake and to evaluate the relationship between socioeconomic status (SES) and food consumption of northeastern Thai children a dietary survey was carried out among 108 urban and rural 3-8-year-olds in Sakon Nakhon province. Energy and nutrient intakes were assessed by the 24 hour recall method and calculated with local food consumption tables. Urban children consumed significantly more eggs and products containing animal proteins than rural children. In urban areas the percentage of users of meat, eggs, and fruit was significantly higher than in rural areas; fish was consumed more frequently in rural areas. As compared with the FAO/WHO RDA (Recommended Daily Allowances) all children showed a very inadequate supply of energy, calcium, iron (except urban children), vitamin A, thiamin, riboflavin, and niacin. The mean daily protein intake was almost equal to or higher than the calculated requirements. Children of lower socioeconomic background showed a lower fat intake, a lower contribution of fat to the energy intake, and a higher contribution of carbohydrates to the energy intake than children from families with a higher SES. This study shows that nutrient intakes far below recommended intakes are common among the examined northeastern Thai children and of a serious nature, and that much more emphasis needs to be given to increase the energy or food intake rather than the protein content of their grossly inadequate diets.
