A dimensional approach to the psychopathology of migrants: a cross-sectional matched sample study

Abstract

Objectives
Moving to a foreign country, whether out of necessity, seeking refuge, opportunity or mere curiosity, makes the individual more vulnerable to mental disorders. Even in the same conditions, many factors contribute to make migrants more susceptible to this risk than the natives. Among many, these include linguistic and cultural differences. Unfortunately, these differences lead to a higher frequency of ‘not otherwise specified’ diagnoses in this part of the population. This limitation can lead to greater difficulties in therapeutic choices and epidemiological assessments. This study aims to enhance the clinician’s resources by testing a trans-diagnostic, dimensional, psychopathological approach in the assessment of a group of migrants and a control group of natives referred to a psychiatric outpatient service.
Methods
The two groups of patients were matched for gender, age, categorical diagnosis and level of clinical severity. The SVARAD scale was used for the dimensional assessment, diagnoses were assigned according to DSM IV-TR criteria.
Results
A total of n = 224 patients, including cases (n = 112) and controls (n = 112), were recruited and agreed to participate in the study. The dimensions somatization, obsessiveness, and activation showed a significant difference between groups (p = .018; .011; .004, respectively). Given the same degree of severity and the same diagnosis, migrants with mental disorders showed less activation and greater somatization.
Conclusions
Cross-cultural aspects and language differences, as well as the same social status of “migrant”, are certainly implicated in these differences. By taking these dimensional aspects into account, clinicians could achieve greater precision in the diagnostic process and determine a significant change in the care of this risk group.