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.

scholarly journals Pathways to care and ethnicity. 2: Source of referral and help-seeking

2005 ◽  
Vol 186 (4) ◽  
pp. 290-296 ◽  
Author(s):  
Craig Morgan ◽  
Rosemarie Mallett ◽  
Gerard Hutchinson ◽  
Hemant Bagalkote ◽  
Kevin Morgan ◽  
...  
Keyword(s):  
Mental Health ◽  
Criminal Justice ◽  
Help Seeking ◽  
Pathways To Care ◽  
First Episode ◽  
Criminal Justice Agency ◽  
Black African ◽  
African Caribbean ◽  
African Patients ◽  
Pathway To Care

BackgroundPrevious research has found that African–Caribbean and Black African patients are likely to come into contact with mental health services via more negative routes, when compared with White patients. We sought to investigate pathways to mental health care and ethnicity in a sample of patients with a first episode of psychosis drawn from two UK centres.MethodWe included all White British, other White, African–Caribbean and Black African patients with a first episode of psychosis who made contact with psychiatric services over a 2-year period and were living in defined areas. Clinical, socio-demographic and pathways to care data were collected from patients, relatives and case notes.ResultsCompared with White British patients, general practitioner referral was less frequent for both African–Caribbean and Black African patients and referral by a criminal justice agency was more common. With the exception of criminal justice referrals for Black African patients, these findings remained significant after adjusting for potential confounders.ConclusionsThese findings suggest that factors are operating during a first episode of psychosis to increase the risk that the pathway to care for Black patients will involve non-health professionals.

scholarly journals Ethnicity and long-term course and outcome of psychotic disorders in a UK sample: The ÆSOP-10 study

2017 ◽  
Vol 211 (2) ◽  
pp. 88-94 ◽  
Author(s):  
Craig Morgan ◽  
Paul Fearon ◽  
Julia Lappin ◽  
Margaret Heslin ◽  
Kim Donoghue ◽  
...  
Keyword(s):  
Service Use ◽  
Psychotic Disorders ◽  
Ethnic Disparities ◽  
First Episode ◽  
Black African ◽  
African Patients ◽  
The Uk ◽  
Multiple Domains

BackgroundThe incidence of psychotic disorders is elevated in some minority ethnic populations. However, we know little about the outcome of psychoses in these populations.AimsTo investigate patterns and determinants of long-term course and outcome of psychoses by ethnic group following a first episode.MethodÆSOP-10 is a 10-year follow-up of an ethnically diverse cohort of 532 individuals with first-episode psychosis identified in the UK. Information was collected, at baseline, on clinical presentation and neurodevelopmental and social factors and, at follow-up, on course and outcome.ResultsThere was evidence that, compared with White British, Black Caribbean patients experienced worse clinical, social and service use outcomes and Black African patients experienced worse social and service use outcomes. There was evidence that baseline social disadvantage contributed to these disparities.ConclusionsThese findings suggest ethnic disparities in the incidence of psychoses extend, for some groups, to worse outcomes in multiple domains.

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.

Differing patterns of brain structural abnormalities between black and white patients with their first episode of psychosis

2009 ◽  
Vol 40 (7) ◽  
pp. 1137-1147 ◽  
Author(s):  
K. D. Morgan ◽  
P. Dazzan ◽  
C. Morgan ◽  
J. Lappin ◽  
G. Hutchinson ◽  
...  
Keyword(s):  
Grey Matter ◽  
First Episode Psychosis ◽  
First Episode ◽  
Grey Matter Volume ◽  
Black African ◽  
Caribbean Black ◽  
Matter Volume ◽  
Episode Psychosis ◽  
African Caribbean ◽  
African Patients

