Psychotic symptoms in the general population of England: A comparison of ethnic groups (The EMPIRIC study)

Dept. of Mental Health Sciences, Royal Free & University College Medical School Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK.
Social Psychiatry and Psychiatric Epidemiology (Impact Factor: 2.54). 06/2005; 40(5):375-81. DOI: 10.1007/s00127-005-0900-7
Source: PubMed


There is considerable evidence that incidence of schizophrenia and other psychoses varies across ethnic groups in the UK, with particularly high rates for people of African-Caribbean origin.
The aims of this shady were to estimate in a community-based sample of people from ethnic minorities: 1) the prevalence of psychotic symptoms; and 2) risk factors for reporting psychotic symptoms.
Face-to-face interviews were carried out with a probabilistic sample of 4281 adults from six ethnic groups living in the UK. Psychotic symptoms were measured using the psychosis screening questionnaire (PSQ).
There was a twofold higher rate of reporting psychotic symptoms on the PSQ in Black Caribbean people compared with Whites. Adjustment for demographic factors had little effect on this association.
Prevalence rates of psychotic symptoms were higher in people from ethnic minorities, but were not consistent with the much higher first contact rates for psychotic disorder reported previously, particularly in Black Caribbeans.

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Available from: Michael B King, Jan 14, 2014
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    • "The link between socio-economic status and mental health has long been established, with mental health problems more prevalent in communities with greatest deprivation (Weich & Lewis, 1998). Ethnic minorities tend to have higher rates of poverty than the White British population (Kenway & Palmer, 2007), while there is evidence that some subgroups display increased incidence of psychosis (Bhugra, Leff, Mallett, Der, Corridan & Rudge, 1997; King et al., 2005) and common mental disorders such as anxiety and depression (Weich et al., 2004). In some cases mental health problems interact with lower income to the greatest detriment of African Caribbean, Pakistani and Bangladeshi populations (Mangalore & Knapp, 2012). "
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    Full-text · Chapter · Aug 2014
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    • "Motivated by previous studies that indicate significantly more frequent endorsement of psychotic-like symptom by Blacks, including African-Americans and Caribbean Blacks (Arnold et al. 2004; Ferron, Barron, and Chen 2002; King et al. 2005), this study demonstrates the importance of examining heterogeneity within the Black American population and across other racial/ethnic minority populations in the USA. Furthermore, our results suggest that psychotic like symptoms could be indicative of underlying distress, depression, and even coping with discrimination and other stressful circumstances, which if better understood and better assessed could assist in providing culturally responsive care. "
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    ABSTRACT: Objective: . To examine racial-ethnic differences in the endorsement and attribution of psychotic-like symptoms in a nationally representative sample of African-Americans, Asians, Caribbean Blacks, and Latinos living in the USA. Design: Data were drawn from a total of 979 respondents who endorsed psychotic-like symptoms as part of the National Latino and Asian American Study (NLAAS) and the National Survey of American Life (NSAL). We use a mixed qualitative and quantitative analytical approach to examine sociodemographic and ethnic variations in the prevalence and attributions of hallucinations and other psychotic-like symptoms in the NLAAS and NSAL. The lifetime presence of psychotic-like symptoms was assessed using the World Health Organization Composite International Diagnostic Interview (WMH-CIDI) psychotic symptom screener. We used logistic regression models to examine the probability of endorsing the four most frequently occurring thematic categories for psychotic-like experiences by race/ethnicity (n > 100). We used qualitative methods to explore common themes from participant responses to open ended questions on their attributions for psychotic-like symptoms. Results: African-Americans were significantly less likely to endorse visual hallucinations compared to Caribbean Blacks (73.7% and 89.3%, p < .001), but they endorsed auditory hallucinations symptoms more than Caribbean Blacks (43.1% and 25.7, p < .05). Endorsing delusions of reference and thought insertion/withdrawal were more prevalent for Latinos than for African-Americans (11% and 4.7%, p < .05; 6.3% and 2.7%, p < .05, respectively). Attribution themes included: supernatural, ghosts/unidentified beings, death and dying, spirituality or religiosity, premonitions, familial and other. Respondents differed by race/ethnicity in the attributions given to psychotic like symptoms. Conclusion: Findings suggest that variations exist by race/ethnicity in both psychotic-like symptom endorsement and in self-reported attributions/understandings for these symptoms on a psychosis screening instrument. Ethnic/racial differences could result from culturally sanctioned beliefs and idioms of distress that deserve more attention in conducting culturally informed and responsive screening, assessment and treatment.
    Full-text · Article · Jun 2014 · Ethnicity and Health
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    • "Past studies suggest that psychotic-like symptoms are associated with being female, low levels of social support, alcohol [5] and cannabis use [6], and a family history of mental illness [5,6]. Psychotic-like symptoms appear to be more prevalent in some ethnic groups [7], but available data are restricted to minorities living in developed countries. "
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    ABSTRACT: Background Studies in developed countries indicate that psychotic-like symptoms are prevalent in the community and are related to trauma exposure and PTSD. No comparable studies have been undertaken in low-income, post-conflict countries. This study aimed to assess the prevalence of psychotic-like symptoms in conflict-affected Timor Leste and to examine whether symptoms were associated with trauma and PTSD. Methods The Psychosis Screening Questionnaire and the Harvard Trauma Questionnaire (assessing trauma exposure and PTSD) were administered in an epidemiological survey of 1245 adults (response rate 80.6%) in a rural and an urban setting in Timor Leste. We defined PSQ screen-positive cases as those people reporting at least one psychotic-like symptom (paranoia, hallucinations, strange experiences, thought interference, hypomania). Results The prevalence of PSQ screen-positive cases was 12 percent and these persons were more disabled. PSQ cases were more likely to reside in the urban area, experienced higher levels of trauma exposure and a greater prevalence of PTSD. PTSD only partially mediated the relationship between trauma exposure and psychotic-like symptoms. Conclusions Psychotic-like symptoms may be prevalent in countries exposed to mass conflict. The cultural and contextual meaning of psychotic-like symptoms requires further inquiry in low-income, post-conflict settings such as Timor Leste.
    Full-text · Article · Dec 2012 · BMC Psychiatry
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