First episodes of psychosis in Afro-Caribbean and White people. An 18-year follow-up population-based study.
BACKGROUND
There have been few prospective studies of the long-term outcome of psychosis in people of Afro-Caribbean origin in the UK.


METHODS
We followed-up a population-based, consecutive series of 34 Afro-Caribbean and 54 White people with psychosis who had been extensively investigated during their first admission in 1973/74. Diagnoses were made by direct interview using the Present State Examination at both first admission and follow-up.


RESULTS
Ninety-seven percent of the original sample were traced. A slightly greater proportion of the Afro-Caribbean people were assigned to the S+ Catego class (schizophrenia), both on first assessment and at follow-up. No difference was found between the two groups in the consistency of diagnosis over the 18 years or in the proportion of patients considered psychotic but Afro-Caribbean people tended to have fewer negative symptoms at follow-up. There were striking differences between the two groups in their experience of psychiatric care; Afro-Caribbean people were more likely to have been readmitted, to have experienced longer hospitalisations, and to have undergone more involuntary admissions than their White counterparts.


CONCLUSIONS
Afro-Caribbean people who met clinical and research criteria for schizophrenia had a less satisfactory experience of, and response to, psychiatric care over 18 years than their White counterparts.
Takei
N
N
Department of Psychological Medicine, Institute of Psychiatry, Denmark Hill, London. spjunot@iop.bpmf.ac.uk
Persaud
R
R
Woodruff
P
P
Brockington
I
I
Murray
R M
RM
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D010342:Patient Acceptance of Health Care; D011379:Prognosis; D011446:Prospective Studies; D012559:Schizophrenia / Q000208:ethnology*; D006113:United Kingdom / Q000453:epidemiology; D014900:West Indies / Q000208:ethnology; D044465:White People