Haringey Healthcare Trust and University Department of Psychiatry, Royal Free and University College Medical Schools, Royal Free Hospital, London
Institute of Psychiatry, London
St Mary's/St Charles Hospital, London
Royal Infirmary, Bristol
University of Limburg, Maastricht, The Netherlands
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
Background The comparative outcome of psychosis in British Whites and UK AfricanCaribbeans is unclear. Some report that AfricanCaribbeans 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 AfricanCaribbeans 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 AfricanCaribbeans 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 AfricanCaribbeans and British Whites. This may reflect risk factors that increase the rate of psychosis in UK AfricanCaribbeans. Treatment differences require further investigation.
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