Psychological Medicine

Original Article

Parental separation, loss and psychosis in different ethnic groups: a case-control study

a1 Division of Psychological Medicine, Institute of Psychiatry, London, UK
a2 Psychiatry Unit, University of the West Indies, Trinidad
a3 Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, London, UK
a4 Department of Psychiatry, University of Cambridge, Cambridge, UK
a5 Division of Psychiatry, University of Nottingham, Nottingham, UK

Article author query
morgan c   [PubMed][Google Scholar] 
kirkbride j   [PubMed][Google Scholar] 
leff j   [PubMed][Google Scholar] 
craig t   [PubMed][Google Scholar] 
hutchinson g   [PubMed][Google Scholar] 
mckenzie k   [PubMed][Google Scholar] 
morgan k   [PubMed][Google Scholar] 
dazzan p   [PubMed][Google Scholar] 
doody ga   [PubMed][Google Scholar] 
jones p   [PubMed][Google Scholar] 
murray r   [PubMed][Google Scholar] 
fearon p   [PubMed][Google Scholar] 


Background. Numerous studies have reported high rates of psychosis in the Black Caribbean and Black African populations in the UK. However, few studies have investigated the role of specific risk factors in different ethnic groups. We sought to investigate the relationship between long-term separation from, and death of, a parent before the age of 16 and risk of adult psychosis in different ethnic groups.

Method. All patients with a first episode of psychosis who made contact with psychiatric services in defined catchment areas in London and Nottingham, UK and a series of community controls were included in the AESOP (Aetiology and Ethnicity in Schizophrenia and Other Psychoses) study. Data relating to clinical and social variables, including parental separation and loss, were collected from patients and controls.

Results. Separation from, and death of, a parent before the age of 16 were both strongly associated with a two- to threefold increased risk of psychosis. The strength of these associations were similar for White British and Black Caribbean (but not Black African) subjects. Separation from (but not death of) a parent was more common among Black Caribbean controls than White British controls.

Conclusions. Early separation may have a greater impact in the Black Caribbean population, because it is more common, and may contribute to the excess of psychosis in this population.

c1 Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. (Email: