Heterogeneity in Incidence Rates of Schizophrenia and Other Psychotic Syndromes

Kirkbride, James; Fearon, Paul; Morgan, Craig; Dazzan, Paola; Morgan, Kevin; Tarrant, Jane; Lloyd, T A; Holloway, John; Hutchinson, Gerard; Leff, Julian; Mallett, R; Harrison, Glynn; Murray, Robin M.; Jones, Peter B.

doi:10.1001/archpsyc.63.3.250

Cited by 453 publications

(451 citation statements)

References 56 publications

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“…Environmental or socioeconomic variables (i.e., poor early nutrition, exposure to stress, exposure to environmental toxins, poverty, etc.) that are correlated with race and risk for psychosis could also contribute [Bebbington et al, 2004;Sundquist et al, 2004;Van Os, 2004;Kirkbride et al, 2006;Bresnahan et al, 2007].…”

Section: Discussionmentioning

confidence: 99%

Symptoms of psychosis in schizophrenia, schizoaffective disorder, and bipolar disorder: A comparison of African Americans and Caucasians in the Genomic Psychiatry Cohort

Perlman

Kotov

et al. 2015

American J of Med Genetics Pt B

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Several studies have reported differences between African Americans and Caucasians in relative proportion of psychotic symptoms and disorders, but whether this reflects racial bias in the assessment of psychosis is unclear. The purpose of this study was to examine the distribution of psychotic symptoms and potential bias in symptoms assessed via semi-structured interview using a cohort of 3,389 African American and 5,692 Caucasian participants who were diagnosed with schizophrenia, schizoaffective disorder, or bipolar disorder. In this cohort, the diagnosis of schizophrenia was relatively more common, and the diagnosis of bipolar disorder and schizoaffective disorder-bipolar type was less relatively common, among African Americans than Caucasians. With regard to symptoms, relatively more African Americans than Caucasians endorsed hallucinations and delusions symptoms, and this pattern was striking among cases diagnosed with bipolar disorder and schizoaffective-bipolar disorder. In contrast, the relative endorsement of psychotic symptoms was more similar among cases diagnosed with schizophrenia and schizoaffective disorder-depressed type. Differential item function analysis revealed that African Americans with mild psychosis over-endorsed "hallucinations in any modality" and underendorsed "widespread delusions" relative to Caucasians. Other symptoms did not show evidence of racial bias. Thus, racial bias in assessment of psychotic symptoms does not appear to explain differences in the proportion of symptoms between Caucasians and African Americans. Rather, this may reflect ascertainment bias, perhaps indicative of a disparity in access to services, or differential exposure to risk factors for psychosis by race. Key words: schizophrenia; race; psychosis INTRODUCTIONOver the last 50 years, several studies have reported differences between individuals of African heritage and Caucasians in relative proportion of psychotic symptoms and diagnosis of schizophrenia versus bipolar disorder. Specifically, reports from samples ascertained in clinical settings have suggested that compared to Caucasians, individuals of African heritage have higher rates of schizophrenia [Robins and Regier, 1991;Strakowski et al., 1993Strakowski et al., , 1996Strakowski et al., , 2003Bresnahan et al., 2007;Gara et al., 2012;Kirkbride et al., 2012] 546Neuropsychiatric Genetics severe psychotic symptoms [Mukherjee et al., 1983;Strakowski et al., 2003;Arnold et al., 2004] and less severe negative symptoms [Sharpley et al., 2001]. Other studies of psychotic symptoms have found race differences in the quality and scope of hallucinations and delusions [Barrio et al., 2003;Yamada et al., 2006].To date, the underlying source of these apparent differences is unknown. It has been argued that the difference could reflect clinician or instrument bias [Neighbors et al., 2003;Trierweiler et al., 2006], although differences remained when clinicians were blinded to ethnicity information [Arnold et al., 2004]. On the other hand, race differences may reflect t...

