Age at migration and future risk of psychotic disorders among immigrants in the Netherlands: a 7-year incidence study

Wim Veling*, Hans W. Hoek, Jean-Paul Selten, Ezra Susser

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


OBJECTIVE: The purpose of this study was to examine whether the increased risk for developing a psychotic disorder among immigrants is related to their age at the time of migration.

METHOD: In a 7-year first-contact incidence study, immigrants to the Netherlands and Dutch citizens, ages 15-54 years, who made a first contact with a physician for a suspected psychotic disorder were identified. Diagnostic interviews were administered, and DSM-IV diagnoses were determined by consensus between two psychiatrists. A comprehensive municipal registration system provided the denominator, including information on ethnicity and age at the time of migration.

RESULTS: Lower age at the time of migration was associated with a higher incidence of psychotic disorders among immigrants. People who migrated between the ages of 0 and 4 years had the most elevated risk for psychotic disorders compared with the risk among Dutch citizens (age- and sex-adjusted incidence rate ratio=2.96, 95% confidence interval [CI]=2.10-4.17), and the risk gradually decreased with older age at migration (adjusted incidence rate ratio for migration at 5-9 years, 10-14 years, and >29 years, respectively: 2.31 [CI=1.61-3.29], 1.51 [CI=1.02-2.25], and 1.00 [CI=0.58-1.72]).

CONCLUSIONS: The adverse influence of migration on the risk for psychotic disorders is most prominent in early life, suggesting that this is an important period in the etiology of the illness.

Original languageEnglish
Pages (from-to)1278-85
Number of pages8
JournalAmerican Journal of Psychiatry
Issue number12
Publication statusPublished - Dec 2011


  • Adolescent
  • Adult
  • Age Factors
  • Cohort Studies
  • Emigrants and Immigrants
  • Emigration and Immigration
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Netherlands
  • Psychotic Disorders
  • Risk Factors
  • Journal Article
  • Research Support, Non-U.S. Gov't

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