The study found that a "group of disadvantages" could explain ethnic differences in psychosis rates in some areas


Hackney road sign

The document, published today in the British Journal of Psychiatry, is the first to apply a union approach to psychiatry. A syndrome is a set of interactions between individual risk factors and disadvantages in the local area under study.

The team compared the incidence of different health conditions – including psychosis – between white, black men and South Asia across the UK. They also studied the data for a further group of men from the private Hackney neighborhood in central London. Although the levels of psychosis diagnosed were significantly higher among black men and those from southern Asia than in Britain compared to white men, the gap disappeared after taking into account socio-economic factors such as social class and unemployment.

Diagnosed levels of psychosis

However, after allowing these factors, the team found that a significant gap remained in the diagnosed levels of psychosis and other health conditions among black men and South Asia living in Hackney. This could be explained, they suggest, by four vulnerability markers that could reinforce each other and aggravate the risk of developing serious mental illnesses.

The components of the union were drug and alcohol addiction, crime and violence, risky or coercive sexual behavior and psychosis / anxiety.

The diagnosed levels of psychosis and anxiety were much more severe among Hackney men who behaved in such behaviors.

After taking these indicators into consideration, diagnosis rates closely matched those for their ethnic counterparts in Britain and for white men in Hackney.

"Place" should be seen as a risk factor

Co-author, Professor Kam Bhui, head of the Queen Mary Center for Psychiatry, said: "These findings suggest that the broader challenges and social circumstances facing certain ethnic minorities in specific deprived urban areas may explain a variation significant of the rates of diagnosed psychosis.To put it bluntly, the "place" should be seen as a risk factor in psychosis.This conclusion has significant implications for commissioners and public health services.

"The historical, political and social factors at work contribute to these health conditions. Location-based measures and early childhood interventions are more likely to succeed than costly aids or even punitive measures in future life. "

He continued: "We believe that the application of a trade union approach in psychiatry is a significant advance. Our results should be widely used in psychiatry and help shape preventive public health practices.

"Given the factors we have identified as risk factors for psychosis, the cuts we have seen in vital public health services such as drug and alcohol treatment and sexual health in recent years are both unfortunate and false. A syndrome-based approach to research and practice can help design better prevention in the health sector and inform the implementation of the long-term NHS plan for England. "

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