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

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posted on 22.11.2019 by Olesya Ajnakina, John Lally, Marta Di Forti, Anna Kolliakou, Poonam Gardner-Sood, Javier Lopez-Morinigo, Paola Dazzan, Carmine M. Pariante, Valeria Mondelli, James MacCabe, Anthony S. David, Fiona Gaughran, Robin Murray, Evangelos Vassos

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.

Funding

This study was funded by the United Kingdom NationalInstitute of Health Research Biomedical Research Centre for MentalHealth, South London and Maudsley NHS Foundation Trust; theInstitute of Psychiatry, Psychology and Neuroscience at King’s Col-lege London; the Psychiatry Research Trust; Guy’s and St ThomasCharity; and the Maudsley Charitable research fund.

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The original article is available at https://link.springer.com

Published Citation

Ajnakina O, Lally J, Di Forti M, Kolliakou A, Gardner-Sood P, Lopez-Morinigo J, Dazzan P, Pariante CM, Mondelli V, MacCabe J, David AS, Gaughran F, Murray RM, Vassos E. Social Psychiatry and Psychiatric Epidemiology. 2017;52(9):1101-1111.

Publication Date

01/09/2017

Publisher

Springer International Publishing AG

PubMed ID

28681264

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