Psychological Medicine



Original Article

Incidence of schizophrenia and other psychoses in ethnic minority groups: results from the MRC AESOP Study


PAUL FEARON a1c1 1 , JAMES B. KIRKBRIDE a2 1 , CRAIG MORGAN a1 1 , PAOLA DAZZAN a1 1 , KEVIN MORGAN a1 1 , TUHINA LLOYD a3 1 , GERARD HUTCHINSON a4 1 , JANE TARRANT a3 1 , WAI LUN ALAN FUNG a2 1 , JOHN HOLLOWAY a5 1 , ROSEMARIE MALLETT a1 1 , GLYNN HARRISON a6 1 , JULIAN LEFF a1 1 , PETER B. JONES a2 1 and ROBIN M. MURRAY a1 1
a1 Division of Psychological Medicine, Institute of Psychiatry, King's College, London, UK
a2 Department of Psychiatry, University of Cambridge, Cambridge, UK
a3 Division of Psychiatry, University of Nottingham, Nottingham, UK
a4 Faculty of Medical Sciences, University of the West Indies, St Augustine, Trinidad
a5 Department of Mental Health, University of Bristol, Bristol, UK
a6 Division of Psychiatry, University of Bristol, Bristol, UK

Article author query
fearon p   [PubMed][Google Scholar] 
kirkbride jb   [PubMed][Google Scholar] 
morgan c   [PubMed][Google Scholar] 
dazzan p   [PubMed][Google Scholar] 
morgan k   [PubMed][Google Scholar] 
lloyd t   [PubMed][Google Scholar] 
hutchinson g   [PubMed][Google Scholar] 
tarrant j   [PubMed][Google Scholar] 
lun alan fung w   [PubMed][Google Scholar] 
holloway j   [PubMed][Google Scholar] 
mallett r   [PubMed][Google Scholar] 
harrison g   [PubMed][Google Scholar] 
leff j   [PubMed][Google Scholar] 
jones pb   [PubMed][Google Scholar] 
murray rm   [PubMed][Google Scholar] 

Abstract

Background. The incidence of schizophrenia in the African-Caribbean population in England is reported to be raised. We sought to clarify whether (a) the rates of other psychotic disorders are increased, (b) whether psychosis is increased in other ethnic minority groups, and (c) whether particular age or gender groups are especially at risk.

Method. We identified all people (n=568) aged 16–64 years presenting to secondary services with their first psychotic symptoms in three well-defined English areas (over a 2-year period in Southeast London and Nottingham and a 9-month period in Bristol). Standardized incidence rates and incidence rate ratios (IRR) for all major psychosis syndromes for all main ethnic groups were calculated.

Results. We found remarkably high IRRs for both schizophrenia and manic psychosis in both African-Caribbeans (schizophrenia 9·1, manic psychosis 8·0) and Black Africans (schizophrenia 5·8, manic psychosis 6·2) in men and women. IRRs in other ethnic minority groups were modestly increased as were rates for depressive psychosis and other psychoses in all minority groups. These raised rates were evident in all age groups in our study.

Conclusions. Ethnic minority groups are at increased risk for all psychotic illnesses but African-Caribbeans and Black Africans appear to be at especially high risk for both schizophrenia and mania. These findings suggest that (a) either additional risk factors are operating in African-Caribbeans and Black Africans or that these factors are particularly prevalent in these groups, and that (b) such factors increase risk for schizophrenia and mania in these groups.


Correspondence:
c1 Box 63, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. (Email: p.fearon@iop.kcl.ac.uk)


Footnotes

1 on behalf of the AESOP Study Group. Members of the AESOP Study Group are listed in the Appendix.



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