Race, ethnicity, and the duration of untreated psychosis: a systematic review

TY - JOUR

T1 - Race, ethnicity, and the duration of untreated psychosis

T2 - a systematic review

AU - Anderson, Kelly K.

AU - Flora, Nina

AU - Archie, Suzanne

AU - Morgan, Craig

AU - McKenzie, Kwame

PY - 2014/7

Y1 - 2014/7

N2 - Purpose An extended duration of untreated psychosis (DUP) is associated with poor outcome in first-episode psychosis (FEP). Some have suggested that minority ethnic groups have longer treatment delays, and this could lead to worse outcomes. We systematically reviewed the literature on racial and ethnic differences in DUP in patients with FEP. Methods We searched electronic databases and conducted forward and backward tracking to identify studies that had compared DUP for people with FEP from different racial or ethnic groups. Results We identified ten papers that reported on the association between race or ethnicity and DUP. Overall, these studies did not find evidence of differences between groups; however, three of ten studies suggested that Black patients generally, and Black-African patients specifically, may have a shorter DUP relative to White patients. There were methodological limitations in most studies with respect to ethnicity classification, sample size, and adjustment for potential confounders. Conclusion Racial and ethnic differences in DUP were rarely found. This could reflect that DUP does not differ between groups, or may reflect the methodological limitations of prior research. Studies that are designed and powered to examine these differences in treatment delay are needed to determine whether there are differences in DUP for minority groups.

AB - Purpose An extended duration of untreated psychosis (DUP) is associated with poor outcome in first-episode psychosis (FEP). Some have suggested that minority ethnic groups have longer treatment delays, and this could lead to worse outcomes. We systematically reviewed the literature on racial and ethnic differences in DUP in patients with FEP. Methods We searched electronic databases and conducted forward and backward tracking to identify studies that had compared DUP for people with FEP from different racial or ethnic groups. Results We identified ten papers that reported on the association between race or ethnicity and DUP. Overall, these studies did not find evidence of differences between groups; however, three of ten studies suggested that Black patients generally, and Black-African patients specifically, may have a shorter DUP relative to White patients. There were methodological limitations in most studies with respect to ethnicity classification, sample size, and adjustment for potential confounders. Conclusion Racial and ethnic differences in DUP were rarely found. This could reflect that DUP does not differ between groups, or may reflect the methodological limitations of prior research. Studies that are designed and powered to examine these differences in treatment delay are needed to determine whether there are differences in DUP for minority groups.

KW - First-episode psychosis

KW - Duration of untreated psychosis

KW - Ethnicity

KW - Race

KW - Treatment delay

KW - Early intervention

KW - MENTAL-HEALTH-SERVICES

KW - 1ST-EPISODE PSYCHOSIS

KW - EARLY INTERVENTION

KW - PSYCHIATRIC EPIDEMIOLOGY

KW - MINORITY GROUPS

KW - HELP-SEEKING

KW - SCHIZOPHRENIA

KW - PATHWAYS

KW - CARE

KW - DETERMINANTS

U2 - 10.1007/s00127-013-0786-8

DO - 10.1007/s00127-013-0786-8

M3 - Literature review

SN - 0933-7954

VL - 49

SP - 1161

EP - 1174

JO - Social Psychiatry and Psychiatric Epidemiology

JF - Social Psychiatry and Psychiatric Epidemiology

IS - 7

ER -