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Ethnicity and long-term course and outcome of psychotic disorders in a UK sample: The ÆSOP-10 study

  • Craig Morgan (a1), Paul Fearon (a2), Julia Lappin (a3), Margaret Heslin (a4), Kim Donoghue (a4), Ben Lomas (a5), Ulrich Reininghaus (a6), Adanna Onyejiaka (a7), Tim Croudace (a8), Peter B. Jones (a9), Robin M. Murray (a1), Gillian A. Doody (a5) and Paola Dazzan (a1)...
Abstract
Background

The incidence of psychotic disorders is elevated in some minority ethnic populations. However, we know little about the outcome of psychoses in these populations.

Aims

To investigate patterns and determinants of long-term course and outcome of psychoses by ethnic group following a first episode.

Method

ÆSOP-10 is a 10-year follow-up of an ethnically diverse cohort of 532 individuals with first-episode psychosis identified in the UK. Information was collected, at baseline, on clinical presentation and neurodevelopmental and social factors and, at follow-up, on course and outcome.

Results

There was evidence that, compared with White British, Black Caribbean patients experienced worse clinical, social and service use outcomes and Black African patients experienced worse social and service use outcomes. There was evidence that baseline social disadvantage contributed to these disparities.

Conclusions

These findings suggest ethnic disparities in the incidence of psychoses extend, for some groups, to worse outcomes in multiple domains.

Copyright
Corresponding author
Craig Morgan, Society and Mental Health Research Group, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK. Email: craig.morgan@kcl.ac.uk
Footnotes
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Declaration of interest

None.

