A Jamaican psychiatrist evaluates diagnoses at a London psychiatric hospital

1999 ◽  
Vol 175 (3) ◽  
pp. 283-285 ◽  
Author(s):  
F. W. Hickling ◽  
K. McKenzie ◽  
R. Mullen ◽  
R. Murray
Keyword(s):  
Psychiatric Hospital ◽  
Present State ◽  
Clinical Assessment ◽  
Interrater Reliability ◽  
Case Note ◽  
High Rate ◽  
Black African ◽  
African Caribbean ◽  
The Uk ◽  
State Examination

BackgroundAuthors have suggested that the high rate of schizophrenia reported for African–Caribbeans living in the UK is due to misdiagnosis by British psychiatrists.AimsTo compare the diagnoses made by a Black Jamaican psychiatrist with those of White British psychiatrists.MethodAll in-patients on four wards at the Maudsley hospital were approached for the study; 66 participated: 24 White, 29 Black African–Caribbeans and 13 Blacks from other countries of origin. F. W. H., a Black Jamaican psychiatrist, conducted his standard clinical assessment and performed the Present State Examination (PSE) on these patients. His diagnoses were compared with the case note diagnoses made by British psychiatrists, and with the PSE CATEGO diagnoses.ResultsOf 29 African and African–Caribbean patients diagnosed with schizophrenia, the diagnoses of the British and the Jamaican psychiatrists agreed in 16 instances (55%) and disagreed in 13 (45%). Hence, interrater reliability was poor (κ=0.45). PSE CATEGO diagnosed a higher proportion of subjects as having schizophrenia than the Jamaican psychiatrist did (χ2=3.74, P=0.052)ConclusionsAgreement between the Jamaican psychiatrist and his UK counterparts about which patients had schizophrenia was poor. PSE CATEGO may overestimate rates of schizophrenia.

The Incidence of First Contact Schizophrenia in Jamaica

1995 ◽  
Vol 167 (2) ◽  
pp. 193-196 ◽  
Author(s):  
Frederick W. Hickling ◽  
Pamela Rodgers-Johnson
Keyword(s):  
Incidence Rate ◽  
Present State ◽  
Incidence Rates ◽  
High Rate ◽  
Population Groups ◽  
Caribbean Immigrants ◽  
The Uk ◽  
First Contact ◽  
State Examination

BackgroundAfro-Caribbean immigrants are reported to have a high rate of schizophrenia compared with other population groups.MethodIn a prospective first contact study of schizophrenia in Jamaica in 1992, 335 patients were examined using the Present State Examination.Results285 patients were evaluated as having a PSE ‘restrictive’ S + diagnosis of schizophrenia, and 32 as having a ‘broad’ S?, P, or O diagnosis of schizophrenia. With a population of 2.46 million, this represents a first-contact incidence rate for ‘restrictive’ schizophrenia of 1.16 per 10 000 population, and an age-corrected (15–54) incidence rate of 2.09 per 10 000.ConclusionIncidence rates for schizophrenia in Jamaica are lower than those reported in Afro-Caribbean immigrants in the UK and Holland, and within the reported range for other population groups worldwide.

scholarly journals The Effects of the UK Pregnancies Better Eating and Activity Trial Intervention on Dietary Patterns in Obese Pregnant Women Participating in a Pilot Randomized Controlled Trial

2015 ◽  
Vol 8s1 ◽  
pp. NMI.S29529 ◽  
Author(s):  
Angela C. Flynn ◽  
Caroline Schneeberger ◽  
Paul T. Seed ◽  
Suzanne Barr ◽  
Lucilla Poston ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Dietary Patterns ◽  
Controlled Trial ◽  
Principal Component ◽  
Black African ◽  
Minority Ethnic Groups ◽  
Cultural Pattern ◽  
African Caribbean ◽  
The Uk ◽  
Study Participants

Objective The objective of this study is to investigate the effects of the UK Pregnancies Better Eating and Activity Trial (UPBEAT) behavioral intervention on dietary patterns in obese pregnant women. Methods Dietary patterns were derived from Food Frequency Questionnaires using principal component analysis in 183 UPBEAT pilot study participants. Results Two unhealthy dietary patterns, processed and traditional, predominantly characterized by foods high in sugar and fat, improved [processed -0.54 (-0.92 to -0.16), P = 0.006 and traditional -0.83 (-1.20 to -0.45), P < 0.001] following the intervention, while a cultural pattern that was found to be associated with the Black African/Caribbean participants did not change [-0.10 (-0.46 to 0.26), P = 0.589]. Conclusion Unhealthy dietary patterns are evident in obese pregnant women. The UPBEAT intervention was effective in improving maternal dietary patterns; however, obese pregnant women from minority ethnic groups may be less receptive to intervention.

