Incidence of schizophrenia and other psychoses in ethnic minority groups: results from the MRC AESOP Study.
BACKGROUND
The incidence of schizophrenia in the African-Caribbean population in England is reported to be raised. We sought to clarify whether (a) the rates of other psychotic disorders are increased, (b) whether psychosis is increased in other ethnic minority groups, and (c) whether particular age or gender groups are especially at risk.


METHODS
We identified all people (n=568) aged 16-64 years presenting to secondary services with their first psychotic symptoms in three well-defined English areas (over a 2-year period in Southeast London and Nottingham and a 9-month period in Bristol). Standardized incidence rates and incidence rate ratios (IRR) for all major psychosis syndromes for all main ethnic groups were calculated.


RESULTS
We found remarkably high IRRs for both schizophrenia and manic psychosis in both African-Caribbeans (schizophrenia 9.1, manic psychosis 8.0) and Black Africans (schizophrenia 5.8, manic psychosis 6.2) in men and women. IRRs in other ethnic minority groups were modestly increased as were rates for depressive psychosis and other psychoses in all minority groups. These raised rates were evident in all age groups in our study.


CONCLUSIONS
Ethnic minority groups are at increased risk for all psychotic illnesses but African-Caribbeans and Black Africans appear to be at especially high risk for both schizophrenia and mania. These findings suggest that (a) either additional risk factors are operating in African-Caribbeans and Black Africans or that these factors are particularly prevalent in these groups, and that (b) such factors increase risk for schizophrenia and mania in these groups.
Fearon
Paul
P
Division of Psychological Medicine, Institute of Psychiatry, King's College, London, UK. p.fearon@iop.kcl.ac.uk
Kirkbride
James B
JB
Morgan
Craig
C
Dazzan
Paola
P
Morgan
Kevin
K
Lloyd
Tuhina
T
Hutchinson
Gerard
G
Tarrant
Jane
J
Fung
Wai Lun Alan
WL
Holloway
John
J
Mallett
Rosemarie
R
Harrison
Glynn
G
Leff
Julian
J
Jones
Peter B
PB
Murray
Robin M
RM
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D044383:Black People / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004739:England; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000453:epidemiology / Q000208:ethnology*; D012306:Risk; D012559:Schizophrenia / Q000453:epidemiology / Q000208:ethnology*