Differences in prevalence and treatment of bipolar disorder among immigrants: results from an epidemiologic survey (original) (raw)
Related papers
2014
and the introduction to clarify the research questions. For example, in the introduction the text now reads: “This study compared rates of primary care visits, psychiatry visits and hospital use for nonpsychotic mental health disorders for recent immigrants to Ontario from nine world regions of origin to long term residents (LTRs), a group of long term immigrants or Canadian born individuals to whom immigrants were matched on age.” (pgs. 5-6) 3) The authors miss an opportunity to address the more interesting and important policy-relevant question of what the actual mediators or determinants are of the differences they observe. They examine only some of the key indicators available for both immigrants and long-term residents, (i.e. sex and neighborhood income); they do not do any analyses within the immigrant group itself to examine the impact of variables likely to account for the difference: e.g., reason for migration (refugee, family reunification), language proficiency, level of ...
JMIR Mental Health, 2020
Background There is a significant body of evidence on the link between migration and mental health stressors. However, there has been very little research on the use of mental health services by immigrants in Canada. The prevalence of mental health professional consultations among immigrants, as well as its correlations, are not well understood and remain largely unknown. Objective This study aims to examine how specialist mental health visits (to a psychiatrist) differ from general mental health visits (to a family doctor or general practitioner) from immigrants, when compared to visits from those born in Canada, in a nationally representative sample of Canadian adults. This study also examines which group—immigrant or Canadian-born—suffers more from depression or anxiety, 2 of the more common mental health conditions. Methods We used data from the Canadian Community Health Survey (CCHS) between the years 2015 and 2016. The outcome variables included consultation with any mental he...
Journal of racial and ethnic health disparities, 2016
Due to the serious and recurrent nature of bipolar disorder, continuous long-term medication treatment is typically recommended. Little is known about whether these treatment recommendations are effectively implemented for Hispanics. This study examined differences in mood stabilizer use and mental health service utilization between adult English-speaking Hispanic and non-Hispanic white respondents with bipolar disorder. The sample included 163 participants with lifetime bipolar I and II disorders in the National Comorbidity Survey Replication. Demographics, symptom presentation, and acculturation were examined as covariates. None of the 26 Hispanic respondents were taking mood-stabilizing medication, compared to 21 % of non-Hispanic whites, and Hispanics were less likely to receive medications for emotional problems, see a professional for manic episodes, or attend psychotherapy. Even after accounting for differences in symptom profiles and sociodemographics, ethnicity continued to...
Immigrant Mental Health, A Public Health Issue: Looking Back and Moving Forward
The Mental Health Commission of Canada’s (MHCC) strategy calls for promoting the health and wellbeing of all Canadians and to improve mental health outcomes. Each year, one in every five Canadians experiences one or more mental health problems, creating a significant cost to the health system. Mental health is pivotal to holistic health and wellbeing. This paper presents the key findings of a comprehensive literature review of Canadian research on the relationship between settlement experiences and the mental health and well-being of immigrants and refugees. A scoping review was conducted following a framework provided by Arskey and O’Malley (Int J Soc Res Methodol 8:19–32, 2005). Over two decades of relevant literature on immigrants’ health in Canada was searched. These included English language peer-reviewed publications from relevant online databases Medline, Embase, PsycInfo, Healthstar, ERIC and CINAHL between 1990 and 2015. The findings revealed three important ways in which s...
Incidence of psychotic disorders among first-generation immigrants and refugees in Ontario
Canadian Medical Association Journal, 2015
Background: Evidence suggests that migrant groups have an increased risk of psychotic disorders and that the level of risk varies by country of origin and host country. Canadian evidence is lacking on the incidence of psychotic disorders among migrants. We sought to examine the incidence of schizophrenia and schizoaffective disorders in first-generation immigrants and refugees in the province of Ontario, relative to the general population. Methods: We constructed a retrospective cohort that included people aged 14-40 years residing in Ontario as of Apr. 1, 1999. Population-based administrative data from physician billings and hospital admissions were linked to data from Citizenship and Immigration Canada. We used Poisson regression models to calculate age-and sex-adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for immigrant and refugee groups over a 10-year period. Results: In our cohort (n = 4 284 694), we found higher rates of psychotic disorders among immigrants from the Caribbean and Bermuda (IRR 1.60, 95% CI 1.29-1.98). Lower rates were found among immigrants from northern Europe (IRR 0.50, 95% CI 0.28-0.91), southern Europe (IRR 0.60, 95% CI 0.41-0.90) and East Asia (IRR 0.56, 95% CI 0.41-0.78). Refugee status was an independent predictor of risk among all migrants (IRR 1.27, 95% CI 1.04-1.56), and higher rates were found specifically for refugees from East Africa (IRR 1.95, 95% CI 1.44-2.65) and South Asia (IRR 1.51, 95% CI 1.08-2.12). Interpretation: The differential pattern of risk across ethnic subgroups in Ontario suggests that psychosocial and cultural factors associated with migration may contribute to the risk of psychotic disorders. Some groups may be more at risk, whereas others are protected.
Mental Health and Mental Healthcare Utilization in Canada's Immigrant and Ethnocultural Populations
2014
One in five Canadians will experience a mental illness or addiction during their lifetime, but only 50% of those with a current diagnosis of mental illness will actually seek care (Lesage et al., 2006). Canada is home to growing immigrant and ethnocultural populations. Factors of migration, ethnicity, and racialization are important social determinants of mental health. However, Canada's Mental Health Strategy identifies the lack of information available on these diverse populations and calls for further research in order to develop mental health programming (Mental Health Commission, 2012). This three-part doctoral dissertation sought to address these research gaps at the nationallevel, provincial-level, and community-level. The first study, "South Asian Populations in Canada: Migration and Mental Health," was a national-level epidemiological analysis, which examined the prevalence and characteristics of mental health outcomes for South Asian immigrant populations in Canada compared to their South Asian Canadian-born counterparts. The second study, "The Epidemiology of Mental Healthcare Utilization by Service Provider Type for Ontario's Immigrant Populations," was a provincial-level epidemiological analysis examining the prevalence and characteristics of past-year mental health consultation by service provider type for Ontario's immigrant populations. Lastly the third study, "The Barriers and Promoters of Seeking Mental Healthcare: A Mixed Methods Study of Bangladeshi Populations in Toronto," was a community-level mixed methods project investigating the barriers and promoters of seeking mental healthcare identified by Toronto Bangladeshi newcomer and longer-term immigrant populations. These three studies seek to address the knowledge and research gaps identified by Canada's Mental Health Strategy (Mental Health Commission, 2012). This research provides important information on the mental health outcomes, mental health service utilization, and Research Centre. In addition, I would like to thank the donors of the Armand and Denise La Barge Graduate Scholarship in Multiculturalism for believing in my work. vi
Community survey of bipolar disorder in Canada: lifetime prevalence and illness characteristics
Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2006
This study reports on the lifetime prevalence and illness characteristics of bipolar disorder (BD) in a large, representative sample of Canadians. Data were obtained from the Canadian Community Health Survey: Mental Health and Well-Being. This representative, cross-sectional survey, conducted by Statistics Canada in 2002, examines the mental health of Canadians aged 15 years and over. The national response rate was 77%. We determined the prevalence rate of BD, correlates of a bipolar diagnosis, and illness characteristics. The weighted lifetime prevalence rate of BD was 2.2% (95% confidence interval [CI], 1.94% to 2.37%). Younger age, low income adequacy, lifetime anxiety disorder, and presence of a substance use disorder in the past 12 months were each significantly associated with the presence of a BD diagnosis (P < 0.001 for each). The largest effect found was for the presence of an anxiety disorder (odds ratio 7.94; 95% CI, 6.35 to 9.92). A lifetime history of anxiety disorde...
Examining the “Healthy Immigrant Effect” for Mental Health in Canada
University of Toronto Medical Journal (UTMJ), 2013
"This paper is a literature review examining the evidence for and against the existence of the “healthy immigrant effect” for mental health in Canada, a phenomenon where the foreign-born population has better levels of mental health compared to the national-born population. The methodological strengths and weaknesses of the present body of literature are examined, followed by recommendations for future research. The literature review yielded inconclusive evidence. The “healthy immigrant effect” for mental health did not hold true across all immigrant populations. It varied by factors such as country of origin, visible minority status, and wave of immigration. Future studies need to consider these important factors and include analyses of longitudinal data to further elucidate the “healthy immigrant effect” for mental health in Canada."
Chronic diseases and injuries in Canada, 2011
Informed provision of population mental health services requires accurate estimates of disease burden. We estimated the treated prevalence of bipolar disorders by mental health services in the Calgary Zone, a catchment area in Alberta with a population of over one million. Administrative data in a central repository provides information of mental health care contacts for about 95% of publically funded mental health services. We compared this treated prevalence against self-reported data in the 2002 Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2). Of the 63 016 individuals aged 18 years plus treated in the Calgary Zone in 2002-2008, 3659 (5.81%) and 1065 (1.70%) were diagnosed with bipolar I and bipolar II disorder, respectively. The estimated treated population prevalence of these disorders was 0.41% and 0.12%, respectively. We estimated that 0.44% to 1.17% of the Canadian population was being treated by psychiatrists for bipolar I disorder from CCHS 1.2. F...
Canadian Journal of Public Health
Objectives Mental health and neurocognitive conditions are important causes of hospitalization among immigrants, though patterns may vary by immigrant category, world region of origin, and time since arrival in Canada. This study uses linked administrative data to explore differences in mental health hospitalization rates between immigrants and individuals born in Canada. Methods Hospital records from the Discharge Abstract Database and the Ontario Mental Health Reporting System for 2011 to 2017 were linked to the 2016 Longitudinal Immigrant Database and to Statistics Canada’s 2011 Canadian Census Health and Environment Cohort. Age-standardized hospitalization rates for mental health–related conditions (ASHR-MHs) were derived for immigrants and the Canadian-born population. ASHR-MHs overall and for leading mental health conditions were compared between immigrants and the Canadian-born population, stratified by sex and selected immigration characteristics. Quebec hospitalization data...