First-contact incidence rate of schizophrenia on Barbados

1999 ◽  
Vol 175 (1) ◽  
pp. 28-33 ◽  
Author(s):  
George E. Mahy ◽  
Rosemarie Mallett ◽  
Julian Leff ◽  
Dinesh Bhugra
Keyword(s):  
Incidence Rate ◽  
High Rate ◽  
World Health ◽  
Measurement Instruments ◽  
Comparable Rate ◽  
The United Kingdom ◽  
African Caribbean ◽  
Health Organization ◽  
The Uk ◽  
First Contact

BackgroundThe incidence rate for broad schizophrenia among second-generation African–Caribbean people in the United Kingdom has been reported as high. Ethnicity, migration and psychosocial stressors have been suggested as causal factors.AimsTo determine the incidence of schizophrenia for the whole population of Barbados using an identical methodology to two previous studies in Trinidad (Bhugra et al, 1996) and London (Bhugra et al, 1997)MethodA12-month study of all persons in the 18–54-year age group presenting with a psychosis for the first time was carried out on the population of Barbados. Information was collected using World Health Organization screening and measurement instruments.ResultsOn an island of just over a quarter of a million, 40 out of the 53 patients that met the inclusion criteria were categorised as S+ (narrow) schizophrenia, giving an incidence rate of 2.8/10 000 (95% CI 1.97–3.7). The incidence rate for broad schizophrenia was calculated at 3.2/10 000 (95% CI 2.3–4.1), which is significantly lower than the comparable rate for London's African–Caribbeans of 6.6/10000 (95% CI 4.5–8.7)ConclusionsThe very high rate for broad schizophrenia among African–Caribbean people in the UK is probably due to environmental factors.

scholarly journals Clinical and laboratory phenotypes in juvenile-onset Systemic Lupus Erythematosus across ethnicities in the UK

Lupus ◽  
2021 ◽  
pp. 096120332098425
Author(s):  
Joseph S Massias ◽  
Eve MD Smith ◽  
Eslam Al-Abadi ◽  
Kate Armon ◽  
Kathryn Bailey ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Renal Involvement ◽  
Disease Onset ◽  
Adult Onset ◽  
Systemic Lupus ◽  
Juvenile Onset ◽  
Black African ◽  
African Caribbean ◽  
The Uk

Systemic lupus erythematosus (SLE) is a systemic autoimmune/inflammatory disease. Patients diagnosed with juvenile-onset SLE (jSLE), when compared to individuals with adult-onset SLE, develop more severe organ involvement, increased disease activity and greater tissue and organ damage. In adult-onset SLE, clinical characteristics, pathomechanisms, disease progression and outcomes do not only vary between individuals and age groups, but also ethnicities. However, in children and young people, the influence of ethnicity on disease onset, phenotype and outcome has not been investigated in detail. In this study, we investigated clinical and laboratory characteristics in pediatric SLE patients from different ethnic backgrounds (White Caucasian, Asian, Black African/Caribbean) accessing data from a national cohort of jSLE patients (the UK JSLE Cohort Study). Among jSLE patients in the UK, ethnicity affects both the disease’s clinical course and outcomes. At diagnosis, Black African/Caribbean jSLE patients show more “classical” laboratory and clinical features when compared to White Caucasian or Asian patients. Black African/Caribbean jSLE patients exhibit more renal involvement and more frequently receive cyclophosphamide and rituximab. Studies targeting ethnicity-specific contributors to disease expression and phenotypes are necessary to improve our pathophysiological understanding, diagnosis and treatment of jSLE.

