Patterns of illness and care over the 5 years following onset of psychosis in different ethnic groups: the GAP-5 study

TY - JOUR

T1 - Patterns of illness and care over the 5 years following onset of psychosis in different ethnic groups

T2 - the GAP-5 study

AU - Ajnakina, Olesya

AU - Lally, John Alexander

AU - Di Forti, Marta

AU - Kolliakou, Anna Anna

AU - Lopez-Morinigo, Javier David

AU - Gardner-Sood, Poonam

AU - Dazzan, Paola

AU - Pariante, Carmine Maria

AU - Mondelli, Valeria

AU - MacCabe, James

AU - David, Anthony Sion

AU - Gaughran, Fiona Patricia

AU - Murray, Robin MacGregor

AU - Vassos, Evangelos

PY - 2017/7/5

Y1 - 2017/7/5

N2 - PURPOSE: Previous 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. METHODS: 245 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. RESULTS: During 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 (χ 2 = 17.34, p = 0.002) and instances of police involvement during an admission to a psychiatric unit (χ 2 = 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. CONCLUSIONS: The 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.

AB - PURPOSE: Previous 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. METHODS: 245 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. RESULTS: During 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 (χ 2 = 17.34, p = 0.002) and instances of police involvement during an admission to a psychiatric unit (χ 2 = 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. CONCLUSIONS: The 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.

U2 - 10.1007/s00127-017-1417-6

DO - 10.1007/s00127-017-1417-6

M3 - Article

SN - 0933-7954

SP - 1

EP - 11

JO - Social Psychiatry and Psychiatric Epidemiology

JF - Social Psychiatry and Psychiatric Epidemiology

ER -