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

BMJ Glob Health. 2020 Sep;5(9):e002471. doi: 10.1136/bmjgh-2020-002471.


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.

Keywords: epidemiology; mental health & psychiatry.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Africa South of the Sahara
  • Cohort Studies
  • Humans
  • Longitudinal Studies
  • Middle East
  • Sweden / epidemiology
  • Transients and Migrants*