First episode psychosis among migrants in Italy (PEP-Ita Study): preliminary results from Modena.

Purpose. Literature shows that migrants have a higher incidence of psychotic disorders; post-migratory social adversities and discrimination are considered the main environmental risk factors. A recent study of the Bologna Transcultural Psychiatric Team (BoTPT) suggested that psychotic disorders in migrants may have a peculiar psychopathological configuration, characterized by the prevalence of somatic symptoms over positive and negative symptoms. The aim of the present study is to explore the correlation between environmental risk factors and psychopathology in a sample of migrants with a first-episode psychosis. Methods. Through the PEP-Ita (Primo Episodio Psicotico – Italia) study, an Italian multicentric research project exploring risk factors for first-episode psychosis in a population of first-generation migrants, we recruited 79 patients aged 18-64 between January 2012 and December 2013. Social adversities and perceived discrimination were recorded through the Migration History Questionnaire (MHQ), the Discrimination Interview and the Social Environment Assessment Tool (SEAT). The Association for Methodology and Documentation in Psychiatry (AMDP) system was used to assess the psychopathology: symptoms were pooled into eight psychopathological syndromes (positive, negative, depressive, manic, psychoorganic, obsessive-compulsive, hostility and somatic). T-student test was used to study the correlation between the scores of the eight syndromes and the environmental risk factors. Results. Among the 79 patients currently recruited in the study, 27 have so far agreed and managed to answer our questionnaires. Those patients who recently perceived discrimination in at least three domains of life reported higher scores in the somatic syndromes (2.5±0.7 vs 0.3±0.8, p=0.056), and so did those who perceived an economic deterioration (2.5±1.7 vs 0.4±0.9, p=0.01) and poor quality of work position (2.1±2.9 vs 0.2±0.6, p=0.043) after the migration process. Those who went through economic troubles had higher scores of positive (22±6.5 vs 12.7±7.6, p=0.025) and somatic (3.2±3.3 vs 0.4±1.3, p=0.003) syndromes, while those who reported family adversities after resettlement showed higher scores of hostility syndrome (10.6±3.7 vs 5.9±4.3, p=0.016). Discussion. Despite the small size of the current sample we found that, in migrant patients presenting a first-episode psychosis, the perception of discrimination impacted on the somatic dimension of disease, which in a recent study of ours showed to be the main psychopathological dimension of psychotic disorders in migrants. Also the perception of socioeconomic, work and family-related adversities shaped some of the psychopathological dimensions (positive, hostility) underlying psychotic disorders in migrants.