Psychoses, ethnicity and socio-economic status

Abstract

BackgroundConsistent observation of raised rates of psychoses among Black and minority ethnic (BME) groups may possibly be explained by their lower socio-economic statusAimsTo test whether risk for psychoses remained elevated in BME populations compared with the White British, after adjustment for age, gender and current socio-economic statusMethodPopulation-based study of first-episode DSM–IV psychotic disorders, in individuals aged 18–64 years, in East London over 2 yearsResultsAll 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)ConclusionsElevated 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