The British Journal of Psychiatry 175: 43-49 (1999)
© 1999 The Royal College of Psychiatrists

Outcome of psychosis in people of African-Caribbean family origin. Population-based first-episode study

G Harrison, S Amin, SP Singh, T Croudace and P Jones
Division of Psychiatry, University of Bristol, UK.

BACKGROUND: An increased incidence of psychotic disorders has repeatedly been reported among African-Caribbeans in the UK. AIMS: To 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. METHOD: Thirty-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. RESULTS: There 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. CONCLUSION: Pattern 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.

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