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Why Psychosis Rates Vary

December 2006 - Researchers from the Institute of Psychiatry at King's College London have found higher rates of schizophrenia and other psychoses in certain ethnic minority groups and also that parental separation in childhood is associated with an increased risk of developing psychosis later in life. These findings, published in separate papers in Psychological Medicine provide new insights into these disorders and their social risk factors.

Researchers from London, Nottingham and Bristol have been collaborating in the Aetiology and Ethnicity of Schizophrenia and Other Psychoses (AESOP) study since 1997. Funded by the Medical Research Council, the overall aims of the study are to elucidate the overall rates of psychotic disorder, to confirm and extend previous findings of raised rates of psychosis in certain migrant groups in the UK, and to explore biological and social risk factors and their possible interactions.

Researchers found that African Caribbean and black Africans in England suffer from significantly higher rates of schizophrenia and manic psychosis than the white British population. For example, schizophrenia was nine times more common in African Caribbean and six times more common in black Africans. These rates applied to both men and women and across all ages from 16 to 64. Other ethnic minority groups had more modestly increased rates. For example, non-British whites had a 2.5 fold increased risk for schizophrenia.

Dr Paul Fearon, senior lecturer at the Institute of Psychiatry explains:

"Although all ethnic minority groups have a greater risk of schizophrenia and other psychoses, our study found that African Caribbean and black African communities in England appear to be at particularly high risk, regardless of age or gender. If we can understand and explain these phenomena, we can not only plan better services for these groups, but we may also more fully understand the underlying causes of these disorders."

Researchers found that separation from one or both parents for more than one year before the age of 16, as a consequence of family breakdown, was associated with a 2.5 fold increased risk of developing psychosis in later life. This factor was more common in the African Caribbean community sample (31 per cent) than in the white British community sample (18 per cent).

Dr Craig Morgan, MRC research fellow and lecturer at the Institute of Psychiatry, added:

"These findings provide evidence that early social adversity may increase the risk of later psychosis. Such early adversity may be one factor contributing to the high rate of psychosis in the African Caribbean population. However, while these findings are an important step forward, further research is now needed to more fully understand how specific types of early social adversity interact with psychological and biological factors to cause psychosis."

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