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Ethnic density as a buffer for psychotic experiences: findings from a national survey (EMPIRIC)

  • Jayati Das-Munshi (a1), Laia Bécares (a2), Jane E. Boydell (a3), Michael E. Dewey (a1), Craig Morgan (a4), Stephen A. Stansfeld (a5) and Martin J. Prince (a6)...
Abstract
Background

Aetiological mechanisms underlying ethnic density associations with psychosis remain unclear.

Aims

To assess potential mechanisms underlying the observation that minority ethnic groups experience an increased risk of psychosis when living in neighbourhoods of lower own-group density.

Method

Multilevel analysis of nationally representative community-level data (from the Ethnic Minorities Psychiatric Illness Rates in the Community survey), which included the main minority ethnic groups living in England, and a White British group. Structured instruments assessed discrimination, chronic strains and social support. The Psychosis Screening Questionnaire ascertained psychotic experiences.

Results

For every ten percentage point reduction in own-group density, the relative odds of reporting psychotic experiences increased 1.07 times (95% CI 1.01–1.14, P = 0.03 (trend)) for the total minority ethnic sample. In general, people living in areas of lower own-group density experienced greater social adversity that was in turn associated with reporting psychotic experiences.

Conclusions

People resident in neighbourhoods of higher own-group density experience ‘buffering’ effects from the social risk factors for psychosis.

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Copyright
Royal College of Psychiatrists, This paper accords with the Wellcome Trust Open Access policy and is governed by the licence available athttp://www.rcpsych.ac.uk/pdf/Wellcome%20Trust%20licence.pdf
Corresponding author
Dr Jayati Das-Munshi, Department of Health Service and Population Research, Section of Epidemiology, PO 60 King's College London, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. Email: jayati.das-munshi@kcl.ac.uk
Footnotes
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See editorial, pp. 258–259, this issue.

J.D.-M. is supported by a Medical Research Council fellowship. L.B. is supported by a Medical Research Council/Economic and Social Research Council fellowship. C.M. is supported by funding from the Medical Research Council, Wellcome Trust (grant: WT087417) and European Union. (European Community's Seventh Framework Program (grant agreement No. HEALTH-F2-2009-241909) (Project EU-GEI)). In addition, we are grateful to the Institute of Social Psychiatry, who provided a small finds grant that enabled the retrieval and matching of area-level variables to the data-set. We acknowledge the support of the NIHR Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and (Institute of Psychiatry) King's College London.

Declaration of interest

None.

