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The British Journal of Psychiatry (2003) 182: 71-76
© 2003 The Royal College of Psychiatrists


PRELIMINARY REPORT

Discrimination and delusional ideation

I. JANSSEN, MA, M. HANSSEN, MA and M. BAK, MD

Department of Psychiatry and Neuropsychology, Maastricht University

R. V. BIJL, PhD, R. DE GRAAF, PhD and W. VOLLEBERGH, PhD

Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands

K. McKENZIE, MRCPsych

Division of Psychological Medicine, Institute of Psychiatry, London, UK

J. VAN OS, MRCPsych

Maastricht University and Institute of Psychiatry, London, UK

Correspondence: Professor Jim van Os, Department of Psychiatry and Neuropsychology, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. Tel: +31 43 387 5443; fax: +31 43 387 5444; e-mail: j.vanos{at}sp.unimaas.nl

Declaration of interest This research was supported by the Dutch Ministry of Health.

Background In the UK and The Netherlands, people with high rates of psychosis are chronically exposed to discrimination.

Aims To test whether perceived discrimination is associated longitudinally with onset of psychosis.

Method A 3-year prospective study of cohorts with no history of psychosis and differential rates of reported discrimination on the basis of age, gender, disability, appearance, skin colour or ethnicity and sexual orientation was conducted in the Dutch general population (n=4076). The main outcome was onset of psychotic symptoms (delusions and hallucinations).

Results The rate of delusional ideation was 0.5% (n=19) in those who did not report discrimination, 0.9% (n=4) in those who reported discrimination in one domain, and 2.7% (n=3) in those who reported discrimination in more than one domain (exact P=0.027). This association remained after adjustment for possible confounders. No association was found between baseline discrimination and onset of hallucinatory experiences.

Conclusions Perceived discrimination may induce delusional ideation and thus contribute to the high observed rates of psychotic disorder in exposed minority populations.


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