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The British Journal of Psychiatry (2001) 178: 160-165
© 2001 The Royal College of Psychiatrists

Comparison of the outcome and treatment of psychosis in people of Caribbean origin living in the UK and British Whites

Report from the UK700 trial

K. McKENZIE, MRCPsych

Haringey Healthcare Trust and University Department of Psychiatry, Royal Free and University College Medical Schools, Royal Free Hospital, London

C. SAMELE, PhD

Institute of Psychiatry, London

E. VAN HORN, MRCPsych

St Mary's/St Charles Hospital, London

T. TATTAN, MRCPsych

Royal Infirmary, Bristol

J. VAN OS, PhD

University of Limburg, Maastricht, The Netherlands

ROBIN MURRAY, FRCPsych

Institute of Psychiatry, London

Correspondence: Dr Kwame McKenzie, Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, Royal Free Campus, Rowland Hill Street, London NW3 2PF

Declaration of interest None.

Background The comparative outcome of psychosis in British Whites and UK African—Caribbeans is unclear. Some report that African—Caribbeans have worse outcome, whereas others claim better symptomatic outcome and a more benign course.

Aims To compare the course, outcome and treatment of psychosis in African—Caribbeans and British Whites in a large multi-centre sample.

Method A secondary analysis of 708 patients with research diagnostic criteria-defined psychosis from a 2-year, randomised controlled trial of case management. Outcome measures (hospitalisation, illness course, self-harm, social disability and treatment received) were adjusted for socio-economic and clinical differences between groups at baseline using regression analysis.

Results African—Caribbeans were less likely to have a continuous illness and to receive treatment with antidepressant or psychotherapy.

Conclusions The outcome of psychosis is complex but differs between UK African—Caribbeans and British Whites. This may reflect risk factors that increase the rate of psychosis in UK African—Caribbeans. Treatment differences require further investigation.




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