PSYCHIATRIC-DISORDERS AMONG MIGRANTS IN GERMANY - PREVALENCE IN A PSYCHIATRIC CLINIC AND IMPLICATIONS FOR SERVICES AND RESEARCH

Past studies examining the prevalence of psychiatric disorders among m igrants have described a higher rate of schizophrenia, whereas the onl y major German study found a lower rate. Considering the changed compo sition of migrants today, a new assessment has become necessary. All a dmission records of migrants to a psychiatric clinic in 1993 and 1994 were assessed for diagnosis, symptomatology and treatment. Two hundred sixty-three migrant admissions, 8.4% of total admissions, were assess ed. Of these 41.4% received a diagnosis of a schizophrenic disorder, s ignificantly more than other clinic patients. The mean age at admissio n was 33.8 years, at onset of illness 28.6 years and at time of migrat ion 20.3 years. Only 7.9% were mentally ill at the time of migration. Of those with psychotic and depressive symptoms at admission, 70% rece ived a diagnosis of a schizophrenic disorder and 78% were treated with antipsychotics. Antidepressants were prescribed only to 47% of those with a diagnosis of a depressive disorder and only 33% of those with d epressive and no psychotic symptoms. An underrepresentation of migrant s shows differences in the use of psychiatric services. The higher rat e of schizophrenia may be due to misdiagnosis, an artifactual effect o f underrepresentation of other disorders or an actual higher rate amon g migrants. The reluctance to use antidepressants underlines the neces sity of training, so as not to withhold treatment options due to cultu ral barriers.