title: Migrant status, age, gender and social isolation in very late-onset schizophrenia-like psychosis.
abstract: BACKGROUND
  Data from two retrospective first contact studies suggest that the risk of developing very-late onset schizophrenia-like psychosis (SLP) may be raised in older migrant than British-born populations resident in the UK.
  
  
  OBJECTIVE
  To investigate whether the relative excess of SLP observed amongst younger and male migrants in the above studies might have been explained by differences in the age-gender structures of migrant and British-born denominator populations. A secondary aim was to examine the associations of migrant group status and gender with markers of social isolation.
  
  
  METHODS
  Eighty-six new referrals of SLP to the Mile End (1997-2003) and Maudsley (1995-2000) hospitals were identified from two retrospective case note studies. Local census data were used to estimate the denominator populations and to calculate rate ratios for migrant and British-born cases of SLP. Case notes were re-examined, to assess markers of social isolation in migrant and British-born patients.
  
  
  RESULTS
  Migrant patients were more likely to be male (odds ratio = 4.8; CI(odds) = 1.8-13.2) than British-born patients. The ratio of first contact rates for migrant compared to British-born populations were highest amongst men. There was a lower mean age of onset of SLP in migrant than British-born patients (t = 4.30, 95% CI = 3.78-10.27), which was largely explained by a higher mean age of illness onset in British-born women. There were no differences between migrant and British-born patients with respect to markers of social isolation. Male patients were more likely to have never married than women (odds ratio = 0.28; 95% CI odds = 0.09-0.89).
  
  
  CONCLUSIONS
  The age-gender structure of the background population is not sufficient to explain the socio-demographic differences between migrant and British-born patients with SLP. Male patients may be more socially isolated.
authors.affiliation: Old Age Psychiatry, Manzil Way Offices, Manzil Way, Cowley Road, Oxford, UK. paminamitter@doctors.org.uk
authors.forename: P
authors.initials: P
authors.lastname: Mitter
authors.forename: S
authors.initials: S
authors.lastname: Reeves
authors.forename: F
authors.initials: F
authors.lastname: Romero-Rubiales
authors.forename: P
authors.initials: P
authors.lastname: Bell
authors.forename: R
authors.initials: R
authors.lastname: Stewart
authors.forename: R
authors.initials: R
authors.lastname: Howard
mesh_terms: D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D017533:Marital Status; D011618:Psychotic Disorders / Q000208:ethnology* / Q000209:etiology*; D012111:Residence Characteristics; D012189:Retrospective Studies; D012307:Risk Factors; D012559:Schizophrenia / Q000208:ethnology* / Q000209:etiology*; D012737:Sex Factors; D012934:Social Isolation / Q000523:psychology