Hostname: page-component-6766d58669-kl59c Total loading time: 0 Render date: 2026-05-19T14:44:39.176Z Has data issue: false hasContentIssue false
  • English
  • Français

Ethnicity and baseline symptomatology in patients with an At Risk Mental State for psychosis

Published online by Cambridge University Press:  11 August 2011

E. Velthorst ,
D. H. Nieman ,
W. Veling ,
R. M. Klaassen ,
S. Dragt ,
J. Rietdijk ,
H. Ising ,
L. Wunderink ,
D. H. Linszen  and
L. de Haan
...Show all authors
E. Velthorst*
Affiliation:
Department of Early Psychosis, Academic Medical Centre, Amsterdam, The Netherlands
D. H. Nieman
Affiliation:
Department of Early Psychosis, Academic Medical Centre, Amsterdam, The Netherlands
W. Veling
Affiliation:
Parnassia Psychiatric Institute, The Hague, The Netherlands
R. M. Klaassen
Affiliation:
GGZ Rivierduinen, Leiden, The Netherlands
S. Dragt
Affiliation:
Department of Early Psychosis, Academic Medical Centre, Amsterdam, The Netherlands
J. Rietdijk
Affiliation:
VU University and EMGO Institute, Amsterdam, The Netherlands
H. Ising
Affiliation:
Parnassia Psychiatric Institute, The Hague, The Netherlands
L. Wunderink
Affiliation:
GGZ Friesland, Leeuwarden, The Netherlands
D. H. Linszen
Affiliation:
Department of Early Psychosis, Academic Medical Centre, Amsterdam, The Netherlands
L. de Haan
Affiliation:
Department of Early Psychosis, Academic Medical Centre, Amsterdam, The Netherlands
M. van der Gaag
Affiliation:
Parnassia Psychiatric Institute, The Hague, The Netherlands VU University and EMGO Institute, Amsterdam, The Netherlands
*
*Address for correspondence: E. Velthorst, M.Sc., Academic Medical Centre, Department of Early Psychosis, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands. (Email: e.velthorst@amc.uva.nl)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Ethnicity has been associated with different incidence rates and different symptom profiles in young patients with psychotic-like disorders. No studies so far have examined the effect of ethnicity on symptoms in people with an At Risk Mental State (ARMS).

Method

In this cross-sectional study, we analysed the relationship between ethnicity and baseline data on the severity of psychopathology scores in 201 help-seeking patients who met the ARMS criteria and agreed to participate in the Dutch Early Detection and Intervention (EDIE-NL) trial. Eighty-seven of these patients had a non-Dutch ethnicity. We explored the possible mediating role of ethnic identity.

Results

Higher rates of negative symptoms, and of anhedonia in particular, were found in the ethnic minority group. This result could be attributed mainly to the Moroccan-Dutch and Turkish-Dutch subgroups, who also presented with more depression symptoms when the groups were examined separately. The ethnic minority group displayed a lower level of ethnic group identity compared to the immigrants of the International Comparative Study of Ethnocultural Youth (ICSEY). Ethnic identity was inversely related to symptoms in the Moroccan-Dutch patient group.

Conclusions

The prevalence of more severe negative symptoms and depression symptoms in ethnic minority groups deserves more attention, as the experience of attenuated positive symptoms when accompanied by negative symptoms or distress has proven to be predictive for transition to a first psychotic episode.

Keywords

At Risk Mental Stateethnic identityethnicitypsychosis

Information

Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 2 , February 2012 , pp. 247 - 256
Copyright
Copyright © Cambridge University Press 2011

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.)