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Section: Discussionmentioning

confidence: 99%

Symptoms of psychosis in schizophrenia, schizoaffective disorder, and bipolar disorder: A comparison of African Americans and Caucasians in the Genomic Psychiatry Cohort

Perlman

Kotov

et al. 2015

American J of Med Genetics Pt B

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“…In our sample there is no substantial gender difference in the prevalence rate of schizophrenia versus other psychoses. In literature it has been found that the incidence of schizophrenia is higher in males 39,40 .…”

Section: Discussionmentioning

confidence: 99%

First admissions for psychoses in Eastern Piedmont-Italy

et al. 2009

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-Background and Objectives: 1) To identify the sociodemographic, anamnestic characteristics and presentation symptoms of patients, at the time of first hospitalization, associated with a discharge diagnosis of schizophrenic versus non-schizophrenic psychoses; 2) to define risk factors, at the time of the first admission, for a rehospitalization, regardless of reasons for readmission; 3) to assess the diagnostic stability between first and second hospitalization.Methods: This study includes 245 patients first admitted to the University Psychiatric Clinic of Novara in a period of seven years, discharged with a diagnosis of psychosis as reported in the Discharge Register (ICD-9-CM codes 290-299). Data were collected by consulting medical records and registers of community-based services of the South Novara Mental Health Department. A logistic regression model was used to determine the characteristics associated with a discharge diagnosis of schizophrenia. The relationship between the risk of rehospitalization and patients characteristics was studied using Cox's regression analysis.Results: Risk factors for a discharge diagnosis of schizophrenia were age, compulsory admission, positive symptoms, and previous non-psychotic psychiatric episodes. Risk factors for rehospitalization were a diagnosis of schizophrenia, an age of less than 40 years, the absence of a stable affective relationship, and living with the family of origin. The 92% of the patients diagnosed as schizophrenic on the first hospitalization had the same diagnosis on readmission.Conclusions: Schizophrenia differs from other psychoses in terms of the greater prevalence of both some symptomatological characteristics and an history of previous non psy- Background and objectives

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“…Such services aim to reduce DUP and tackle health and social inequalities in young people experiencing FEP (typically aged up to 35 years old), thus targeting improvement over a range of clinical, economic and social outcomes. We would expect (Kirkbride et al 2006) such services to see at least 76% and 63% of all men and women, respectively, who would develop FEP in their lifetime (Kirkbride et al 2006).…”

Section: Development and Controversies Of Early Intervention In Psychmentioning

confidence: 99%

Parity of esteem begins at home: translating empirical psychiatric research into effective public mental health

Kirkbride

Jones

2013

Psychol. Med.

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There is increasing recognition that parity of esteem between mental and physical health disorders is essential to improve the course, outcome and quality of life of individuals within different populations. Achieving this parity now underpins the objectives of several nations. Here, we argue that parity of esteem between mental and physical health can only be realized when parity of esteem also exists across mental health disorders, particularly in terms of service commissioning and planning. Using first-episode psychosis and early intervention in psychosis services as a motivating example, we demonstrate how carefully conducted psychiatric epidemiology can be translated to develop precise forecasts of the anticipated incidence of first-episode psychosis in different populations, based on an understanding of underlying local needs and inequalities. Open-access prediction tools such as PsyMaptic will allow commissioners of mental health services to more effectively allocate resources across services, based on empirical evidence and local need, thus reducing inequalities in access to mental health care.

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Heterogeneity in Incidence Rates of Schizophrenia and Other Psychotic Syndromes

Cited by 453 publications

References 56 publications

Symptoms of psychosis in schizophrenia, schizoaffective disorder, and bipolar disorder: A comparison of African Americans and Caucasians in the Genomic Psychiatry Cohort

Symptoms of psychosis in schizophrenia, schizoaffective disorder, and bipolar disorder: A comparison of African Americans and Caucasians in the Genomic Psychiatry Cohort

First admissions for psychoses in Eastern Piedmont-Italy

Parity of esteem begins at home: translating empirical psychiatric research into effective public mental health

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