Footnotes
References
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1 Cantor-Graae, E, Selten, JP. Schizophrenia and migration: a meta-analysis and review. Am J Psychiatry 2005; 162: 1224.
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 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.
4 Tortelli, A, Errazuriz, A, Croudace, T, Morgan, C, Murray, RM, Jones, PB, et al. Schizophrenia and other psychotic disorders in Caribbean-born migrants and their descendants in England: systematic review and meta-analysis of incidence rates, 1950–2013. Soc Psychiatry Psychiatr Epidemiol 2015; 50: 1039–55.
5 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.
6 Morgan, C, Mallett, R, Hutchinson, G, Bagalkote, H, Morgan, K, Fearon, P, et al. Pathways to care and ethnicity. 1: sample characteristics and compulsory admission. Report from the AESOP study. Br J Psychiatry 2005; 186: 281–9.
7 Morgan, C, Mallett, R, Hutchinson, G, Bagalkote, H, Morgan, K, Fearon, P, et al. Pathways to care and ethnicity. 2: source of referral and help-seeking. Report from the AESOP study. Br J Psychiatry 2005; 186: 290–6.
8 Mulder, CL, Koopmans, GT, Selten, JP. Emergency psychiatry, compulsory admissions and clinical presentation among immigrants to the Netherlands. Br J Psychiatry 2006; 188: 386–91
9 Morgan, C, Mallett, R, Hutchinson, G, Leff, J. Negative pathways to psychiatric care and ethnicity: the bridge between social science and psychiatry. Soc Sci Med 2004; 58: 739–52.
10 Chorlton, E, McKenzie, K, Morgan, C, Doody, G. Course and outcome of psychosis in Black Caribbean populations and other ethnic groups living in the UK: a systematic review. Int J Soc Psychiatry 2012; 58: 400–8.
11 Fernando, S. Mental Health, Race and Culture. Macmillan, 1991.
12 Littlewood, R, Lipsedge, M. Aliens and Alienists: Ethnic Minorities and Psychiatry (3rd edn). Routledge, 1997.
13 McKenzie, K, van, OS 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; 18; 311: 1325–8.
14 Selten, J-P, Veen, ND, Hoek, HW, Laan, W, Schols, D, van der Tweel, I, et al. Early course of schizophrenia in a representative Dutch incidence cohort. Schizophr Res 2007; 97: 7987.
15 Harrison, G, Amin, S, Singh, SP, Croudace, T, Jones, P. Outcome of psychosis in people of African-Caribbean family origin. Population-based first-episode study. Br J Psychiatry 1999; 175: 43–9.
16 Goater, N, King, M, Cole, E, Leavey, G, Johnson-Sabine, E, Blizard, R, et al. Ethnicity and outcome of psychosis. Br J Psychiatry 1999; 175: 3442.
17 Birchwood, M, Cochrane, R, Macmillan, F, Copestake, S, Kucharska, J, Carriss, M. The influence of ethnicity and family structure on relapse in first-episode schizophrenia. A comparison of Asian, Afro-Caribbean, and white patients. Br J Psychiatry 1992; 161: 783–90.
18 McGovern, D, Hemmings, P, Cope, R, Lowerson, A. Long-term follow-up of young Afro-Caribbean Britons and white Britons with a first admission diagnosis of schizophrenia. Soc Psychiatry Psychiatr Epidemiol 1994; 29: 819.
19 Morgan, C, Lappin, J, Heslin, M, Donoghue, K, Lomas, B, Reininghaus, U, et al. Reappraising the long-term course and outcome of psychotic disorders: the ÆSOP-10 Study. Psychol Med 2014; 44: 2713–26.
20 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.
21 Morgan, C, Dazzan, P, Morgan, K, Jones, P, Harrison, G, Leff, J, et al. First episode psychosis and ethnicity: initial findings from the AESOP study. World Psychiatry 2006; 5: 40–6.
22 World Health Organization. Schedules for Clinical Assessment in Neuropsychiatry. WHO, 1992.
23 Sartorius, N, Gulbinat, W, Harrison, G, Laska, E, Siegel, C. Long-term follow-up of schizophrenia in 16 countries. A description of the International Study of Schizophrenia conducted by the World Health Organization. Soc Psychiatry Psychiatr Epidemiol 1996; 31: 249–58.
24 Burns, T, Creed, F, Fahy, T, Thompson, S, Tyrer, P, White, I. Intensive versus standard case management for severe psychotic illness: a randomised trial. UK 700 Group. Lancet 1999; 26: 2185–9.
25 Harrison, G, Hopper, K, Craig, T, Laska, E, Siegel, C, Wanderling, J, et al. Recovery from psychotic illness: a 15- and 25-year international follow-up study. Br J Psychiatry 2001; 178: 506–17.
26 Endicott, J, Spitzer, RL, Fleiss, JL, Cohen, J. The Global Assessment Scale. A procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry 1976; 33: 766–71.
27 Susser, E, Finnerty, M, Mojtabai, R, Yale, S, Conover, S, Goetz, R, et al. Reliability of the Life Chart Schedule for assessing the long-term course of schizophrenia. Schizophr Res 2000; 42; 6777.
28 Jablensky, A, Sartorius, N, Ernberg, G, Anker, M, Korten, A, Cooper, JE, et al (1992) Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organizsation ten-country study. Psychol Med Monogr Suppl 1992; 20: 197.
29 Hopper, K, Harrison, G, Janca, A, Sartorius, N. Recovery from Schizophrenia: An International Perspective. Oxford University Press, 2007.
30 Sartorius, N, Janca, A. Psychiatric assessment instruments developed by the World Health Organization. Soc Psychiatry Psychiatr Epidemiol 1996; 31: 5569.
31 Andreasen, NC. Carpenter WT Jr, Kane JM, Lasser RA, Marder SR, Weinberger DR. Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry 2005; 162: 441–9.
32 Robinson, DG, Woerner, MG, McMeniman, M, Mendelowitz, A, Bilder, RM. Symptomatic and functional recovery from a first episode of schizophrenia or schizoaffective disorder. Am J Psychiatry 2004; 161: 473–9.
33 Morgan, C, Kirkbride, J, Hutchinson, G, Craig, T, Morgan, K, Dazzan, P, et al. Cumulative social disadvantage, ethnicity and first-episode psychosis: a case-control study. Psychol Med 2008; 38: 1701–15.
34 office for National Statistics, Official Labour Market Statistics: Economic Activity by Ethnic Group by Sex by Age. ONS, 2011 (http://www.nomisweb.co.uk/census/2011/dc6201ew).
35 McKenzie, K, Samele, C, Van Horn, E, Tattan, T, Van Os, J, Murray, R. Comparison of the outcome and treatment of psychosis in people of Caribbean origin living in the UK and British Whites. Report from the UK700 trial. Br J Psychiatry 2001; 178: 160–5.
36 Heslin, M, Lomas, B, Lappin, JM, Donoghue, K, Reininghaus, U, Onyejiaka, A, et al. Diagnostic change 10 years after a first episode of psychosis. Psychol Med 2015; 4: 113.
37 Agius, M, Shah, S, Ramkisson, R, Persaud, A, Murphy, S, Zaman, R. Three year outcomes in an early intervention service for psychosis in a multicultural and multiethnic population. Psychiatr Danub 2008; 20: 494–9.
38 Eack, SM, Newhill, CE. Racial disparities in mental health outcomes after psychiatric hospital discharge among individuals with severe mental illness. Soc Work Res 2012; 36: 4152.
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Ethnicity and long-term course and outcome of psychotic disorders in a UK sample: The ÆSOP-10 study

  • Craig Morgan (a1), Paul Fearon (a2), Julia Lappin (a3), Margaret Heslin (a4), Kim Donoghue (a4), Ben Lomas (a5), Ulrich Reininghaus (a6), Adanna Onyejiaka (a7), Tim Croudace (a8), Peter B. Jones (a9), Robin M. Murray (a1), Gillian A. Doody (a5) and Paola Dazzan (a1)...
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