Footnotes
References
Hide All
1 Bourque, F, van der Ven, E, Malla, A. A meta-analysis of the risk for psychotic disorders among first- and second-generation immigrants. Psychol Med 2011; 41: 897910.
2 Fearon, P, Kirkbride, JB, Morgan, C, Dazzan, P, Morgan, K, Lloyd, T, et al. Incidence of schizophrenia and other psychoses in ethnic minority groups: results from the MRC AESOP Study. Psychol Med 2006; 36: 1541–50.
3 Cochrane, R, Bal, SS. Mental hospital admission rates of immigrants to England: a comparison of 1971 and 1981. Soc Psychiatry Psychiatr Epidemiol 1989; 24: 211.
4 King, M, Coker, ME, Leavey, G, Hoare, A, Johnson-Sabine, E. Incidence of psychotic illness in London: comparison of ethnic groups. BMJ 1994; 309: 1115–9.
5 Kirkbride, JB, Barker, D, Cowden, F, Stamps, R, Yang, M, Jones, PB, et al. Psychoses, ethnicity and socio-economic status. Br J Psychiatry 2008; 193: 1824.
6 Veling, W, Selten, J-P, Susser, E, Laan, W, Mackenbach, JP, Hoek, HW. Discrimination and the incidence of psychotic disorders among ethnic minorities in The Netherlands. Int J Epidemiol 2007; 36: 761–8.
7 March, D, Hatch, SL, Morgan, C, Kirkbride, JB, Bresnahan, M, Fearon, P, et al. Psychosis and place. Epidemiol Rev 2008; 30: 84100.
8 Boydell, J, Van Os, J, McKenzie, K, Allardyce, J, Goel, R, McCreadie, RG, et al. Incidence of schizophrenia in ethnic minorities in London: ecological study into interactions with environment. BMJ 2001; 323: 1336–9.
9 Bécares, L, Nazroo, J, Stafford, M. The buffering effects of ethnic density on experienced racism and health. Health Place 2009; 15: 670–8.
10 Kirkbride, JB, Morgan, C, Fearon, P, Dazzan, P, Murray, RB, Jones, PB. Neighbourhood-level effects on psychoses: re-examining the role of context. Psychol Med 2007; 37: 1413–25.
11 Veling, W, Susser, E, van Os, J, Mackenbach, JP, Selten, J-P, Hoek, HW. Ethnic density of neighborhoods and incidence of psychotic disorders among immigrants. Am J Psychiatry 2008; 165: 6673.
12 Schofield, P, Ashworth, M, Jones, M. Ethnic isolation and psychosis: re-examining the ethnic density effect. Psychol Med 2011; 41: 1263–9.
13 Bhui, K, Stansfeld, S, Hull, S, Priebe, S, Mole, F, Feder, G. Ethnic variations in pathways to and use of specialist mental health services in the UK: systematic review. Br J Psychiatry 2003; 182: 105–16.
14 Bebbington, P, Nayani, V. The Psychosis Screening Questionnaire. Int J Soc Psychiatr Res 1995; 5: 11–9.
15 van Os, J, Hanssen, M, Bijl, RV, Vollebergh, W. Prevalence of psychotic disorder and community level of psychotic symptoms: an urban-rural comparison. Arch Gen Psychiatry 2001; 58: 663–8.
16 King, M, Nazroo, J, Weich, S, McKenzie, K, Bhui, K, Karlson, S, et al. Psychotic symptoms in the general population of England. Soc Psychiatry Psychiatr Epidemiol 2005; 40: 375–81.
17 Dominguez, MDG, Wichers, M, Lieb, R, Wittchen, HU, Van Os, J. Evidence that onset of clinical psychosis is an outcome of progressively more persistent subclinical psychotic experiences: an 8-year cohort study. Schizophr Bull 2011; 37: 8493.
18 Morgan, C, Charalambides, M, Hutchinson, G, Murray, RM. Migration, ethnicity, and psychosis: toward a sociodevelopmental model. Schizophr Bull 2010; 36: 655–64.
19 Sproston, J, Nazroo, J. Ethnic Minority Psychiatric Illness Rates in the Community (EMPIRIC): Quantitative Report. TSO (The Stationery Office), 2002.
20 UKDA. Ethnic Minority Psychiatric Illness Rates In The Community (EMPIRIC): User Guide for UK Data Archive. UKDA, no date (http://www.esds.ac.uk/doc/4685/mrdoc/pdf/4685userguide.pdf)
21 Office of Population Censuses and Surveys. Census Definitions Great Britain. OPCS, 1992.
