Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-10T07:49:00.008Z Has data issue: false hasContentIssue false

A prospective study of severe mental disorder in Afro-Caribbean patients

Published online by Cambridge University Press:  09 July 2009

Glynn Harrison*
Affiliation:
Department of Psychiatry, University Hospital, Nottingham
David Owens
Affiliation:
Department of Psychiatry, University Hospital, Nottingham
Anthony Holton
Affiliation:
Department of Psychiatry, University Hospital, Nottingham
David Neilson
Affiliation:
Department of Psychiatry, University Hospital, Nottingham
Daphne Boot
Affiliation:
Department of Psychiatry, University Hospital, Nottingham
*
1Address for correspondence: Dr Glynn Harrison, Academic Department of Psychiatry, University Hospital, Nottingham, NG7 2UH.

Synopsis

Several previous studies have reported increased rates of schizophrenia among Afro-Caribbean immigrants, although doubt has been cast upon the value of case-note diagnoses and retrospective case-finding. A prospective study was therefore undertaken, including all patients of Afro-Caribbean ethnic origin with a first onset psychosis presenting to the psychiatric services from a defined catchment area. Utilizing several diagnostic classifications, rates for schizophrenia were found to be substantially increased in the Afro-Caribbean community, and especially in the ‘second generation’ British born. Mode of onset and symptom profiles of psychoses suggest that atypical syndromes, and by implication ‘misdiagnoses’, do not account for reported higher rates of schizophrenic illness in these patients.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1988

