Psychiatric care use among migrants to Sweden compared with Swedish-born residents: a longitudinal cohort study of 5 150 753 people

Background To investigate differences in psychiatric care use over time between Swedish born and those born abroad who migrate to Sweden.Methods Population-based cohort study analysing linked population and health registers, following individuals born 1944–1990 from 1 January 2005 to 31 December 201...

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Main Authors: James B Kirkbride, Christina Dalman, Anna-Clara Hollander, Euan Mackay, Hugo Sjöqvist, Sofie Bäärnhielm
Format: Article
Language:English
Published: BMJ Publishing Group 2020-09-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/5/9/e002471.full
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author James B Kirkbride
Christina Dalman
Anna-Clara Hollander
Euan Mackay
Hugo Sjöqvist
Sofie Bäärnhielm
author_facet James B Kirkbride
Christina Dalman
Anna-Clara Hollander
Euan Mackay
Hugo Sjöqvist
Sofie Bäärnhielm
author_sort James B Kirkbride
collection DOAJ
description Background To investigate differences in psychiatric care use over time between Swedish born and those born abroad who migrate to Sweden.Methods Population-based cohort study analysing linked population and health registers, following individuals born 1944–1990 from 1 January 2005 to 31 December 2016. Time-stratified survival analysis using Cox regression estimated time to psychiatric care use. Population included 5 150 753 individuals with 78.1% Swedish born. Migrant status was coded as Swedish born or migrant. Migrants were grouped by year of immigration and region of origin. The main outcome: psychiatric care use, defined as any psychiatric care; psychiatric inpatient or outpatient care; or use of psychotropics.Results Migrants arriving before 2005 had a higher use of any psychiatric care relative to Swedish born but migrants arriving 2005 onwards had lower use. Migrants from sub-Saharan Africa and Asia had a lower use of any psychiatric care during the first decade in Sweden whereas migrants from Middle East and North Africa had a higher use, driven by use of psychotropics.Conclusions The lower use of psychiatric care during the first decade contrasts with higher use among migrants with a longer duration of stay. Psychiatric care use among migrants should be analysed multi-dimensionally, taking duration of stay, region of origin and type of care into account.
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spelling doaj-art-0116a8b4b2634a1f8a07aa631f2e59732025-08-20T02:31:13ZengBMJ Publishing GroupBMJ Global Health2059-79082020-09-015910.1136/bmjgh-2020-002471Psychiatric care use among migrants to Sweden compared with Swedish-born residents: a longitudinal cohort study of 5 150 753 peopleJames B Kirkbride0Christina Dalman1Anna-Clara Hollander2Euan Mackay3Hugo Sjöqvist4Sofie Bäärnhielm5Division of Psychiatry, Faculty of Brain Sciences, UCL, London, UK1 Department of Global Public Health, Karolinska Institutet, Stockholm, SwedenDepartment of Global Public Health, Karolinska Institutet, Stockholm, SwedenGlobal Public Health Sciences, Karolinska Institutet, Stockholm, SwedenGlobal Public Health Sciences, Karolinska Institutet, Stockholm, SwedenTranscultural Center, Stockholm, SwedenBackground To investigate differences in psychiatric care use over time between Swedish born and those born abroad who migrate to Sweden.Methods Population-based cohort study analysing linked population and health registers, following individuals born 1944–1990 from 1 January 2005 to 31 December 2016. Time-stratified survival analysis using Cox regression estimated time to psychiatric care use. Population included 5 150 753 individuals with 78.1% Swedish born. Migrant status was coded as Swedish born or migrant. Migrants were grouped by year of immigration and region of origin. The main outcome: psychiatric care use, defined as any psychiatric care; psychiatric inpatient or outpatient care; or use of psychotropics.Results Migrants arriving before 2005 had a higher use of any psychiatric care relative to Swedish born but migrants arriving 2005 onwards had lower use. Migrants from sub-Saharan Africa and Asia had a lower use of any psychiatric care during the first decade in Sweden whereas migrants from Middle East and North Africa had a higher use, driven by use of psychotropics.Conclusions The lower use of psychiatric care during the first decade contrasts with higher use among migrants with a longer duration of stay. Psychiatric care use among migrants should be analysed multi-dimensionally, taking duration of stay, region of origin and type of care into account.https://gh.bmj.com/content/5/9/e002471.full
spellingShingle James B Kirkbride
Christina Dalman
Anna-Clara Hollander
Euan Mackay
Hugo Sjöqvist
Sofie Bäärnhielm
Psychiatric care use among migrants to Sweden compared with Swedish-born residents: a longitudinal cohort study of 5 150 753 people
BMJ Global Health
title Psychiatric care use among migrants to Sweden compared with Swedish-born residents: a longitudinal cohort study of 5 150 753 people
title_full Psychiatric care use among migrants to Sweden compared with Swedish-born residents: a longitudinal cohort study of 5 150 753 people
title_fullStr Psychiatric care use among migrants to Sweden compared with Swedish-born residents: a longitudinal cohort study of 5 150 753 people
title_full_unstemmed Psychiatric care use among migrants to Sweden compared with Swedish-born residents: a longitudinal cohort study of 5 150 753 people
title_short Psychiatric care use among migrants to Sweden compared with Swedish-born residents: a longitudinal cohort study of 5 150 753 people
title_sort psychiatric care use among migrants to sweden compared with swedish born residents a longitudinal cohort study of 5 150 753 people
url https://gh.bmj.com/content/5/9/e002471.full
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