22 Bhui, K, Stansfeld, S, McKenzie, K, Karlsen, S, Nazroo, J, Weich, S. Racial/ethnic discrimination and common mental disorders among workers: findings from the EMPIRIC study of ethnic minority groups in the United Kingdom. Am J Public Health 2005; 95: 496501.
23 Pearlin, LI, Schooler, C. The Structure of coping. J Health Soc Behav 1978; 19: 221.
24 Stansfeld, S, Marmot, M. Deriving a survey measure of social support: the reliability and validity of the close persons questionnaire. Soc Sci Med 1992; 35: 1027–35.
25 Office for National Statistics. Beginners' Guide to UK Geography – Super Output Areas (SOAs). ONS, no date (http://www.ons.gov.uk/ons/guidemethod/geography/beginner-s-guide/census/super-output-areas–soas-/index.html)).
26 Noble, M, Wright, G, Smith, G, Dibben, C. Measuring multiple deprivation at the small-area level. Environ Plan A 2006; 38: 169–85.
27 Wing, JK, Babor, T, Brugha, T, Burke, J, Cooper, JE, Giel, R, et al. SCAN. Schedules for Clinical Assessment in Neuropsychiatry. Arch Gen Psychiatry 1990; 47: 589–93.
28 Nazroo, JY. Ethnicity and Mental Health: Findings from a National Community Survey. Policy Studies Institute, 1997.
29 Singleton, N, Bumpstead, R, O'Brien, M, Lee, A, Meltzer, H. Psychiatric Morbidity Among Adults Living in Private Households, 2000. TSO (The Stationery Office), 2001.
30 Prince, M. Commentary: two-phase surveys. A death is announced; no flowers please. Int J Epidemiol 2003; 32: 1078–80.
31 Das-Munshi, J, Becares, L, Dewey, ME, Stansfeld, SA, Prince, MJ. Understanding the effect of ethnic density on mental health: multi-level investigation of survey data from England. BMJ 2010; 341: c5367.
32 Kirkwood, BR, Sterne, JAC. Analysis of clustered data. In Essential Medical Statistics (eds Kirkwood, BR, Sterne, JAC): 355–70. Blackwell Science, 2003.
33 Merlo, J, Chaix, B, Yang, M, Lynch, J, Rastam, L. A brief conceptual tutorial of multilevel analysis in social epidemiology: linking the statistical concept of clustering to the idea of contextual phenomenon. J Epidemiol Community Health 2005; 59: 443–9.
34 Whitley, R, Prince, M, McKenzie, K, Stewart, R. Exploring the ethnic density effect: a qualitative study of a London electoral ward. Int J Soc Psychiatry 2006; 52: 376–91.
35 Dobbs, J, Green, H, Zealey, L. Focus on Ethnicity and Religion. Palgrave Macmillan, 2006.
36 Tyrer, P, Nur, U, Crawford, M, Karlsen, S, MacLean, C, Rao, B, et al. The Social Functioning Questionnaire: a rapid and robust measure of perceived functioning. Int J Soc Psychiatry 2005; 51: 265–75.
37 Morgan, C, Fisher, H, Hutchinson, G, Kirkbride, J, Craig, TK, Morgan, K, et al. Ethnicity, social disadvantage and psychotic-like experiences in a healthy population based sample. Acta Psychiatr Scand 2009; 119: 226–35.
38 Karlsen, S, Nazroo, J, McKenzie, K, Bhui, K, Weich, S. Racism, psychosis and common mental disorder among ethnic minority groups in England. Psychol Med 2005; 35: 1795–803.
39 Kirkbride, JB, Fearon, P, Morgan, C, Dazzan, P, Morgan, K, Tarrant, J, et al. Heterogeneity in incidence rates of schizophrenia and other psychotic syndromes: findings from the 3-center AeSOP study. Arch Gen Psychiatry 2006; 63: 250–8.
40 McKenzie, K, van, J, Fahy, T, Jones, P, Harvey, I, Toone, B, et al. Psychosis with good prognosis in Afro-Caribbean people now living in the United Kingdom. BMJ 1995; 311: 1325–7.
41 van Os, J, Linscott, RJ, Myin-Germeys, I, Delespaul, P, Krabbendam, L. A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Psychol Med 2009; 39: 179–95.
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Ethnic density as a buffer for psychotic experiences: findings from a national survey (EMPIRIC)

  • Jayati Das-Munshi (a1), Laia Bécares (a2), Jane E. Boydell (a3), Michael E. Dewey (a1), Craig Morgan (a4), Stephen A. Stansfeld (a5) and Martin J. Prince (a6)...
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Re:Ethnic density as a buffer for psychotic experiences: findings from a national survey (EMPIRIC). Das-Munshi et al. BJP 2012, 201:282-290.

Jayati Das-Munshi
13 February 2013

Dr Topiwala raises two additional points which we have discussed in our paper. The original EMPIRIC survey omitted a number of minority ethnicgroups[1]. We were therefore unable to analyse associations for these groups as we did not have the data. As we mention in the 'Limitations' section of our paper[2], since this survey (2000) there have been a numberof other new migrant groups to Britain, for example, from Eastern Europe. Therefore we caution that the findings should not be generalised outside of the ethnic minority groups surveyed in our study.

The issue of non-response has been discussed in the 'Survey Design' (under 'Methods') section of our paper[2]. Weights to account for non-response bias were derived using stepwise logistic regression techniques using data which was available from the previous HSE surveys[1]. A number of important demographic predictors of non-response were included in the models (including individual and household predictors, as well as primary sampling units)[1]. Interactions by ethnicity were also included in the models, in order to account for the differing probabilities of response byethnic group[1]. As mentioned in our paper, wherever possible, we used these survey weights to correct for non-response in our analyses[2].

References:1. Sproston J and Nazroo J, Ethnic Minority Psychiatric Illness Rates in the Community (EMPIRIC): Quantitative Report. 2002, The Stationery Office:London 2. Das-Munshi J, Becares L, Boydell JE, et al., Ethnic density as a bufferfor psychotic experiences: findings from a national survey (EMPIRIC). The British Journal of Psychiatry, 2012. 201(4): p. 282-290.

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Conflict of interest: None declared

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Re:Ethnic Effects: a View from West London

Jayati Das-Munshi
19 December 2012

We are pleased that our study has been discussed amongst a group of practising Psychiatrists and appreciate Dr Yates' interest.

We disagree, however, that the clinical applicability of the study findings are limited. As Van Os highlighted in the accompanying editorial to our paper[1], psychotic experiences elicited through the Psychosis Screening Questionnaire are probably indicative of a dimensional phenotypewhich is frequently present in common mental disorders, as well as presentin psychotic disorders. Although a proportion of people screening positiveon the PSQ may later convert to clinical psychosis (cited in[1, 2]), for common mental disorders the presence of these symptoms usually suggests a poorer prognosis[1]. The clinical applicability of our findings is that there may be important risk factors in the environment which are associated with an increased risk of mental disorders in ethnic minority groups. From both a public health perspective as well as a clinical perspective, the findings suggest ways in which one may intervene to modify these social risk factors. As Van Os suggests[1], the advantage of using the PSQ as an outcome measure also meant that the findings of the study cut across traditional diagnostic boundaries. This may be why we found similar associations in a related analysis on common mental disorders[3].

We wholeheartedly agree that associations of psychotic experiences with ethnic density should be seen within a multifactorial model where individual-level factors are understood from within a contextual framework. The inference of causality in a complex condition like psychosis (or any other mental disorder) should be multifactorial, and should also assess possible interactions between causes[4], as we believe our study has done.

The assertion that 'the general trend was supportive' of density associations for all of the ethnic minority groups was a reference to figure 1 in the paper which suggests that only the white British group were not party to protective density effects. Focusing on an arbitrary significance cut-off of p=0.05 masks an understanding of the study which we feel must also be informed by looking at effect sizes, as well as associated confidence intervals[5].

An advantage of our analysis was the ability to examine contextual and individual-level experiences by ethnic group. We did assess and present data relating to the 'combined' ethnic minority sample as well (figures 2-4)[2]. Although we assert that research should refrain from 'lumping' minority groups together, some experiences (especially those relating to discrimination, social support and adversity) may have salience and cut across cultural or ethnic differences, and so we felt justified in presenting this for the full sample.

Finally, Dr Yates' suggestion for some of the 'cross over effects' shown in the interaction models are fully justified as this is a cross-sectional study and so temporality cannot be assumed. We are pleased that the study lends speculation as well as an understanding to this area, and hope that future research may help address some of the issues highlighted by our paper.

The authors have no competing interests to declare.

References1. Van Os J, Psychotic experiences: disadvantaged and different from the norm. The British Journal of Psychiatry. 201(4): p. 258-259

2. Das-Munshi J, Becares L, Boydell JE, et al., Ethnic density as a buffer for psychotic experiences: findings from a national survey (EMPIRIC). The British Journal of Psychiatry. 201(4): p. 282-290

3. Das-Munshi J, Becares L, Dewey ME, Stansfeld SA, and Prince MJ, Understanding the effect of ethnic density on mental health: multi-level investigation of survey data from England. British Medical Journal. 341: p. 9

4. Rothman KJ and Greenland S, Causation and Causal Inference in Epidemiology. American Journal of Public Health, 2005. 95(S1): p. S144-S150

5. Gardner MJ and Altman DG, Confidence intervals rather than P values: estimation rather than hypothesis testing. BMJ, 1986. 292(6522): p. 746-750

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Conflict of interest: None declared

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Ethnic density as a buffer for psychotic experiences: findings from a national survey (EMPIRIC). Das-Munshi et al. BJP 2012, 201:282-290.

Hinesh Topiwala, Psychiatry Core Trainee 2
14 November 2012

Dear Sir,

To investigate the concept of ethnic density one would have to draw asample representative of the rich diversity of ethnicities in England. Berthoud, et al. (1) define ethnic group as 'a community whose heritage offers important characteristics in common between its members and which makes them distinct from other communities. There is a boundary, which separates 'us' from 'them', and the distinction would probably be recognised on both sides of that boundary. Ethnicity is a multi-faceted phenomenon based on physical appearance, subjective identification, cultural and religious affiliation, stereotyping, and social exclusion.'

The study by Das-Munshi et al. (2) looks at White British, Irish, Black Caribbean, Bangladeshi, Indian and Pakistani. In the Empiric study, ethnicity was defined by self-assessment using the same categories as the 1991 Census (3). The 1991 Census collected data on nine ethnicity groups -White, Black Caribbean, Black African, Black other, Indian, Pakistani, Bangladeshi, Chinese and any other ethnic group (4). The study has not looked at 4 of the 9 ethnicity subgroups listed and is therefore not representative of the ethnicities in the England.

The study by Das-Munshi et al. (2) have not explained the significantnon-participation of candidates (37.8%) for the study making it difficult to draw conclusions from the data. Out of the 7009 issued names, 6271 werefound to be in scope (89%). Due to various factors, including the participant having moved out of the survey area or to an unknown new address; or the participant having died or having become 75 after the sample was drawn, 11% of the sample was no longer eligible for interview (5).

Of eligible individuals, refusals were received in person directly from the selected participant in 18% of cases, a further 2% refusing by post and 2% being proxy refusals. Most non-contacts resulted from the interviewer being unable to make contact with the selected participant, though there were also cases where no contact was made with anyone at the household after 4 or more call attempts. The most common reason for any other unproductive outcome was that the participant was away on holiday orin hospital throughout the survey period (5).

Yours sincerely,

Hinesh TopiwalaCore Trainee 2Royal Edinburgh Hospital

References

1. Modood, T. and Berthoud, R. (1997) Ethnic Minorities in Britain, The Fourth National Survey of Ethnic Minorities, London, Policy Studies Institute

2. Jayati Das-Munshi, Laia B?cares, Jane E. Boydell, Michael E. Dewey, Craig Morgan, Stephen A., Stansfeld and Martin J. Prince. Ethnic density as a buffer for psychotic experiences: findings from a national survey (EMPIRIC). BJP 2012, 201:282-290.

3.Weich S, Nazroo J, Sproston K, McManus S, Blanchard M, Erens B, Karlsen S, King M, Lloyd K, Stansfeld S, Tyrer P. Common mental disorders and ethnicity in England: the EMPIRIC study. Psychol Med. 2004 Nov;34(8):1543-51.

