Ethnicity and baseline symptomatology in patients with an At Risk Mental State for psychosis

Abstract

Background. Ethnicity has been associated with different incidence rates and different symptom profiles in young patients with psychotic-like disorders. No studies so far have examined the effect of ethnicity on symptoms in people with an At Risk Mental State (ARMS).Method. In this cross-sectional study, we analysed the relationship between ethnicity and baseline data on the severity of psychopathology scores in 201 help-seeking patients who met the ARMS criteria and agreed to participate in the Dutch Early Detection and Intervention (EDIE-NL) trial. Eighty-seven of these patients had a non-Dutch ethnicity. We explored the possible mediating role of ethnic identity.Results. Higher rates of negative symptoms, and of anhedonia in particular, were found in the ethnic minority group. This result could be attributed mainly to the Moroccan-Dutch and Turkish-Dutch subgroups, who also presented with more depression symptoms when the groups were examined separately. The ethnic minority group displayed a lower level of ethnic group identity compared to the immigrants of the International Comparative Study of Ethnocultural Youth (ICSEY). Ethnic identity was inversely related to symptoms in the Moroccan-Dutch patient group.Conclusions. The prevalence of more severe negative symptoms and depression symptoms in ethnic minority groups deserves more attention, as the experience of attenuated positive symptoms when accompanied by negative symptoms or distress has proven to be predictive for transition to a first psychotic episode.

What drives poor functioning in the at-risk mental state? A systematic review

“…A much larger study that distinguished ethnicity through nationality (Dutch or non-Dutch) also reported a trend difference in functioning, with Dutch nationals exhibiting marginally better functioning after adjusting for potential confounders (Velthorst et al, 2012). However, when examined longitudinally, ethnicity was reported to be unrelated to functional outcome within this population (Carrión et al, 2013).…”

Early intervention for everyone? A review of cross‐cultural issues and their treatment in ultra‐high‐risk (UHR) cohorts

“…One study took the variable of ethnicity into account and studied its association with symptom severity (Velthorst et al, 2012). Two…”

Ethnic identity, racial discrimination and attenuated psychotic symptoms in an urban population of emerging adults

“…Undergraduate students from several disciplines were recruited through an online participant recruitment website. The students were prescreened for age (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) and for self-identifying as black/African American/African descent or as a first-or second-generation immigrant to maximize recruitment of young ethnic minority adults possessing characteristics that have been implicated in psychosis risk. 33 A total of 650 participants completed self-report questionnaires in a research lab with completion times generally ranging from 30 minutes to 1 hour.…”

“…Research examining ethnic identity's direct relationship to psychosis has been equivocal, with some studies finding strong ethnic identification predicts lower rates of psychosis 21,22 and others suggesting strong ethnic identity may enhance risk for psychosis. 23,24 Velthorst et al 22 found that a strong ethnic identity resulted in less severe overall psychopathology for Dutch adolescents of Moroccan descent at risk for developing psychosis. On the other hand, Gonidakis et al 24 found low ethnic identity was conducive to higher functioning in psychotic patients.…”