title: First-contact incidence rate of schizophrenia on Barbados.
abstract: BACKGROUND
  The incidence rate for broad schizophrenia among second-generation African-Caribbean people in the United Kingdom has been reported as high. Ethnicity, migration and psychosocial stressors have been suggested as causal factors.
  
  
  OBJECTIVE
  To determine the incidence of schizophrenia for the whole population of Barbados using an identical methodology to two previous studies in Trinidad (Bhugra et al, 1996) and London (Bhugra et al, 1997).
  
  
  METHODS
  A 12-month study of all persons in the 18-54-year age group presenting with a psychosis for the first time was carried out on the population of Barbados. Information was collected using World Health Organization screening and measurement instruments.
  
  
  RESULTS
  On an island of just over a quarter of a million, 40 out of the 53 patients that met the inclusion criteria were categorised as S+ (narrow) schizophrenia, giving an incidence rate of 2.8/10,000 (95% CI 1.97-3.7). The incidence rate for broad schizophrenia was calculated at 3.2/10,000 (95% CI 2.3-4.1), which is significantly lower than the comparable rate for London's African-Caribbeans of 6.6/10,000 (95% CI 4.5-8.7).
  
  
  CONCLUSIONS
  The very high rate for broad schizophrenia among African-Caribbean people in the UK is probably due to environmental factors.
authors.affiliation: School of Clinical Medicine and Research, University of the West Indies, Queen Elizabeth Hospital, St Michael, Barbados.
authors.forename: G E
authors.initials: GE
authors.lastname: Mahy
authors.forename: R
authors.initials: R
authors.lastname: Mallett
authors.forename: J
authors.initials: J
authors.lastname: Leff
authors.forename: D
authors.initials: D
authors.lastname: Bhugra
mesh_terms: D000293:Adolescent; D000328:Adult; D001460:Barbados / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D006801:Humans; D015994:Incidence; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology* / Q000208:ethnology / Q000628:therapy; D012959:Socioeconomic Factors