Research watch: people of Black African and African Caribbean heritage in the UK and USA – psychosis, racism and inclusion

2020 ◽  
Vol 24 (2) ◽  
pp. 67-74
Author(s):  
Sue Holttum
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Social Inclusion ◽  
Spiritual Beliefs ◽  
Content Type ◽  
Black African ◽  
African Caribbean ◽  
The Usa ◽  
The Uk

Purpose This paper aims to examine three recent papers on psychosis and social inclusion in relation to people of Black African and African Caribbean heritage in the UK and the USA. Design/methodology/approach A search was carried out for recent papers on psychosis and social inclusion in relation to people of Black African and African Caribbean heritage in the UK and the USA. I selected three papers addressing this theme from different angles. Findings The first paper extends previous findings (that psychosis can follow traumatic events) to Black Americans and includes the contribution of societal inequalities and racism. The second paper illustrates Black men’s experiences of mental health services for psychosis in the UK. It finds, not surprisingly, that a lack of listening combined with coercive use of medication reduces trust in services. The third paper offers hope in reporting collaborative work with people of Black African Caribbean heritage in the UK to culturally adapt family intervention for psychosis. The first and third papers both place importance on valuing people’s spiritual beliefs. Originality/value All three papers highlight the on-going need for increased equity and social inclusion in mental health services for people of Black African and African Caribbean heritage, in terms of recognising the role of childhood trauma and later stresses, addressing the potential harm of over-reliance on medication, offering therapy that is collaborative and culturally adapted and respecting valued spiritual beliefs.

scholarly journals Perceptions of disadvantage, ethnicity and psychosis

2008 ◽  
Vol 192 (3) ◽  
pp. 185-190 ◽  
Author(s):  
Claudia Cooper ◽  
Craig Morgan ◽  
Majella Byrne ◽  
Paola Dazzan ◽  
Kevin Morgan ◽  
...  
Keyword(s):  
Ethnic Groups ◽  
Black People ◽  
Religious Affiliation ◽  
Population Based ◽  
First Episode ◽  
Black African ◽  
Episode Psychosis ◽  
African Caribbean ◽  
The Uk ◽  
Control Study

BackgroundPeople 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.AimsTo investigate whether the higher incidence of psychosis in Black people is mediated by perceptions of disadvantage.MethodA 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.ResultsBlack 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.ConclusionsPerceived disadvantage is partly associated with the excess of psychosis among Black people living in the UK. This may have implications for primary prevention.

scholarly journals Nutritional composition of the diets of South Ssian, black African Caribbean and white European children in the UK: the Child Heart and Health Study in England

2009 ◽  
Vol 63 (Suppl 2) ◽  
pp. 59-59
Author(s):  
A. S. Brock ◽  
C. M. Nightingale ◽  
C. G. Owen ◽  
A. R. Rudnicka ◽  
M. C. McNamara ◽  
...  
Keyword(s):  
Nutritional Composition ◽  
Health Study ◽  
Black African ◽  
African Caribbean ◽  
The Uk

scholarly journals Pathways to care and ethnicity. 1: Sample characteristics and compulsory admission

2005 ◽  
Vol 186 (4) ◽  
pp. 281-289 ◽  
Author(s):  
Craig Morgan ◽  
Rosemarie Mallett ◽  
Gerard Hutchinson ◽  
Hemant Bagalkote ◽  
Kevin Morgan ◽  
...  
Keyword(s):  
Pathways To Care ◽  
First Episode ◽  
Compulsory Admission ◽  
Sampling Frame ◽  
Black African ◽  
Epidemiological Sample ◽  
African Caribbean ◽  
Sample Characteristics ◽  
African Patients ◽  
The Uk

BackgroundMany studies have found high levels of compulsory admission to psychiatric hospital in the UK among African–Caribbean and Black African patients with a psychotic illness.AimsTo establish whether African–Caribbean and Black African ethnicity is associated with compulsory admission in an epidemiological sample of patients with a first episode of psychosis drawn from two UK centres.MethodAll patients with a first episode of psychosis who made contact with psychiatric services over a 2-year period and were living in defined areas were included in the (ÆSOP) study. For this analysis we included all White British, other White, African–Caribbean and Black African patients from the ÆSOP sampling frame. Clinical, socio-demographic and pathways to care data were collected from patients, relatives and case notes.ResultsAfrican–Caribbean patients were significantly more likely to be compulsorily admitted than White British patients, as were Black African patients. African–Caribbean men were the most likely to be compulsorily admitted.ConclusionsThese findings suggest that factors are operating at or prior to first presentation to increase the risk of compulsory admission among African–Caribbean and Black African patients.

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