BackgroundAfrican-Caribbean and black African people living in the UK are reported to have a higher incidence of diagnosed psychosis compared with white British people. It has been argued that this may be a consequence of misdiagnosis. If this is true they might be less likely to show the patterns of structural brain abnormalities reported in white British patients. The aim of this study therefore was to investigate whether there are differences in the prevalence of structural brain abnormalities in white and black first-episode psychosis patients.MethodWe obtained dual-echo (proton density/T2-weighted) images from a sample of 75 first-episode psychosis patients and 68 healthy controls. We used high resolution magnetic resonance imaging and voxel-based methods of image analysis. Two separate analyses were conducted: (1) 34 white British patients were compared with 33 white British controls; (2) 41 African-Caribbean and black African patients were compared with 35 African-Caribbean and black African controls.ResultsWhite British patients and African-Caribbean/black African patients had ventricular enlargement and increased lenticular nucleus volume compared with their respective ethnic controls. The African-Caribbean/black African patients also showed reduced global grey matter and increased lingual gyrus grey-matter volume. The white British patients had no regional or global grey-matter loss compared with their normal ethnic counterparts but showed increased grey matter in the left superior temporal lobe and right parahippocampal gyrus.ConclusionsWe found no evidence in support of our hypothesis. Indeed, the finding of reduced global grey-matter volume in the African-Caribbean/black African patients but not in the white British patients was contrary to our prediction.

scholarly journals Criminal justice pathways to psychiatric care for psychosis

2015 ◽  
Vol 207 (6) ◽  
pp. 523-529 ◽  
Author(s):  
Kamaldeep Bhui ◽  
Simone Ullrich ◽  
Constantinos Kallis ◽  
Jeremy W. Coid
Keyword(s):  
Criminal Justice ◽  
Drug Use ◽  
Psychiatric Care ◽  
Care Pathway ◽  
Population Based ◽  
First Episode ◽  
Black African ◽  
Black Caribbean ◽  
African Patients ◽  
First Contact

BackgroundSome patients are at higher risk of contact with criminal justice agencies when experiencing a first episode of psychosis.AimsTo investigate whether violence explains criminal justice pathways (CJPs) for psychosis in general, and ethnic vulnerability to CJPs.MethodTwo-year population-based survey of people presenting with a first-episode of psychosis. A total of 481 patients provided information on pathways to psychiatric care. The main outcome was a CJP at first contact compared with other services on the care pathway.ResultsCJPs were more common if there was violence at first presentation (odds ratio (OR) = 4.23, 95% CI 2.74–6.54, P<0.001), drug use in the previous year (OR = 2.28, 95% CI 1.50–3.48, P<0.001) and for high psychopathy scores (OR = 2.54, 95% CI 1.43–4.53, P = 0.002). Compared with White British, CJPs were more common among Black Caribbean (OR = 2.97, 95% CI 1.54–5.72, P<0.001) and Black African patients (OR = 1.95, 95% CI 1.02–3.72, P = 0.01). Violence mediated 30.2% of the association for Black Caribbeans, but was not a mediator for Black African patients. These findings were sustained after adjustment for age, marital status, gender and employment.ConclusionsCJPs were more common in violent presentations, for greater psychopathy levels and drug use. Violence presentations did not fully explain ethnic vulnerability to CJPs.

Pathways to Care for Patients with a First Episode of Psychosis

1995 ◽  
Vol 167 (6) ◽  
pp. 770-776 ◽  
Author(s):  
Eleanor Cole ◽  
Gerard Leavey ◽  
Michael King ◽  
Eric Johnson-Sabine ◽  
Amanda Hoar
Keyword(s):  
Help Seeking ◽  
Minority Groups ◽  
Important Variable ◽  
Psychiatric Services ◽  
Pathways To Care ◽  
First Episode ◽  
Compulsory Admission ◽  
Chronic Patients ◽  
Black Patients ◽  
First Contact

