Psychoses, ethnicity and socio-economic status.
BACKGROUND
Consistent observation of raised rates of psychoses among Black and minority ethnic (BME) groups may possibly be explained by their lower socio-economic status.


OBJECTIVE
To test whether risk for psychoses remained elevated in BME populations compared with the White British, after adjustment for age, gender and current socio-economic status.


METHODS
Population-based study of first-episode DSM-IV psychotic disorders, in individuals aged 18-64 years, in East London over 2 years.


RESULTS
All BME groups had elevated rates of a psychotic disorder after adjustment for age, gender and socio-economic status. For schizophrenia, risk was elevated for people of Black Caribbean (incidence rate ratios (IRR)=3.1, 95% CI 2.1-4.5) and Black African (IRR=2.6, 95% CI 1.8-3.8) origin, and for Pakistani (IRR=3.1, 95% CI 1.2-8.1) and Bangladeshi (IRR=2.3, 95% CI 1.1-4.7) women. Mixed White and Black Caribbean (IRR=7.7, 95% CI 3.2-18.8) and White Other (IRR=2.1, 95% CI 1.2-3.8) groups had elevated rates of affective psychoses (and other non-affective psychoses).


CONCLUSIONS
Elevated rates of psychoses in BME groups could not be explained by socio-economic status, even though current socio-economic status may have overestimated the effect of this confounder given potential misclassification as a result of downward social drift in the prodromal phase of psychosis. Our findings extended to all BME groups and psychotic disorders, though heterogeneity remains.
Kirkbride
J B
JB
University Department of Psychiatry, Addenbrooke's Hospital, Hills Road, Cambridge, UK. jbk25@cam.ac.uk
Barker
D
D
Cowden
F
F
Stamps
R
R
Yang
M
M
Jones
P B
PB
Coid
J W
JW
D000293:Adolescent; D000328:Adult; D000349:Africa / Q000208:ethnology; D001208:Asia / Q000208:ethnology; D005260:Female; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000208:ethnology; D012307:Risk Factors; D012931:Social Environment; D012959:Socioeconomic Factors; D014900:West Indies / Q000208:ethnology