A meta-analysis of ethnic differences in pathways to care at the first episode of psychosis

TY - JOUR

T1 - A meta-analysis of ethnic differences in pathways to care at the first episode of psychosis

AU - Anderson, K. K.

AU - Flora, N.

AU - Archie, S.

AU - Morgan, C.

AU - Mckenzie, K.

PY - 2014/2

Y1 - 2014/2

N2 - Objective: We sought to systematically review the literature on ethnic differences in the likelihood of general practitioner (GP) involvement, police involvement, and involuntary admission on the pathway to care of patients with first-episode psychosis (FEP). Method: We searched electronic databases and conducted forward and backward tracking to identify relevant studies. We calculated pooled odds ratios (OR) to examine the variation between aggregated ethnic groups in the indicators of the pathway to care. Results: We identified seven studies from Canada and England that looked at ethnic differences in GP involvement (n = 7), police involvement (n = 7), or involuntary admission (n = 5). Aggregated ethnic groups were most often compared. The pooled ORs suggest that Black patients have a decreased likelihood of GP involvement (OR = 0.70, 0.57-0.86) and an increased likelihood of police involvement (OR = 2.11, 1.67-2.66), relative to White patients. The pooled ORs were not statistically significant for patients with Asian backgrounds (GP involvement OR = 1.23, 0.87-1.75; police involvement OR = 0.86, 0.57-1.30). There is also evidence to suggest that there may be ethnic differences in the likelihood of involuntary admission; however, effect modification by several sociodemographic factors precluded a pooling of these data. Conclusion: Ethnic differences in pathways to care are present at the first episode of psychosis.

AB - Objective: We sought to systematically review the literature on ethnic differences in the likelihood of general practitioner (GP) involvement, police involvement, and involuntary admission on the pathway to care of patients with first-episode psychosis (FEP). Method: We searched electronic databases and conducted forward and backward tracking to identify relevant studies. We calculated pooled odds ratios (OR) to examine the variation between aggregated ethnic groups in the indicators of the pathway to care. Results: We identified seven studies from Canada and England that looked at ethnic differences in GP involvement (n = 7), police involvement (n = 7), or involuntary admission (n = 5). Aggregated ethnic groups were most often compared. The pooled ORs suggest that Black patients have a decreased likelihood of GP involvement (OR = 0.70, 0.57-0.86) and an increased likelihood of police involvement (OR = 2.11, 1.67-2.66), relative to White patients. The pooled ORs were not statistically significant for patients with Asian backgrounds (GP involvement OR = 1.23, 0.87-1.75; police involvement OR = 0.86, 0.57-1.30). There is also evidence to suggest that there may be ethnic differences in the likelihood of involuntary admission; however, effect modification by several sociodemographic factors precluded a pooling of these data. Conclusion: Ethnic differences in pathways to care are present at the first episode of psychosis.

KW - Health services accessibility

KW - Population groups

KW - Schizophrenia and disorders with psychotic features

UR - http://www.scopus.com/inward/record.url?scp=84927575962&partnerID=8YFLogxK

U2 - 10.1111/acps.12254

DO - 10.1111/acps.12254

M3 - Article

AN - SCOPUS:84927575962

SN - 0001-690X

VL - 130

SP - 257

EP - 268

JO - Acta Psychiatrica Scandinavica

JF - Acta Psychiatrica Scandinavica

IS - 4

ER -