Schizophrenia among Surinamese in the Netherlands: high admission rates not explained by high emigration rates

Background. A high risk of schizophrenia has been found among Caribbean immigrants in the Netherlands and Great Britain. One hypothesis to explain these findings is that patients with a diagnosis of schizophrenia or patients with symptoms of psychosis not specifically diagnosed, emigrate more than the general population. Such selection might account for high rates of Surinamese patients with a diagnosis of schizophrenia in Netherlands psychiatric hospitals. We examined this hypothesis. Methods. The files of patients with schizophrenia or patients suffering from unspecified psychosis were selected from the archives of the National Psychiatric Hospital in Surinam. These patients were traced to investigate patterns of emigration. Data from the Central Bureau for Statistics in the Netherlands and from the Central Population Bureau in Surinam provided the percentage of the general Surinamese population that emigrated to the Netherlands. The difference between the two percentages was evaluated using the chi-squared test. Using the same method the percentage of remigration from the Netherlands among Surinamese patients was compared with the percentage of remigration among the general Surinamese population. Results. Surinamese patients with schizophrenia or unspecified psychosis did not emigrate more frequently to the Netherlands compared with the general Surinamese population. They did remigrate significantly more frequently. Conclusion. High migration rates do not explain the high hospital admission rates for schizophrenia among Surinamese in the Netherlands.