Article purchase

Temporarily unavailable

References

Addington, D, Addington, N, Maticka-Tyndale, E, Joyce, J (1992). Reliability and validity of a depression rating scale for schizophrenics. Schizophrenia Research 6, 201–208.CrossRefGoogle ScholarPubMed
Arnold, LM, Keck, Jr. PE, Collins, J, Wilson, R, Fleck, DE, Corey, KB, Amicone, J, Adebimpe, VR, Strakowski, SM (2004). Ethnicity and first-rank symptoms in patients with psychosis. Schizophrenia Research 67, 207–212.CrossRefGoogle ScholarPubMed
Barrio, C, Yamada, AM, Atuel, H, Hough, RL, Yee, S, Berthot, B, Russo, PA (2003). A tri-ethnic examination of symptom expression on the positive and negative syndrome scale in schizophrenia spectrum disorders. Schizophrenia Research 60, 259–269.Google Scholar
Beck, AT, Steer, RA, Ball, R, Ranieri, W (1996). Comparison of Beck Depression Inventories-IA and -II in psychiatric outpatients. Journal of Personality Assessment 67, 588–597.Google Scholar
Berry, JW, Phinney, JS, Sam, DL, Vedder, PE (2006). Immigrant Youth in Cultural Transition. Acculturation, Identity, and Adaptation Across National Contexts. Lawrence Erlbaum Associates: Mahwah, NJ.Google Scholar
Bhugra, D, Hilwig, M, Corridan, B, Neehall, J, Rudge, S, Mallett, R, Leff, J (2000). A comparison of symptoms in cases with first onset of schizophrenia across four groups. European Journal of Psychiatry 14, 241–249.Google Scholar
Blom, JD, Eker, H, Basalan, H, Aouaj, Y, Hoek, HW (2010). Hallucinations attributed to djinns [in Dutch]. Nederlands Tijdschrift voor de Geneeskunde 154, A973.Google Scholar
Cannon, TD, Cadenhead, K, Cornblatt, B, Woods, SW, Addington, J, Walker, E, Seidman, LJ, Perkins, D, Tsuang, M, McGlashan, T, Heinssen, R (2008). Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. Archives of General Psychiatry 65, 28–37.Google Scholar
Goldman, HH, Skodol, AE, Lave, TR (1992). Revising axis V for DSM-IV: a review of measures of social functioning. American Journal of Psychiatry 149, 1148–1156.Google ScholarPubMed
Harvey, I, Williams, M, McGuffin, P, Toone, BK (1990). The functional psychoses in Afro-Caribbeans. British Journal of Psychiatry 157, 515–522.CrossRefGoogle ScholarPubMed
Hutchinson, G, Sharpley, M (1999). Ethnicity and first year of contact with psychiatric services. British Journal of Psychiatry 175, 492.CrossRefGoogle ScholarPubMed
Kirkbride, JB, Barker, D, Cowden, F, Stamps, R, Yang, M, Jones, PB, Coid, JW (2008). Psychosis, ethnicity and socio-economic status. British Journal of Psychiatry 193, 18–24.CrossRefGoogle ScholarPubMed
Morgan, C, Charalambides, M, Hutchinson, G, Murray, RM (2010). Migration, ethnicity, and psychosis: toward a sociodevelopmental model. Schizophrenia Bulletin 36, 655–664.Google Scholar
Morgan, C, Hutchinson, G (2010). Letter to the editor: Prevention is better than cure: a reply to McKenzie, March et al. and Selten & Cantor-Graae. Psychological Medicine 40, 876–877.Google Scholar
Phinney, JS (1992). The Multigroup Ethnic Identity Measure: a new scale for use with adolescents and young adults from diverse groups. Journal of Adolescence 7, 156–175.CrossRefGoogle Scholar
Rathod, S, Kingdon, D, Phiri, P, Gobbi, M (2010). Developing culturally sensitive cognitive behaviour therapy for psychosis for ethnic minority patients by exploration and incorporation of service users' and health professionals' views and opinions. Behavioural and Cognitive Psychotherapy 38, 511–533.Google Scholar
Reininghaus, U, Craig, TK, Fisher, HL, Hutchinson, G, Fearon, P, Morgan, K, Dazzan, P, Doody, GA, Jones, PB, Murray, RM, Morgan, C (2010). Ethnic identity, perceptions of disadvantage, and psychosis: findings from the ÆSOP study. Schizophrenia Research 124, 43–48.CrossRefGoogle ScholarPubMed
