title: Factors in the onset of schizophrenia: a comparison between London and Trinidad samples.
abstract: OBJECTIVE
  Sociodemographic factors play an important role in the genesis of mental disorders. High rates of unemployment and other social factors have been reported previously among African-Caribbeans with schizophrenia in London. The aim of the present study was to compare these factors in Trinidad with London African-Caribbeans.
  
  
  METHODS
  Using internationally defined criteria, patients with first-onset schizophrenia were recruited in both countries, and information on the onset of symptoms, help-seeking, pathways into care, premorbid personality and educational and employment status were collected. These two samples are compared on a number of these factors. A total of 56 cases of first onset of psychosis coming into contact with psychiatric services in Trinidad were studied. Of these, 46 cases were diagnosed as having schizophrenia using the CATEGO program. Over a period of 2 years, 38 African-Caribbean patients with schizophrenia were recruited in London.
  
  
  RESULTS
  African-Caribbean patients with schizophrenia in London were more likely to be admitted for perceived threat to others and to have shown loss of interest and serious neglect and to have assaulted others. A lower proportion were admitted via a psychiatrist and a higher proportion by the police. The unemployment rate among the London sample of African-Caribbeans was much higher than that in the general population, whereas this was not the case for the Trinidad patients.
  
  
  CONCLUSIONS
  These findings are discussed in the context of culture and aetiology of schizophrenia, and suggestions with regard to future research are made.
authors.affiliation: Institute of Psychiatry, London, UK.
authors.forename: D
authors.initials: D
authors.lastname: Bhugra
authors.forename: M
authors.initials: M
authors.lastname: Hilwig
authors.forename: R
authors.initials: R
authors.lastname: Mallett
authors.forename: B
authors.initials: B
authors.lastname: Corridan
authors.forename: J
authors.initials: J
authors.lastname: Leff
authors.forename: J
authors.initials: J
authors.lastname: Neehall
authors.forename: S
authors.initials: S
authors.lastname: Rudge
mesh_terms: D000328:Adult; D017668:Age of Onset; D004522:Educational Status; D005260:Female; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D010342:Patient Acceptance of Health Care; D010554:Personality Disorders / Q000175:diagnosis; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D014300:Trinidad and Tobago / Q000453:epidemiology; D014478:Unemployment / Q000523:psychology