The British Journal of Psychiatry (2008) 192: 185-190. doi: 10.1192/bjp.bp.107.042291
© 2008 The Royal College of Psychiatrists
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Perceptions of disadvantage, ethnicity and psychosis

Claudia Cooper, MRCPsych, MSc, PhD

Department of Mental Health Services, University College London

Craig Morgan, BA(Hons), MSc, PhD, MRC, Majella Byrne, BA, MA, MSc, PhD, DClinPsy, Cpsychol and Paola Dazzan, MSc, PhD, MRCPsych

Institute of Psychiatry, London

Kevin Morgan, PhD

Department of Psychology, University of Westminster, London

Gerard Hutchinson, MRCPsych

Psychiatry Unit, Department of Clinical Medical Sciences, University of the West Indies, Champs Fleurs, Trinidad

Gillian A. Doody, BSc, MBBS, MPhil, MD(Dist.), MRCPsych

University of Nottingham, Nottingham

Glynn Harrison, FRCPsych

Academic Unit of Psychiatry, Cotham House, Bristol

Julian Leff, FRCPsych

Department of Mental Health Sciences, University College London

Peter Jones, PhD, MRCPsych

Department of Psychiatry, University of Cambridge, Addenbrooke’s Hospital, Cambridge

Khalida Ismail, MRCPsych, PhD and Robin Murray, MD, DSc, FRCP, FRCPsych, FMedSci

Institute of Psychiatry, London

Paul Bebbington, MA, MPhil, PhD, FRCP, FRCPsych

Department of Mental Health Sciences, University College London

Paul Fearon, MB, MSc, PhD, MRCPI, MRCPsych

Institute of Psychiatry, London, UK

Correspondence: Professor Paul Bebbington, UCL Department of Mental Health Sciences, Charles Bell House, Riding House Street, London W1W 7EY, UK. Email: p.bebbington{at}ucl.ac.uk

Declaration of interest

None.

Background

People from Black ethnic groups (African–Caribbean and Black African) are more prone to develop psychosis in Western countries. This excess might be explained by perceptions of disadvantage.

Aims

To investigate whether the higher incidence of psychosis in Black people is mediated by perceptions of disadvantage.

Method

A population-based incidence and case–control study of first-episode psychosis (Aetiology and Ethnicity in Schizophrenia and Other Psychoses (ÆSOP)). A total of 482 participants answered questions about perceived disadvantage.

Results

Black ethnic groups had a higher incidence of psychosis (OR= 4.7, 95% CI 3.1–7.2). After controlling for religious affiliation, social class and unemployment, the association of ethnicity with psychosis was attenuated (OR=3.0, 95% CI 1.6–5.4) by perceptions of disadvantage. Participants in the Black non-psychosis group often attributed their disadvantage to racism, whereas Black people in the psychosis group attributed it to their own situation.

Conclusions

Perceived disadvantage is partly associated with the excess of psychosis among Black people living in the UK. This may have implications for primary prevention.


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