Abstract
PurposePrevious research has not provided us with a comprehensive picture of the longitudinal course of psychotic disorders in Black people living in Europe. We sought to investigate clinical outcomes and pattern of care in Black African and Black Caribbean groups compared with White British patients during the first 5 years after first contact with mental health services for psychosis.Methods245 FEP cases aged 18–65 who presented to psychiatric services in 2005–2010 in South London (UK). Using the electronic psychiatric clinical notes in the South London and Maudsley NHS Foundation Trust (SLaM), extensive information was collected on three domains—clinical, social, and service use.ResultsDuring the 5-year follow-up (mean = 5.1 years, s.d. = 2.4; 1251 person years) after first contact with mental health services, a higher proportion of Black African and Black Caribbean ethnicity had compulsory re-admissions (χ2 = 17.34, p = 0.002) and instances of police involvement during an admission to a psychiatric unit (χ2 = 22.82, p < 0.001) compared with White British ethnic group. Patients of Black African and Black Caribbean ethnicity did not differ from the ethnic group in overall functional disability and illness severity, or frequency of remission or recovery during the follow-up period. However, patients of Black ethnicity become increasing socially excluded as their illness progress.ConclusionsThe longitudinal trajectory of psychosis in patients of Black ethnicity did not show greater clinical or functional deterioration than white patients. However, their course remains characterised by more compulsion, and longer periods of admission.
Highlights
Psychiatric epidemiology has consistently demonstrated that the incidence rates of psychotic disorders are considerably elevated among those of Black ethnicity residing inSoc Psychiatry Psychiatr Epidemiol (2017) 52:1101–1111 the UK compared to the host population [1,2,3]
The evidence further suggests that individuals of Black ethnicity are more likely to make the first contact with mental health services via admissions under Mental Health Act (MHA) legislation [4], in many cases with police present at admission [5, 6], or to be admitted to high-security psychiatric hospitals [7] compared to White British patients
Earlier research into longitudinal illness trajectory across ethnic groups is marked by methodological limitations, such as small sample sizes [8] and a tendency to neglect the diversity in culture, religious beliefs and life experience between Black African and Black Caribbean populations by combining these ethnic groups in analyses [8, 9, 16, 17]
Summary
Psychiatric epidemiology has consistently demonstrated that the incidence rates of psychotic disorders are considerably elevated among those of Black ethnicity residing inSoc Psychiatry Psychiatr Epidemiol (2017) 52:1101–1111 the UK compared to the host population [1,2,3]. Psychiatric epidemiology has consistently demonstrated that the incidence rates of psychotic disorders are considerably elevated among those of Black ethnicity residing in. The evidence further suggests that individuals of Black ethnicity are more likely to make the first contact with mental health services via admissions under Mental Health Act (MHA) legislation [4], in many cases with police present at admission [5, 6], or to be admitted to high-security psychiatric hospitals [7] compared to White British patients. The evidence is consistent that one-third of patients with FEP recover [14, 15] It is still unclear whether this recovery rate applies to those in Black ethnic groups. Some investigators have limited their sample to those with diagnosis of schizophrenia only [5, 17] or who had been re-admitted during a follow-up period, and as such bias results towards poorer outcomes [18]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
