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Cumulative social disadvantage, ethnicity and first-episode psychosis: a case-control study

Morgan, Craig and Kirkbride, James B. and Hutchinson, Gerard and Craig, Tom K.J. and Morgan, Kevin D. and Dazzan, Paola and Boydell, Jane and Doody, Gillian A. and Jones, Peter B. and Murray, Robin M. and Leff, Julian and Fearon, Paul (2008) Cumulative social disadvantage, ethnicity and first-episode psychosis: a case-control study. Psychological Medicine, 38 (12). pp. 1701-1715. ISSN 0033-2917

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Official URL: http://dx.doi.org/10.1017/S0033291708004534


Background. Numerous studies have reported high rates of psychosis in the Black Caribbean population in the UK. Recent speculation about the reasons for these high rates has focused on social factors. However, there have been few empirical Studies. We sought to compare the prevalence of specific indicators of social disadvantage and isolation, and variations by ethnicity, in subjects with a first episode of psychosis and a series of healthy controls. Method. All cases with a first episode of psychosis who made contact with psychiatric services in defined catchment areas in London and Nottingham, UK and a series of community controls were recruited over a 3-year period. Data g to clinical and social variables were collected from cases and controls. Results. On all indicators, cases were more socially, disadvantaged and isolated than controls, after controlling for potential confounders. These associations held when the sample was restricted to those with in affective diagnosis and to those with a short prodrome and short duration Of untreated psychosis. There was a clear linear relationship between concentrated disadvantage and odds of psychosis. Similar patterns were evident in the two main ethnic groups, White British and Black Caribbean. However, indicators of social disadvantage and isolation were more common in Black Caribbean Subjects than White British subjects. Conclusions. We found strong associations between indicators of disadvantage and psychosis. If these variables index exposure to factors that increase risk of psychosis, their greater prevalence in the Black Caribbean Population may contribute to the reported high rates of psychosis in this population.

Item Type:Article
Uncontrolled Keywords:Ethnicity, first-episode psychosis, social disadvantage
Research Community:University of Westminster > Social Sciences, Humanities and Languages, School of
ID Code:6697
Deposited On:30 Apr 2009 11:47
Last Modified:16 Jun 2009 16:21

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