title: Ethnic enclaves and risk of psychiatric disorders among first- and second-generation immigrants in Sweden.
abstract: OBJECTIVE
  Some non-Western immigrant groups in Europe have elevated risk of psychosis relative to native-born. It is hypothesized that neighborhood ethnic density moderates this risk. Immigration to Sweden has increased substantially recently, particularly from the Middle East. This study examined the relationship between neighborhood ethnic density (i.e., living in an immigrant enclave) and risk of psychotic and affective disorders among three groups: Iraqi immigrants, immigrants from other nations, and native-born Swedes.
  
  
  METHODS
  Individuals aged 15-60, without prevalent psychopathology, were drawn from Swedish population-based registries and followed from 2005 to 2010 (N = 950,979). Multi-level logistic regression was used to examine the association between neighborhood ethnic composition and incident psychopathology.
  
  
  RESULTS
  Cumulative incidence of psychopathology was greater in Iraqi enclaves relative to predominantly Swedish neighborhoods (6.3 vs. 4.5%). Iraqis living in enclaves did not have significantly greater risk of psychosis (Odds Ratio (OR): 1.66, 95% Confidence Interval (CI) 0.92-2.97) or affective disorders (OR: 1.04, 95%CI 0.85-1.27) relative to those in predominantly Swedish neighborhoods. There was no increased risk of psychosis (OR: 0.93, p > 0.05) or affective disorders (OR: 0.93, p > 0.05) for other immigrants living in an enclave. Swedes living in an enclave had elevated risk of both psychosis (OR: 1.37, p < 0.05) and affective disorders (OR: 1.14, p < 0.05) relative to those in predominantly Swedish neighborhoods. Second-generation Iraqis had higher risk of psychotic but not affective disorders relative to first-generation.
  
  
  CONCLUSIONS
  Neighborhood ethnic density does not moderate risk of psychopathology for immigrants in Sweden. Findings regarding Swedes are consistent with social drift.
authors: Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, One Capitol Plaza, Suite 824, PO Box 980212, Richmond, VA, USA. bmezuk@vcu.edu.|Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA. bmezuk@vcu.edu.|Institute for Social Research, University of Michigan, Ann Arbor, MI, USA. bmezuk@vcu.edu.
authors: Briana
authors: B
authors: Mezuk
authors: Center for Primary Health Care Research, Lund University, Malmö, Sweden.
authors: Xinjun
authors: X
authors: Li
authors: Center for Primary Health Care Research, Lund University, Malmö, Sweden.
authors: Klas
authors: K
authors: Cederin
authors: Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, One Capitol Plaza, Suite 824, PO Box 980212, Richmond, VA, USA.
authors: Jeannie
authors: J
authors: Concha
authors: Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
authors: Kenneth S
authors: KS
authors: Kendler
authors: Center for Primary Health Care Research, Lund University, Malmö, Sweden.|Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA.
authors: Jan
authors: J
authors: Sundquist
authors: Center for Primary Health Care Research, Lund University, Malmö, Sweden.|Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA.
authors: Kristina
authors: K
authors: Sundquist
mesh_terms: D000293:Adolescent; D000328:Adult; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D007493:Iraq / Q000208:ethnology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology*; D055361:Multilevel Analysis; D011156:Population Density; D011618:Psychotic Disorders / Q000453:epidemiology*; D012042:Registries; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D018570:Risk Assessment; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: Depression; Immigrants; Multi-level; Neighborhood; Psychosis