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Schizophrenia in the Afro-Caribbean Community

Published online by Cambridge University Press:  02 January 2018

Philip A. Sugarman
Affiliation:
Reaside Clinic, Bristol Road South, Birmingham B45 9BE
David Craufurd*
Affiliation:
Department of Medical Genetics, St Mary's Hospital, Hathersage Road, Manchester M13 0JH
*
Correspondence

Abstract

Previous studies have shown high rates of schizophrenia among the Afro-Caribbean population in Britain. In order to assess the role of genetic factors in the aetiology of this phenomenon, we have used a standardised family history method (FHRDC) to compare lifetime morbidity risks for first-degree relatives of Afro-Caribbean and white patients with RDC schizophrenia admitted in Central Manchester between 1982 and 1988. Lifetime morbidity risk for parents of Afro-Caribbean subjects was 8.9%, and for parents of white patients 8.4%. For the siblings of black probands, however, the risk was 15.9%, as compared with 1.8% for white siblings (P < 0.05). Among siblings of UK-born Afro-Caribbean probands, morbid risk was even higher at 27.3% (P = 0.001). High rates among siblings of younger Afro-Caribbean patients are consistent with previous reports of a higher incidence in the UK-born. These observations suggest that schizophrenia among Afro-Caribbeans is no less familial than for the remainder of the population, but that the increased frequency of the disorder is due to environmental factors which are most common in the Afro-Caribbean community, and capable of precipitating schizophrenia in those who are genetically predisposed.