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adams, G. L., Dworkin, R. J. & Rosenberg, S. D. (1984). Diagnosis and pharmacotherapy issues in the care of hispanics in the public sector. American Journal of Psychiatry 141, 970974.Google ScholarPubMed
Bagley, C. (1971). Mental illness in immigrant minorities in London. Journal of Biosocial Science 3, 449459.CrossRefGoogle Scholar
Bagley, C. (1975). Sequels of alienation: a social psychological view of the adaptation of West Indian migrants in Britain. In Case Studies of Human Rights and Fundamental Problems, Vol. 2 (ed. Glaser, K.), pp. 5781. Nijhoff: The Hague.Google Scholar
Balajaran, R. & McDowell, M. (1985). Mortality for congenital malformations by mother's country of birth. Journal of Epidemiology and Community Health 39, 102106.CrossRefGoogle Scholar
Brewin, C. (1980). Explaining the lower rates of psychiatric treatment among Asian immigrants to the United Kingdom: a preliminary study. Social Psychiatry 15, 1719.CrossRefGoogle Scholar
Burke, A. W. (1974). First admission and planning in Jamaica. Social Psychiatry 123, 109111.Google Scholar
Burke, A. W. (1984). Racism and psychological disturbance among West Indians in Britain. International Journal of Social Psychiatry 30, 5068.Google Scholar
Carpenter, L. & Brockington, I. F. (1980). A study of mental illness in Asians, West Indians and Africans living in Manchester. British Journal of Psychiatry 137, 201205.CrossRefGoogle ScholarPubMed
Cochrane, R. (1977). Mental illness in immigrants to England and Wales. Social Psychiatry 12, 2535.CrossRefGoogle Scholar
Cochrane, R. (1983). The Social Creation of Mental Illness. Longman, Office of Population Census and Statistics: London.Google Scholar
Cooper, J. E., Goodhead, D., Craig, T., Harris, M., Howat, J. & Korer, J. (1987). The incidence of schizophrenia in Nottingham. British Journal of Psychiatry 151, 619626.CrossRefGoogle ScholarPubMed
Dean, G., Walsh, D., Downing, H. & Shelley, E. (1981). First admissions of native-born and immigrants to psychiatric hospitals in South-East England 1976. British Journal of Psychiatry 139, 506512.CrossRefGoogle ScholarPubMed
Diagnostic & Statistical Manual of Mental Disorders (1980) (Third Edn). The American Psychiatric Association: Washington.Google Scholar
Giggs, J. (1986). Ethnic status and mental illness in urban areas. In Health, Race & Ethnicity (ed. Rathwell, T. and Phillips, D.), pp. 137174. Croom Helm: London.Google Scholar
Gordon, E. B. (1965). Mentally ill West Indian immigrants. British Journal of Psychiatry 111, 877887.CrossRefGoogle ScholarPubMed
Harrison, G., Ineichen, B., Smith, J. & Morgan, H. G. (1984). Psychiatric hospital admissions in Bristol. II. Social and clinical aspects of compulsory admission. British Journal of Psychiatry 145, 605611.CrossRefGoogle ScholarPubMed
Ineichen, B., Harrison, G. & Morgan, H. G. (1984). Psychiatric hospital admissions in Bristol, I. Geographical and ethnic factors. British Journal of Psychiatry 145, 600604.Google Scholar
Jablensky, A., Schwarz, R. & Tomov, T. (1980). WHO collaborative study on impairments and disabilities associated with schizophrenic disorders. A preliminary communication: Objectives and methods. Acta Psychiatrica Scandinavica Supplement 285 62, 152163.CrossRefGoogle Scholar
Kiev, A. (1965). Psychiatric morbidity of West Indian immigrants in an urban group practice. British Journal of Psychiatry 111, 5156.CrossRefGoogle Scholar
Landau, N. (1986). Statistics of London's Ethnic Minorities, 1979 and 1981. GLC Statistical Series No. 40. Greater London Council: London.Google Scholar
Leff, J. P., Fischer, M. & Bertelsen, A. (1976). A cross-national epidcmiological study of mania. British Journal of Psychiatry 129, 428437.Google Scholar
Leff, J. P., Kuipers, L., Berkowitz, R., Eberlein-Vries, R. & Sturgeon, D. (1982). A controlled trial of social intervention in the families of schizophrenic patients. British Journal of Psychiatry 141, 121134.CrossRefGoogle ScholarPubMed
Lewis, P., Rack, P. H., Vaddadi, K. S. & Allen, J. J. (1980). Ethnic differences in drug response. Postgraduate Medical Journal 56, Supplement 1.Google Scholar
Littlewood, R., & Lipsedge, M. (1981 a). Some social and phenomenological characteristics of psychotic immigrants. Psychological Medicine 11, 289302.CrossRefGoogle ScholarPubMed
Littlewood, R. & Lipsedge, M. (1981 b). Acute psychotic reactions in Caribbean-born patients. Psychological Medicine 11, 303318.CrossRefGoogle ScholarPubMed
Littlewood, R. & Lipsedge, M. (1982). Aliens and Alienists: Ethnic Minorities and Psychiatry. Penguin: Harmondsworth.Google Scholar
McGovern, D., & Cope, R. V. (1987 a). The compulsory detention of males of different ethnic groups, with special reference to offender patients. British Journal of Psychiatry 150, 502512.Google Scholar
McGovern, D., & Cope, R. V. (1987 b). First psychiatric admission rates of first and second generation Afro-Caribbeans. Social Psychiatry 22, 139149.CrossRefGoogle ScholarPubMed
Murphy, H. B. (1972). The evocation role of complex social demands. In Genetic Factors in Schizophrenia (ed. Kaplan, A. R.), pp. 407421. Thomas: Springfield, Illinois.Google Scholar
Ødegaard, O. (1932). Emigration and insanity. Acta Psychiatrica Scandinavica Supplement 4.Google Scholar
Office of Population Censuses & Surveys, Census 1981. Unpublished Table DT 1833 U.Google Scholar
Office of Population Censuses & Surveys (1982 a). Census 1981. County Report, Nottinghamshire, Part 1 and 2. HMSO: London.Google Scholar
Office of Population Censuses & Surveys (1982 b). Labour Force Survey 1981. HMSO: London.Google Scholar
Office of Population Censuses & Surveys (1982 c). Sources of statistics on ethnic minorities. Population Trends 28. HMSO: London.Google Scholar
Office of Population Censuses & Surveys (1986). Estimating the size of the ethnic minority populations in the 1980s. Population Trends 44. HMSO: London.Google Scholar
Parker, R. & Kleiner, S. (1966). Mental Illness in the Urban Negro Community. Free Press: New York.Google Scholar
Pouget, R., Cirba, R., Chiariny, J. F. & Castelnam, D. (1975). Troubles psychiatriques chez les français musculmans immigrés. Annales Medico-Psychologiques (Paris) 2, 541561.Google Scholar
Ratcliffe, P. (1981). Racism and Reaction: A Profile of Handsworth. Routledge & Kegan Paul: London.Google Scholar
Royes, K. (1962). The incidence and features of psychosis in a Caribbean community. In Proceedings of the Third World Congress of Psychiatry, pp. 11211125. University of Toronto Press & McGill University Press: Montreal.Google Scholar
Rwegellera, G. G. C. (1977). Psychiatric morbidity among West Africans and West Indians living in London. Psychological Medicine 7, 317329.Google Scholar
Sartorius, N., Jablensky, A., Korten, A., Ernberg, G., Anker, M., Cooper, J. E. & Day, R. (1986). Early manifestations and first-contact incidence of schizophrenia in different cultures. Psychological Medicine 16, 909928.CrossRefGoogle ScholarPubMed
Sinclair, M., Littlewood, R., Lipsedge, M. & Wood, S. (1988). Admission rates for schizophrenia in the British-born Afro-Caribbean population. (Submitted for publication.)Google Scholar
Spitzer, R., Endicott, J. & Robins, E. (1975). Research Diagnostic Criteria. New York State Psychiatric Institute: New York.Google ScholarPubMed
Torrey, E. F. (1987). Prevalence studies in schizophrenia. British Journal of Psychiatry 150, 598608.CrossRefGoogle ScholarPubMed
Walvin, J. (1984). Passage to Britain. Penguin Books: Harmondsworth, Middlesex.Google Scholar
World Health Organization (1978). Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases. WHO: Geneva.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.Google Scholar