HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS Psychiatric Bulletin Advances in Psychiatric Treatment All RCPsych Journals		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by SHARPLEY, M. S. Articles by McKENZIE, K. Search for Related Content PubMed Articles by SHARPLEY, M. S. Articles by McKENZIE, K.

Understanding the excess of psychosis among the African—Caribbean population in England

Review of current hypotheses

GERARD HUTCHINSON, MD and ROBIN M. MURRAY, MD

Department of Psychiatry, Institute of Psychiatry, King's College London, UK

KWAME McKENZIE, MRCPsych

Department of Psychiatry, Royal Free Hospital, London, UK

Correspondence: Dr Mandy Sharpley, Section of Social Psychiatry, Institute of Psychiatry, DeCrespigny Park, London SE5 8AF, UK

Declaration of interest None.

ABSTRACT

Background Increased rates of schizophrenia continue to be reported among the African—Caribbean population in England.

Aims To evaluate the competing biological, psychological and social explanations that have been proposed.

Method Literature review.

Results The African—Caribbean population in England is at increased risk of both schizophrenia and mania; the higher rates remain when operational diagnostic criteria are used. The excess of the two psychotic disorders are probably linked: African—Caribbean patients with schizophrenia show more affective symptoms, and a more relapsing course with greater social disruption but fewer chronic negative symptoms, than White patients. No simple hypothesis explains these findings.

Conclusions More complex hypotheses are needed. One such links cultural variation in symptom reporting, the use of phenomenological constructs by psychiatrists and social disadvantage.

This article has been cited by other articles:

				K. Dein, P. S. Williams, and S. Dein Ethnic bias in the application of the Mental Health Act 1983 Advan. Psychiatr. Treat., September 1, 2007; 13(5): 350 - 357. [Abstract] [Full Text] [PDF]

				E. Cantor-Graae Ethnic minority groups, particularly African-Caribbean and Black African groups, are at increased risk of psychosis in the UK Evid. Based Ment. Health, August 1, 2007; 10(3): 95 - 95. [Full Text] [PDF]

				M. Bresnahan, M. D Begg, A. Brown, C. Schaefer, N. Sohler, B. Insel, L. Vella, and E. Susser Race and risk of schizophrenia in a US birth cohort: another example of health disparity? Int. J. Epidemiol., August 1, 2007; 36(4): 751 - 758. [Abstract] [Full Text] [PDF]

				A. T. A. CHENG and B. COOPER Introduction The British Journal of Psychiatry, April 1, 2001; 178 (40): s1 - s2. [Full Text] [PDF]

				S. ROSE Moving on from old dichotomies: beyond nature--nurture towards a lifeline perspective The British Journal of Psychiatry, April 1, 2001; 178 (40): s3 - s7. [Abstract] [Full Text] [PDF]

				B. COOPER Nature, nurture and mental disorder: old concepts in the new millennium The British Journal of Psychiatry, April 1, 2001; 178 (40): s91 - s101. [Abstract] [Full Text] [PDF]