Type
Papers
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

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References

Andreasen, N. C., Endicott, J., Spitzer, R. L., et al (1977) The family history method using diagnostic criteria: reliability and validity. Archives of General Psychiatry, 34, 12291235.Google Scholar
Andreasen, N. C., Rice, J., Endicott, J., et al (1986) The family history approach to diagnosis. How useful is it? Archives of General Psychiatry, 43, 421429.CrossRefGoogle Scholar
Andreasson, S., Allebeck, P., Engstroem, A., et al (1987) Cannabis and schizophrenia. A longitudinal study of Swedish conscripts. Lancet, ii, 14831486.CrossRefGoogle Scholar
Bebbington, P. E., Hurry, J. & Tennant, C. (1981) Psychiatric disorders in selected immigrant groups in Camberwell. Social Psychiatry, 16, 4351.CrossRefGoogle Scholar
Bellodi, L., Bussolini, C., Scorza-Smeraldi, R., et al (1986) Family study of schizophrenia; exploratory analysis for relevant factors. Schizophrenia Bulletin, 12, 120128.Google Scholar
Bleuler, M. (1978) The Schizophrenic Disorders: Long Term Patient and Family Studies (trans. Clemens, S. M.). New Haven, CT: Yale University Press.Google Scholar
Cochrane, R. (1983) The Social Creation of Mental Illness. London: Longman.Google Scholar
Cochrane, R. & Bal, S. S. (1989) Mental hospital admission rates of immigrants to England: a comparison of 1971 and 1981. Social Psychiatry and Psychiatric Epidemiology, 24, 211.CrossRefGoogle Scholar
Cooper, J. E., Goodhead, D., Craig, T., et al (1987) The incidence of schizophrenia in Nottingham. British Journal of Psychiatry, 151, 619626.Google Scholar
Endicott, J., Andreasen, N. & Spitzer, R. L. (1975) Family History - Research Diagnostic Criteria. New York, NY: Biometrics Research, New York State Psychiatric Institute.Google Scholar
Fischer, M., Harvald, B. & Hauge, M. (1969) A Danish twin study of schizophrenia. British Journal of Psychiatry, 115, 981990.Google Scholar
Glover, G. R. (1989) Why is there a high rate of schizophrenia in British Caribbeans? British Journal of Hospital Medicine, 42, 4851.Google Scholar
Goldstein, J. M., Faraone, S. V., Chen, W. J., et al (1990) Sex differences in the familial transmission of schizophrenia. British Journal of Psychiatry, 156, 819826.Google Scholar
Gordon, E. B. (1965) Mentally-ill West Indians. British Journal of Psychiatry, 111, 877887.Google Scholar
Gottesman, I. I. & Bertelsen, A. (1989) Confirming unexpressed genotypes for schizophrenia. Archives of General Psychiatry, 46, 867872.Google Scholar
Gottesman, I. I. & Shields, J. A. (1982) Schizophrenia: the Epigenetic Puzzle. New York: Cambridge University Press.Google Scholar
Harrison, G., Owens, D., Holton, A., et al (1988) A prospective study of severe mental disorder in Afro-Caribbean patients. Psychological Medicine, 18, 643657.CrossRefGoogle ScholarPubMed
Harrison, G., Holton, A., Neilson, D., et al (1989) Severe mental disorder in Afro-Caribbean patients: some social, demographic and service factors. Psychological Medicine, 19, 683696.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
Hemsi, L. K. (1967) Psychiatric morbidity of West Indian immigrants. Social Psychiatry, 2, 95100.CrossRefGoogle Scholar
Heston, L. L. (1966) Psychiatric disorders in foster home reared children of schizophrenic mothers. British Journal of Psychiatry, 112, 819825.CrossRefGoogle ScholarPubMed
Hickling, F. W. (1991) Psychiatric hospital admission rates in Jamaica. British Journal of Psychiatry, 159, 817821.Google Scholar
Ineichen, B., Harrison, G. & Morgan, H. G. (1984) Psychiatric hospital admissions in Bristol. I. Geographical and ethnic factors. British Journal of Psychiatry, 145, 600611.Google Scholar
Kallmann, F. J. (1938) The Genetics of Schizophrenia. New York: August in.Google Scholar
Kay, D. W. K. & Lindelius, R. (1970) Morbidity risks for schizophrenia among parents, siblings, probands' children and siblings' children. In A Study of Schizophrenia: A Clinical, Prognostic and Family Investigation (ed. Lindelius, R.). Acta Psychiatrica Scandinavica (suppl. 216), 8688.Google Scholar
Kendler, K. S., Masterson, C. C., Ungaro, R., et al (1984) A family history study of schizophrenia-related personality disorders. American Journal of Psychiatry, 141, 424427.Google Scholar
Kendler, K. S., Masterson, C. C., & Davis, K. L. (1985) Psychiatric illness in first-degree relatives of patients with paranoid psychosis, schizophrenia, and medical illness. British Journal of Psychiatry, 147, 524531.Google Scholar
Kety, S. S., Rosenthal, D. & Wender, P. H. (1975) Mental illness in the biological and adoptive families of adopted individuals who have become schizophrenic. In Genetic Research in Psychiatry (eds Fieve, R. R., Rosenthal, D. & Brill, H.), pp. 147165. Baltimore, MD: Johns Hopkins University Press.Google Scholar
Leff, J. (1988) Psychiatry Around the Globe. A Transcultural View. London: Gaskell.Google Scholar
Littlewood, R. & Lipsedge, M. (1981) Some social and phenomenological characteristics of psychotic immigrants. Psychological Medicine, 11, 289302.Google Scholar
Littlewood, R. & Lipsedge, M. (1988) Psychiatric illness among British Afro-Caribbeans. British Medical Journal, 296, 950951.Google Scholar
McGovern, D. & Cope, R. (1987) First psychiatric admission rates of first and second generation Afro-Caribbeans. Social Psychiatry, 22, 139149.CrossRefGoogle ScholarPubMed
Nicoll, A. & Logan, S. (1989) Viral infections of pregnancy and childhood. In Ethnic Factors in Health and Disease (eds Cruickshank, J. K. & Beevers, D. G.). London: Wright.Google Scholar
Odegaard, O. (1932) Emigration and insanity. A study of mental disease among the Norwegian population of Minnesota. Acta Psychiatrica et Neurologica, 7 (suppl. 4).Google Scholar
Pearson, M. (1989) Sociology of race and health. In Ethnic Factors in Health and Disease (eds Cruickshank, J. K. & Beevers, D. G.). London: Wright.Google Scholar
Pollin, W., Allen, M. G., Hoffer, A., et al (1969) Psychopathology in 15,909 pairs of veteran twins. American Journal of Psychiatry, 7, 597609.Google Scholar
Prince, M. D., Greenfield, R. & Marriott, J. (1972) Cannabis or alcohol? Observations on their use in Jamaica. United Nations Bulletin on Narcotics, 24, 19.Google Scholar
Rose, E. J. B. (1969) Colour and Citizenship. London: Oxford University Press.Google Scholar
Rosenthal, D., Wender, P. H., Kety, S. S., et al (1968) Schizophrenics' offspring reared in adoptive homes. In The Transmission of Schizophrenia (eds Rosenthal, D. & Kety, S. S.), pp. 377391. Oxford: Pergamon Press.Google Scholar
Rubin, V. & Comitas, L. (1975) Ganja in Jamaica. The Hague: Mouton.Google Scholar
Sartorius, N., Jablensky, A., Korten, G., et al (1986) Early manifestations and first-contact incidence of schizophrenia in different cultures. Psychological Medicine, 16, 909928.Google Scholar
Sashidaran, S. (1989) Epidemiology, ethnicity and schizophrenia. In Report to Council of Special (Ethnic Issues) Committee. London: Royal College of Psychiatrists.Google Scholar
Schulz, P. M., Soloff, P. H., Kelly, T., et al (1989) A family history study of borderline subtypes. Journal of Personality Disorders, 3, 217229.Google Scholar
Shimizu, A., Kurachi, M., Yamaguchi, N., et al (1987) Morbidity risk of schizophrenia to parents and siblings of schizophrenia patients. Japanese Journal of Psychiatry and Neurology, 41, 6570.Google Scholar
Shur, E. (1982) Family history and schizophrenia: characteristics of groups with and without family histories. Psychological Medicine, 12, 591594.Google Scholar
Slater, E. & Cowie, V. (1971) The Genetics of Mental Disorders. London: Oxford University Press.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1975) Research Diagnostic Criteria (RDC) for a Selected Group of Functional Disorders (2nd edn). New York: Biometrics Research, New York State Psychiatric Institute.Google Scholar
Sugarman, P. A. (1992) Outcome of schizophrenia in the Afro-Caribbean community. Social Psychiatry and Psychiatric Epidemiology, 27, 102105.Google Scholar
Tienari, P. (1971) Schizophrenia and monozygotic twins. Psychiatrica Fennica, 97104.Google Scholar
Watt, J. A. G. (1985) The relationship of paranoid states to schizophrenia. American Journal of Psychiatry, 142, 14561458.Google Scholar
Winokur, G., Morrison, J., Clancy, J., et al (1972) The Iowa 500. II. A blind family history comparison of mania, depression, and schizophrenia. Archives of General Psychiatry, 27, 462464.Google Scholar
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