Full spectrum of psychiatric disorders related to foreign migration: a Danish population-based cohort study

JAMA Psychiatry. 2013 Apr;70(4):427-35. doi: 10.1001/jamapsychiatry.2013.441.


Importance: Although increased risk for schizophrenia among immigrants is well established, knowledge of the broader spectrum of psychiatric disorders associated with a foreign migration background is lacking.

Objective: To examine the full range of psychiatric disorders associated with any type of foreign migration background among persons residing in Denmark, including foreign-born adoptees, first- and second-generation immigrants, native Danes with a history of foreign residence, and persons born abroad to Danish expatriates.

Design and setting: Danish population-based cohort study. Persons were followed up from their 10th birthday for the development of mental disorders based on outpatient and inpatient data.

Participants: All persons born between January 1, 1971, and December 31, 2000 (N = 1 859 419) residing in Denmark by their 10th birthday with follow-up data to December 31, 2010.

Main outcome measures: Incidence rate ratios (IRRs) and cumulative incidences for psychiatric outcomes.

Results: All categories of foreign migration background, except persons born abroad to Danish expatriates, were associated with increased risk for at least 1 psychiatric disorder. Foreign-born adoptees had increased IRRs for all psychiatric disorders and had the highest IRRs for these disorders compared with other foreign migration categories. First- and second-generation immigrants having 2 foreign-born parents had significantly increased IRRs for schizophrenia and schizophrenia spectrum disorders and had similar risk magnitudes. Second-generation immigrants having 1 foreign-born parent had significantly increased IRRs for all psychiatric disorders. Native Danes with a history of foreign residence had increased IRRs for bipolar affective disorder, affective disorders, personality disorders, and schizophrenia spectrum disorders.

Conclusions and relevance: The extent to which a background of foreign migration confers an increased risk for the broad spectrum of psychiatric disorders varies according to parental origin, with greatest risks for foreign-born adoptees. The spectrum of psychiatric disorders showed greater variation within the second-generation immigrant group than between first-generation vs second-generation immigrants, and the spectrum differed according to whether individuals had 1 or 2 foreign-born parents.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Bipolar Disorder / epidemiology
  • Bipolar Disorder / ethnology
  • Bipolar Disorder / etiology
  • Child
  • Cohort Studies
  • Denmark / epidemiology
  • Emigrants and Immigrants / psychology*
  • Female
  • Humans
  • Incidence
  • Male
  • Mental Disorders / epidemiology
  • Mental Disorders / ethnology
  • Mental Disorders / etiology*
  • Mood Disorders / epidemiology
  • Mood Disorders / ethnology
  • Mood Disorders / etiology
  • Personality Disorders / epidemiology
  • Personality Disorders / ethnology
  • Personality Disorders / etiology
  • Risk Factors
  • Schizophrenia / epidemiology
  • Schizophrenia / ethnology
  • Schizophrenia / etiology
  • Sex Factors
  • Young Adult