BackgroundIt is reported that patients from ethnic minority groups, in particular Afro-Caribbeans, are more likely to enter less desirable pathways to psychiatric care. We aimed to determine whether ethnicity significantly affected time to presentation, type of first contact, rates of compulsory admission and police and primary care involvement, in patients with their first episode of psychosis.MethodAs part of a prospective epidemiological study, patients and their carers were interviewed using a semi-structured questionnaire to trace the various persons and agencies seen en route to their first contact with psychiatric services.ResultsWhile compulsory admission was more likely for Black patients, the excess was less striking than in previous studies. Black patients were no more likely than other patients to have police involvement. The most important factors in avoiding an adverse pathway were having a supportive family member or friend and the presence of a general practitioner to assist in gaining access to psychiatric services.ConclusionsThe routes to psychiatric services for first onset patients are different to those for chronic patients. Variables associated with social support were more important than ethnicity in determining pathways to care. Police involvement and compulsory admissions were strongly associated with the absence of GP involvement and the absence of help-seeking by a friend or relative. It may be that ethnicity becomes an important variable after the patient has come into contact with psychiatric services.

Duration of untreated psychosis and ethnicity in the ÆSOP first-onset psychosis study

2005 ◽  
Vol 36 (2) ◽  
pp. 239-247 ◽  
Author(s):  
CRAIG MORGAN ◽  
PAUL FEARON ◽  
GERARD HUTCHINSON ◽  
KWAME McKENZIE ◽  
JULIA M. LAPPIN ◽  
...  
Keyword(s):  
Mental Illness ◽  
Study Data ◽  
First Episode ◽  
Duration Of Untreated Psychosis ◽  
Treatment Delays ◽  
Black African ◽  
Black Patients ◽  
Catchment Areas ◽  
African Patients ◽  
First Contact

Background. There is a common assumption that Black patients with a psychotic mental illness experience longer treatment delays during a first episode. We sought to investigate this issue in a large cohort of patients with a first episode of psychosis.Method. All patients with a first episode of psychosis presenting to secondary mental health services within tightly defined catchment areas in south-east London and Nottingham over a 2-year period were included in the study. Data relating to duration of untreated psychosis (DUP) and clinical and sociodemographic characteristics were collected from patients, relatives and case-notes.Results. There was no evidence that African-Caribbean or Black African patients experienced longer periods of untreated psychosis than White British patients prior to first contact with services. There was evidence that Black African patients experienced shorter periods of untreated psychosis than White British patients.Conclusions. Contrary to what is commonly assumed, our study suggests that Black patients with a psychotic mental illness do not experience longer treatment delays prior to first contact with services than White British patients. This suggests that strategies to reduce treatment delays targeted specifically at Black patients will be of limited value.

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.

The first contact of patients with schizophrenia with psychiatric services: social factors and pathways to care in a multi-ethnic population

1999 ◽  
Vol 29 (2) ◽  
pp. 475-483 ◽  
Author(s):  
R. BURNETT ◽  
R. MALLETT ◽  
D. BHUGRA ◽  
G. HUTCHINSON ◽  
G. DER ◽  
...  
Keyword(s):  
Ethnic Groups ◽  
Psychiatric Service ◽  
Psychiatric Services ◽  
Pathways To Care ◽  
Compulsory Admission ◽  
Asian Patients ◽  
Significant Difference ◽  
African Caribbean ◽  
First Contact ◽  
First Admission

Background. African-Caribbean patients have less desirable routes of entry into the psychiatric services than other ethnic groups in Britain but this may not apply to the first contact with services.Methods. Patients' pathways to care, type of admission or referral and sectioning details were recorded for all first contact patients presenting to south London psychiatric services over a 2-year period. We also conducted a retrospective analysis of data from the Camberwell Register, comparing rates of compulsory admission between ‘Whites’ and ‘African-Caribbeans’ for first and readmissions, over a 20-year period.Results. Our first contact sample comprised 38 White, 38 African-Caribbean and 24 Asian patients with CATEGO defined broad schizophrenia. GP referral was found to be the most common mode of contact and there were no significant differences between the ethnic groups with regard to compulsory admission. Similarly, data from the Camberwell Register showed no significant difference in rates of compulsory admission between first admission White and African-Caribbean patients. However, when all readmissions were examined, African-Caribbeans were more likely to be admitted involuntarily.Conclusions. Our findings suggest that reports of less desirable routes of entry for African-Caribbean patients into the psychiatric service do not apply to their first admission but are likely to develop over time and repeated contact with the services.

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