4. OPCS (1992). 1991 Census Definitions Great Britain. HMSO: London.

5. UKDA. Ethnic Minority Psychiatric Illness Rates In The Community (EMPIRIC): User Guide for UK Data Archive. UKDA, no date. (http://www.esds.ac.uk/doc/4685/mrdoc/pdf/4685userguide.pdf)

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Conflict of interest: None declared

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Ethnic Effects: a View from West London

Samuel C Yates, CT3 Psychiatry Doctor
14 November 2012

Dear Editor,

I read with interest Das-Munshi et al.'s paper [1] exploring the notion of ethnic density as a possible buffer against the development of psychotic experiences. With the authors highlighting issues of considerable relevance, I shared a critical review of the paper with colleagues at the Ealing Journal Club, West London Mental Health Trust. Myobservations below (three critical, one inquisitive) have therefore been enriched by the reflections of a group of Doctors working in Psychiatry.

A first observation is that clinical applicability is limited - by the study's use of a screening test and its cross-sectional survey design.A screening test for psychotic experiences rather than a clinical assessment tool for psychotic illness distances the findings from the clinical domain. As Das-Munshi et al. indicate, there is reason to believethat psychotic experiences and illness are correlated; and the statisticalproperties of Bebbington's Psychosis Screening Questionnaire (PSQ) [2] versus a gold standard [3] look impressive. However, especially with the symptom-domain of delusions, there seems room to doubt how effectively a member of the general public will self-assess for presence/absence of symptoms; and, with the symptom-domain of hypomania, how well this taps into the core concept of psychosis (construct validity).

As the authors acknowledge, the cross-sectional design brings broaderlimitations, precluding inferences of temporality. Even if an association between psychosis and ethnic density is granted, it remains unclear which way the arrow is pointing. It may even be that ethnic density is just another factor in a nexus of contributors to overall risk of psychosis (multi-factorial model).

A second observation is that, whilst the associations between psychosis and psychosocial factors (racism/discrimination, chronic strains, and social support) are quite convincing, those between psychosisand ethnic density are less robust. Indeed, statistical significance is only reached for the Indian group and the combined minority sample. From here, it seems a substantial jump to claim that 'the general trend was supportive of similar associations for all minority groups'.

This connects to a third observation: that, in grouping together the different ethnic groups (thereby generating sufficient power for a significant effect), the authors may have fallen foul of the same 'over-homogenising' they rightly deem a 'limitation of previous work'.

Finally, we were intrigued to note the 'cross-over' effects in the interactional models (Figures 3 and 4). It appears that, at very low ethnic densities ('ethnic isolation'), practical/confiding support from the nominated closest person may actually increase risk of psychotic experiences. A chance finding cannot be excluded, but there are other possibilities. Firstly, more supportive relationships may have elements ofenmeshment, possibly related to high expressed emotion. Secondly, a more unwell person might elicit higher levels of support from those closest to them. Thirdly, in the context of 'ethnic isolation', a close and supportive relationship may actually limit chances of encountering disconfirmatory evidence from outside the 'relationship bubble' for any psychotic-spectrum symptoms emerging.

We would like to thank Das-Munshi and colleagues for their thought-provoking paper, and would welcome their own thoughts on the above observations.

Dr Samuel YatesCT3 Psychiatry DoctorOn Behalf of the Ealing Journal Club, West London Mental Health Trust.

WORD COUNT: 499 words

REFERENCES(1) Das-Munshi et al.. Ethnic Density as a Buffer for Psychotic Experiences: Findings from a National Survey (EMPIRIC). British Journal ofPsychiatry. 2012; 201: 282-290.

(2) Bebbington P, Nayani V. The Psychosis Screening Questionnaire. International Journal of Methods in Psychiatric Research. 1995; 5(1): 11-19.

(3) Wing JK et al. SCAN: Scheduled for Clinical Assessment in Neuropsychiatry. Archives of General Psychiatry. 1990; 47: 589-593.

AUTHOR'S DETAILS - E-mail: samuelyates@doctors.org.uk - Work address/appointment: Mott House Specialist Rehabilitation Unit, St Bernard's Hospital, Uxbridge Road, Greater London, UB1 3EU- Tel: 0208 354 8903- Fax: 0208 354 8908

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Conflict of interest: None declared

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