Incidence and outcome of schizophrenia in Whites, African-Caribbeans and Asians in London
D. BHUGRA a1 , J. LEFF a1 , R. MALLETT a1 , G. DER a1 , B. CORRIDAN a1 and S. RUDGE a1
a1 Department of Psychiatry and MRC Social Developmental and Genetic Centre, Institute of Psychiatry and St Bernard's Hospital, W London Heath Care NHS Trust, London; and MRC Medical Sociology Unit, Glasgow
Background. Several previous studies have indicated high rates of schizophrenia in African-Caribbeans in the UK compared to White population.
Method. All people aged 18 to 64 years residing in two health districts in London who made contact with hospital or community services over a 1-year (Whites) or 2-year (ethnic minorities) period were screened for psychotic symptoms.
Results. One hundred and twenty-three patients passed the screen, of whom 100 were assigned a schizophrenic class by the CATEGO program. Of these, 38 were White, 38 African-Caribbean and 24 Asian. The incidence rate for broad schizophrenia was significantly higher for African-Caribbeans than for Whites. Asians showed a high rate among people age 30 and over, particularly women. Poor outcome at 1-year follow-up was significantly more common for African-Caribbeans than for the other two groups. The proportion of African-Caribbeans with a poor outcome was two and a half times greater than that of Whites. On a range of seven socio-demographic variables, African-Caribbeans differed from the other two groups only on unemployment.
Conclusions. A multitide of factors play a role in the aetiology of schizophrenia. Comparison of environmental factors in these groups may identify factors that contribute to the aetiology of schizophrenia.
Dr Dinesh Bhugra, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF.