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First episodes of psychosis in Afro-Caribbean and White people

An 18-year follow-up population-based study

Published online by Cambridge University Press:  02 January 2018

Noriyoshi Takei ,
Rajendra Persaud ,
Peter Woodruff ,
Ian F. Brockington  and
Robin M. Murray
Noriyoshi Takei*
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, London
Rajendra Persaud
Affiliation:
Westways Rehabilitation Unit, West Croydon, Surrey
Peter Woodruff
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, London
Ian F. Brockington
Affiliation:
Department of Psychiatry, Queen Elizabeth Psychiatric Hospital, Birmingham
Robin M. Murray
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, London
*
Dr Noriyoshi Takei. Department of Psychological Medicine. Institute of Psychiatry, Denmark Hill. London. SE5 8AF. Fax: 0171-701-9044; e-mail: [email protected]
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Abstract

Background

There have been few prospective studies of the long-term outcome of psychosis in people of Afro-Caribbean origin in the UK.

Method

We followed-up a population-based, consecutive series of 34 Afro-Caribbean and 54 White people with psychosis who had been extensively investigated during their first admission in 1973/74. Diagnoses were made by direct interview using the Present State Examination at both first admission and follow-up.

Results

Ninety-seven per cent of the original sample were traced. A slightly greater proportion of the Afro-Caribbean people were assigned to the S+ Catego class (schizophrenia), both on first assessment and at follow-up. No difference was found between the two groups in the consistency of diagnosis over the 18 years or in the proportion of patients considered psychotic but Afro-Caribbean people tended to have fewer negative symptoms at follow-up. There were striking differences between the two groups in their experience of psychiatric care; Afro-Caribbean people were more likely to have been readmitted, to have experienced longer hospitalisations, and to have undergone more involuntary admissions than their White counterparts.

Conclusions

Afro-Caribbean people who met clinical and research criteria for schizophrenia had a less satisfactory experience of, and response to, psychiatric care over 18 years than their White counterparts.

Type
Papers
Information
The British Journal of Psychiatry , Volume 172 , Issue 2 , February 1998 , pp. 147 - 153
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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References

Brockington, I. F. Kendell, R. E. & Leff, J. P. (1978) Definitions of schizophrenia: Confordance and prediction of outcome. Psychological Medicine, 8, 387–398.Google Scholar
Endicott, J. Spitzer, R. L. Fleiss, J. L. et al (1976) The Global Assessment Scale. Archives of General Psychiatry, 33, 766–771.Google Scholar
Fernando, S. (1988) Race and Culture in Psychiatry, London: Groom Helm.Google Scholar
Gordon, E. D. (1965) Mentally ill West Indian immigrants. British Journal of Psychiatry, III, 877–887.CrossRefGoogle Scholar
Harrison, G. Owens, D. Holton, A. et al (1988) A prospective study of severe mental disorder in Afro-Caribbean patients. Psychological Medicine, 18, 643–657.Google Scholar
Hutchinson, G. Takei, N. Fahy, T. A. et al (1996) Morbid risk of schizophrenia in first-degree relatives of White and African-Caribbean patients with psychosis. British Journal of Psychiatry, 169, 776–780.Google Scholar
Lewis, G. Croft-Jeffreys, C. & David, A. (1990) Are British psychiatrists racist? British Journal of Psychiatry, 157, 410–415.CrossRefGoogle ScholarPubMed
Littlewood, R. & Lipsedge, M. (1981) Acute psychotic reactions in Caribbean born patients. Psychological Medicine, II. 303–318.Google Scholar
Littlewood, R. (1992) Psychiatric diagnosis and racial bias: empirical and interpretative approaches. Social Science and Medicine, 34, 141–149.Google Scholar
McGovern, D. Hemmings, P. Cope, R. et al (1994) Long-term follow-up of young Afro-Caribbean Britons and white Britons with a first admission diagnosis of schizophrenia. Social Psychiatry and Psychiatric Epidemiology 29, 8–19.Google Scholar
McKenzie, K. Van Os, J. Fahy, T. et al (1995) Psychosis with good prognosis in Afro-Caribbean people now living in the United Kingdom. British Medical Journal, 311, 1325–1328.CrossRefGoogle ScholarPubMed
Paykel, E. S. Weissman, M. M. & Prusoff, B. A. (1978) Social maladjustment and severity of depression. Comprehensive Psychiatry, 19, 121–128.Google Scholar
Twefik, G. I. & Okasha, A. (1965) Psychosis and immigration. Postgraduate Medical Journal, 41, 603–612.Google Scholar
Van Os, J. Castle, D. J. Takei, N. et al (1996) Psychotic illness in ethnic minorities: classification from the 1991 census. Psychological Medicine, 26, 203–208.Google Scholar
Wing, L. Bramley, C. Hailey, A. et al (1968) Camberwell Cumulative Psychiatric Case Register. Part I: Aims and Methods. Social Psychiatry, 3, 116–123.CrossRefGoogle Scholar
Wing, J. K. Cooper, J. E. & Sartorius, N. (1974) The Measurement of Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
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