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Ethnic inequalities in the incidence of diagnosis of severe mental illness in England: a systematic review and new meta-analyses for non-affective and affective psychoses.
Soc Psychiatry Psychiatr Epidemiol. 2019 Nov; 54(11):1311-1323.SP

Abstract

PURPOSE

Although excess risks particularly for a diagnosis of schizophrenia have been identified for ethnic minority people in England and other contexts, we sought to identify and synthesise up-to-date evidence (2018) for affective in addition to non-affective psychoses by specific ethnic groups in England.

METHODS

Systematic review and meta-analysis of ethnic differences in diagnosed incidence of psychoses in England, searching nine databases for reviews (citing relevant studies up to 2009) and an updated search in three databases for studies between 2010 and 2018. Studies from both searches were combined in meta-analyses allowing coverage of more specific ethnic groups than previously.

RESULTS

We included 28 primary studies. Relative to the majority population, significantly higher risks of diagnosed schizophrenia were found in Black African (Relative risk, RR 5.72, 95% CI 3.87-8.46, n = 9); Black Caribbean (RR 5.20, 95% CI 4.33-6.24, n = 21); South Asian (RR 2.27, 95% CI 1.63-3.16, n = 14); White Other (RR 2.24, 95% CI 1.59-3.14, n = 9); and Mixed Ethnicity people (RR 2.24, 95% CI 1.32-3.80, n = 4). Significantly higher risks for diagnosed affective psychoses were also revealed: Black African (RR 4.07, 95% CI 2.27-7.28, n = 5); Black Caribbean (RR 2.91, 95% CI 1.78-4.74, n = 16); South Asian (RR 1.71, 95% CI 1.07-2.72, n = 8); White Other (RR 1.55, 95% CI 1.32-1.83, n = 5); Mixed Ethnicity (RR 6.16, 95% CI 3.99-9.52, n = 4).

CONCLUSIONS

The risk for a diagnosis of non-affective and affective psychoses is particularly elevated for Black ethnic groups, but is higher for all ethnic minority groups including those previously not assessed through meta-analyses (White Other, Mixed Ethnicity). This calls for further research on broader disadvantages affecting ethnic minority people.

Authors+Show Affiliations

Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.Sociology, School of Social Sciences, University of Manchester, Humanities, Bridgeford Street, Oxford Road, Manchester, M13 9PL, UK.Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.Centre for Research in Public Health & Community Care (CRIPACC), University of Hertfordshire, Health Research Building, College Lane, Hatfield, AL10 9AB, UK.Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK. k.s.bhui@qmul.ac.uk.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

31482194

Citation

Halvorsrud, Kristoffer, et al. "Ethnic Inequalities in the Incidence of Diagnosis of Severe Mental Illness in England: a Systematic Review and New Meta-analyses for Non-affective and Affective Psychoses." Social Psychiatry and Psychiatric Epidemiology, vol. 54, no. 11, 2019, pp. 1311-1323.
Halvorsrud K, Nazroo J, Otis M, et al. Ethnic inequalities in the incidence of diagnosis of severe mental illness in England: a systematic review and new meta-analyses for non-affective and affective psychoses. Soc Psychiatry Psychiatr Epidemiol. 2019;54(11):1311-1323.
Halvorsrud, K., Nazroo, J., Otis, M., Brown Hajdukova, E., & Bhui, K. (2019). Ethnic inequalities in the incidence of diagnosis of severe mental illness in England: a systematic review and new meta-analyses for non-affective and affective psychoses. Social Psychiatry and Psychiatric Epidemiology, 54(11), 1311-1323. https://doi.org/10.1007/s00127-019-01758-y
Halvorsrud K, et al. Ethnic Inequalities in the Incidence of Diagnosis of Severe Mental Illness in England: a Systematic Review and New Meta-analyses for Non-affective and Affective Psychoses. Soc Psychiatry Psychiatr Epidemiol. 2019;54(11):1311-1323. PubMed PMID: 31482194.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ethnic inequalities in the incidence of diagnosis of severe mental illness in England: a systematic review and new meta-analyses for non-affective and affective psychoses. AU - Halvorsrud,Kristoffer, AU - Nazroo,James, AU - Otis,Michaela, AU - Brown Hajdukova,Eva, AU - Bhui,Kamaldeep, Y1 - 2019/09/03/ PY - 2019/03/16/received PY - 2019/08/20/accepted PY - 2019/9/5/pubmed PY - 2020/2/14/medline PY - 2019/9/5/entrez KW - Affective psychoses KW - Ethnicity KW - Incidence KW - Meta-analysis KW - Schizophrenia SP - 1311 EP - 1323 JF - Social psychiatry and psychiatric epidemiology JO - Soc Psychiatry Psychiatr Epidemiol VL - 54 IS - 11 N2 - PURPOSE: Although excess risks particularly for a diagnosis of schizophrenia have been identified for ethnic minority people in England and other contexts, we sought to identify and synthesise up-to-date evidence (2018) for affective in addition to non-affective psychoses by specific ethnic groups in England. METHODS: Systematic review and meta-analysis of ethnic differences in diagnosed incidence of psychoses in England, searching nine databases for reviews (citing relevant studies up to 2009) and an updated search in three databases for studies between 2010 and 2018. Studies from both searches were combined in meta-analyses allowing coverage of more specific ethnic groups than previously. RESULTS: We included 28 primary studies. Relative to the majority population, significantly higher risks of diagnosed schizophrenia were found in Black African (Relative risk, RR 5.72, 95% CI 3.87-8.46, n = 9); Black Caribbean (RR 5.20, 95% CI 4.33-6.24, n = 21); South Asian (RR 2.27, 95% CI 1.63-3.16, n = 14); White Other (RR 2.24, 95% CI 1.59-3.14, n = 9); and Mixed Ethnicity people (RR 2.24, 95% CI 1.32-3.80, n = 4). Significantly higher risks for diagnosed affective psychoses were also revealed: Black African (RR 4.07, 95% CI 2.27-7.28, n = 5); Black Caribbean (RR 2.91, 95% CI 1.78-4.74, n = 16); South Asian (RR 1.71, 95% CI 1.07-2.72, n = 8); White Other (RR 1.55, 95% CI 1.32-1.83, n = 5); Mixed Ethnicity (RR 6.16, 95% CI 3.99-9.52, n = 4). CONCLUSIONS: The risk for a diagnosis of non-affective and affective psychoses is particularly elevated for Black ethnic groups, but is higher for all ethnic minority groups including those previously not assessed through meta-analyses (White Other, Mixed Ethnicity). This calls for further research on broader disadvantages affecting ethnic minority people. SN - 1433-9285 UR - https://www.unboundmedicine.com/medline/citation/31482194/Ethnic_inequalities_in_the_incidence_of_diagnosis_of_severe_mental_illness_in_England:_a_systematic_review_and_new_meta_analyses_for_non_affective_and_affective_psychoses_ L2 - https://dx.doi.org/10.1007/s00127-019-01758-y DB - PRIME DP - Unbound Medicine ER -