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Schizophrenia and Afro-Caribbeans a Case-Control Study

Published online by Cambridge University Press:  02 January 2018

S. Wessely*
Affiliation:
Department of Forensic Psychiatry, Institute of Psychiatry, London
D. Castle
Affiliation:
Department of Psychological Medicine, King's College Hospital and Institute of Psychiatry
G. Der
Affiliation:
MRC Social Psychiatry Unit, Institute of Psychiatry
R. Murray
Affiliation:
King's College Hospital and Institute of Psychiatry
*
Senior Lecturer, Department of Psychological Medicine, King's College Hospital and Institute of Psychiatry, Denmark Hill, London SE5 8RS

Abstract

A case-control study was performed using 90% of all first-contact patients with a clinical diagnosis of schizophrenia residing in the London borough of Camberwell between 1965 and 1984. Cases and controls were obtained from the Camberwell psychiatric case register. Controls were those presenting with first episodes of non-psychotic disorders, matched for age, sex and period. The risk of schizophrenia was greater in those of Afro-Caribbean ethnicity, irrespective of age, gender or place of birth. This risk increased over the study period. The results cannot be explained by changes in the age, gender or ethnic structure of the local population. Effects of misdiagnosis or change in diagnostic practice were reduced by using uniform operational criteria. Possible explanations include maternal exposure to unfamiliar infective agents, a differential fall in the age at onset of illness, or worsening social adversity.

Type
Papers
Copyright
Copyright © 1991 The Royal College of Psychiatrists 

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References

Balarajan, R., Raleigh, V. S. & Botting, B. (1989) Mortality from congenital malformations in England and Wales: variations by mother's country of birth. Archives of Disease in Childhood, 64, 14571462.Google Scholar
Bebbington, P., Hurry, J. & Tennant, C. (1981) Psychiatric disorders in selected immigrant groups in Camberwell. Social Psychiatry, 16, 4351.CrossRefGoogle Scholar
Beiser, M. & Iacono, W. (1990) An update on the epidemiology of schizophrenia. Canadian Journal of Psychiatry, 35, 657668.CrossRefGoogle ScholarPubMed
Brown, C. (1984) Black and White Britain: The Third PSI Survey. London: Heinemann.Google Scholar
Cochrane, R. & Bal, R. (1989) Mental hospital admission rates of immigrants to England: a comparison of 1971 and 1981. Social Psychiatry, 24, 211.Google Scholar
Cruickshank, J. & Beevers, D. (1989) Migration, ethnicity, health and disease. In Ethnic Factors in Health and Disease (eds Cruikshank, J. & Beevers, D.), pp. 36. London: Wright.Google Scholar
Der, C., Gupta, S. & Murray, R. (1990) Is schizophrenia disappearing? Lancet, 335, 513516.CrossRefGoogle Scholar
Eaton, W. (1985) Epidemiology of schizophrenia. Epidemiologic Reviews, 7, 105126.Google Scholar
Gardner, M. & Altman, D. (1989) Statistics with Confidence. London: British Medical Journal.Google Scholar
Glover, G. (1989a) The pattern of psychiatric admissions of Caribbean-born immigrants in London. Social Psychiatry, 24, 4956.Google Scholar
Glover, G. (1989b) Why is there a high rate of schizophrenia in British Afro-Caribbeans? British Journal of Hospital Medicine, 42, 4851.Google Scholar
Harrison, G. (1989) A perspective from Nottingham, UK. In Ethnic Factors in Health and Disease (eds Cruickshank, J. & Beevers, D.), pp. 194200. London: Wright.Google Scholar
Harrison, G. (1990) Searching for the causes of schizophrenia: the role of migrant studies. Schizophrenia Bulletin, 16, 663671.Google Scholar
Harrison, G., Owens, D., Holton, A., et al (1988) A prospective study of severe mental illness in Afro-Caribbean patients. Psychological Medicine, 18, 643647.Google Scholar
Harvey, I., Williams, M., McGuffin, P., et al (1990) The functional psychoses in Afro-Caribbeans. British Journal of Psychiatry, 157, 515522.Google Scholar
Kirkwood, B. (1989) Essentials of Medical Statistics. Oxford: Blackwell Scientific Publications.Google Scholar
Kleinman, A. (1977) Depression, somatisation and the new “cross cultural” psychiatry. Social Science & Medicine, 11, 310.Google Scholar
Lewis, G., Croft-Jeffreys, C. & David, A. (1990) Are British psychiatrists racist? British Journal of Psychiatry, 157, 410415.Google Scholar
Littlewood, R. & Lipsedge, M. (1982) Aliens and Alienists: Ethnic Minorities and Psychiatry. Harmondsworth: Penguin.Google Scholar
Littlewood, R. & Lipsedge, M. (1988) Psychiatric illness among British Afro-Caribbeans. British Medical Journal, 296, 950951.Google Scholar
Luck, D. (1966) Poliomyelitis in Jamaica: a short history with comments upon the effects of immunization. West Indies Medical Journal, 15, 189196.Google Scholar
McGovern, D. & Cope, R. (1987) First psychiatric admission rates of first and second generation Afro Caribbeans. Social Psychiatry, 22, 139149.CrossRefGoogle ScholarPubMed
McGuffin, P., Farmer, A. & Harvey, I. (1991) A polydiagnostic application of operational criteria in studies of psychotic illness: development and reliability of the OPCRIT system. Archives of General Psychiatry, 48, 764770.Google Scholar
Mednick, A., Machon, R., Huttunen, M., et al (1989) Adult schizophrenia following prenatal exposure to an influenza epidemic. Archives of General Psychiatry, 45, 189192.CrossRefGoogle Scholar
Neave, H. (1979) Elementary Statistical Tables. London: George Allen.Google Scholar
Nicoll, A. & Logan, S. (1989) Viral infections of pregnancy and childhood. In Ethnic Factors in Health and Disease (eds Cruickshank, J. & Beevers, D.), pp. 95102. London: Wright.Google Scholar
O'Callaghan, E., Sham, P., Takei, N., et al (1991) Prenatal exposure to the ‘Asian flu’ epidemic and later schizophrenia. Lancet, 227, 12481250.Google Scholar
Owen, M., Lewis, S. & Murray, R. (1988) Obstetric complications and schizophrenia: a computerised tomographic study. Psychological Medicine, 18, 331339.Google Scholar
Parsons, C. (1963) West Indian children with multiple congenital defects. Archives of Disease in Childhood, 38, 454458.Google Scholar
Pearson, M. (1991) Ethnic differences in infant health. Archives of Disease in Childhood, 66, 8890.CrossRefGoogle ScholarPubMed
Rwegellera, G. (1977) Psychiatric morbidity among West Africans and West Indians living in London. Psychological Medicine, 7, 317329.Google Scholar
Schlesselman, J. (1982) Case-Control Studies: Design, Conduct, Analysis. New York: Oxford University Press.Google Scholar
Terry, O., Condie, R., Bissenden, J., et al (1987) Ethnic differences in incidence of very low birth weight and neonatal deaths among normally formed infants. Archives of Disease in Childhood, 62, 709711.Google Scholar
Townsend, P., Phillimore, P. & Beattie, A. (eds) (1988) Health and Deprivation: Inequality and the North. London: Croom Helm.Google Scholar
Walker, G., Ashley, D., McCaw, A., et al (1988) Maternal mortality in Jamaica. Lancet, i, 466488.Google Scholar
Wing, L. (1979) Mentally retarded children in Camberwell, London. In Estimating Needs for Mental Health Care (ed. Hafner, H.), pp. 7791. New York: Springer-Verlag.Google Scholar
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