Outcome of psychosis in people of African–Caribbean family origin

Abstract

BackgroundAn increased incidence of psychotic disorders has repeatedly been reported among African–Caribbeans in the UK.AimsTo test whether the increased incidence of psychotic disorders in first-and second-generation African–Caribbeans in the UK could be caused by a relative excess of affective-related psychoses with good prognosis.MethodThirty-three patients of African–Caribbean family origin identified in a population-based study of first-episode psychoses were compared with the remaining cases. Three-year outcomes and patterns of course were compared.ResultsThere was a trend for better outcomes in African–Caribbean patients for symptoms and social disability, but patterns of course were similar (odds ratio=0.9 (–0.50 to –2.00)). Pattern of course improved after adjustment for confounding by gender, social class, age, diagnosis and duration of untreated illness (odds ratio=0.59 (–0.21 to –1.66)). Diagnostic profiles were similar, with no evidence of greater diagnostic instability in the African–Caribbean group.ConclusionPattern of course of psychosis did not differ significantly by ethnic family background. An excess of good-prognosis affective psychoses is an unlikely explanation for increased rates of psychosis in African–Caribbeans.