Rietdijk, J, Dragt, S, Klaassen, R, Ising, H, Nieman, D, Wunderink, L, Delespaul, P, Cuijpers, P, Linszen, D, van der Gaag, M (2010). A single blind randomized controlled trial of cognitive behavioural therapy in a help-seeking population with an At Risk Mental State for psychosis: the Dutch Early Detection and Intervention Evaluation (EDIE-NL) trial. Trials 11, 30.Google Scholar
Selten, JP, Cantor-Graae, E (2005). Social defeat: risk factor for schizophrenia. British Journal of Psychiatry 187, 101–102.CrossRefGoogle ScholarPubMed
Simon, AE, Umbricht, D (2010). High remission rates from an initial ultra-high risk state for psychosis. Schizophrenia Research 116, 168–172.Google Scholar
Strakowski, SM, Flaum, M, Amador, X, Bracha, HS, Pandurangi, AK, Robinson, D, Tohen, M (1996). Racial differences in the diagnosis of psychosis. Schizophrenia Research 23, 117–124.CrossRefGoogle Scholar
Veling, W, Hoek, HW, Wiersma, D, Mackenbach, JP (2010). Ethnic identity and the risk of schizophrenia in ethnic minorities: a case-control study. Schizophrenia Bulletin 36, 1149–1159.Google Scholar
Veling, W, Selten, JP, Mackenbach, JP, Hoek, HW (2007). Symptoms at first contact for psychotic disorder: comparison between native Dutch and ethnic minorities. Schizophrenia Research 95, 30–38.CrossRefGoogle ScholarPubMed
Velthorst, E, Nieman, DH, Becker, HE, van de Fliert, R, Dingemans, PM, de Haan, L, van Amelsvoort, T, Linszen, DH (2009). Baseline differences in clinical symptomatology between ultra high risk subjects with and without a transition to psychosis. Schizophrenia Research 109, 60–65.Google Scholar
Velthorst, E, Nieman, DH, Klaassen, RM, Becker, HE, Dingemans, PM, Linszen, DH, de Haan, L (2011). Three-year course of clinical symptomatology in young people at ultra high risk for transition to psychosis. Acta Psychiatrica Scandinavica 133, 36–42.Google Scholar
WHO (1993). Composite International Diagnostic Interview (CIDI), Core Version 1.1. American Psychiatric Publishing: Arlington, VA.Google Scholar
Wing, JK, Babor, T, Brugha, T, Burke, J, Cooper, JE, Giel, R, Jablenski, A, Regier, D, Sartorius, N (1990). SCAN. Schedules for Clinical Assessment in Neuropsychiatry. Archives of General Psychiatry 47, 589–593.CrossRefGoogle ScholarPubMed
Yung, AR, Buckby, JA, Cotton, SM, Cosgrave, EM, Killackey, EJ, Stanford, E, Godfrey, K, McGorry, PD (2006). Psychotic-like experiences in nonpsychotic help-seekers: associations with distress, depression, and disability. Schizophrenia Bulletin 32, 352–359.Google Scholar
Yung, AR, McGorry, PD, McFarlane, CA, Jackson, HJ, Patton, GC, Rakkar, A (1996). Monitoring and care of young people at incipient risk of psychosis. Schizophrenia Bulletin 22, 283–303.Google Scholar
Yung, AR, Phillips, LJ, McGorry, PD, McFarlane, CA, Francey, S, Harrigan, S, Patton, GC, Jackson, HJ (1998). Prediction of psychosis. A step towards indicated prevention of schizophrenia. British Journal of Psychiatry (Suppl.) 172, 14–20.CrossRefGoogle ScholarPubMed
Yung, AR, Phillips, LJ, Yuen, HP, Francey, SM, McFarlane, CA, Hallgren, M, McGorry, PD (2003). Psychosis prediction: 12-month follow up of a high-risk (‘prodromal’) group. Schizophrenia Research 60, 21–32.Google Scholar
Yung, AR, Yuen, HP, McGorry, PD, Philips, LJ, Kelly, D, Dell'Olio, M, Francey, SM, Cosgrave, EM, Killackey, E, Stanford, C, Godfrey, K, Buckby, J (2005). Mapping the onset of psychosis: the comprehensive assessment of At-Risk Mental States. Australian and New Zealand Journal of Psychiatry 39, 964–971.Google Scholar
Zandi, T, Havenaar, JM, Smits, M, Limburg-Okken, AG, van Es, H, Cahn, W, Algra, A, Kahn, RS, van den Brink, W (2010). First contact incidence of psychotic disorders among native Dutch and Moroccan immigrants in the Netherlands: influence of diagnostic bias. Schizophrenia Research 119, 27–33.Google Scholar