The effect of ethnicity and immigration on treatment resistance in schizophrenia

Compr Psychiatry. 2019 Feb:89:28-32. doi: 10.1016/j.comppsych.2018.12.003. Epub 2018 Dec 7.

Abstract

Background: Treatment resistance is a common issue among schizophrenia patients undergoing antipsychotic treatment. According to the American Psychiatric Association (APA) guidelines, treatment-resistant status is defined as little or no symptom reduction to at least two antipsychotics at a therapeutic dose for a trial of at least six weeks. The aim of the current study is to determine whether ethnicity and migration are associated with treatment resistance.

Methods: In a sample of 251 participants with schizophrenia spectrum disorders, we conducted cross-sectional assessments to collect information regarding self-identified ethnicity, immigration and treatment history. Ancestry was identified using 292 markers overlapping with the HapMap project. Using a regression analysis, we tested whether a history of migration, ethnicity or genetic ancestry were predictive of treatment resistance.

Results: Our logistic regression model revealed no significant association between immigration (OR = 0.04; 95%CI = 0.35-3.07; p = 0.93) and treatment resistant schizophrenia. White Europeans did not show significant association with resistance status regardless of whether ethnicity was determined by self-report (OR = 1.89; 95%CI = 0.89-4.20; p = 0.105) or genetic analysis (OR = -0.73; 95%CI = -0.18-2.97; p = 0.667).

Conclusion: Neither ethnicity nor migrant status was significantly associated with treatment resistance in this Canadian study. However, these conclusions are limited by the small sample size of our investigation.

Keywords: Antipsychotics; Ethnicity; Migration; Schizophrenia; Treatment resistance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antipsychotic Agents / therapeutic use
  • Canada
  • Cross-Sectional Studies
  • Emigrants and Immigrants / psychology*
  • Ethnicity / psychology*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / ethnology*
  • Patient Acceptance of Health Care / psychology
  • Schizophrenia / ethnology*
  • Schizophrenic Psychology*
  • Self Report
  • White People / psychology

Substances

  • Antipsychotic Agents