Psychoses, ethnicity and socio-economic status

Br J Psychiatry. 2008 Jul;193(1):18-24. doi: 10.1192/bjp.bp.107.041566.


Background: Consistent observation of raised rates of psychoses among Black and minority ethnic (BME) groups may possibly be explained by their lower socio-economic status.

Aims: To test whether risk for psychoses remained elevated in BME populations compared with the White British, after adjustment for age, gender and current socio-economic status.

Method: Population-based study of first-episode DSM-IV psychotic disorders, in individuals aged 18-64 years, in East London over 2 years.

Results: All BME groups had elevated rates of a psychotic disorder after adjustment for age, gender and socio-economic status. For schizophrenia, risk was elevated for people of Black Caribbean (incidence rate ratios (IRR)=3.1, 95% CI 2.1-4.5) and Black African (IRR=2.6, 95% CI 1.8-3.8) origin, and for Pakistani (IRR=3.1, 95% CI 1.2-8.1) and Bangladeshi (IRR=2.3, 95% CI 1.1-4.7) women. Mixed White and Black Caribbean (IRR=7.7, 95% CI 3.2-18.8) and White Other (IRR=2.1, 95% CI 1.2-3.8) groups had elevated rates of affective psychoses (and other non-affective psychoses).

Conclusions: Elevated rates of psychoses in BME groups could not be explained by socio-economic status, even though current socio-economic status may have overestimated the effect of this confounder given potential misclassification as a result of downward social drift in the prodromal phase of psychosis. Our findings extended to all BME groups and psychotic disorders, though heterogeneity remains.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Africa / ethnology
  • Asia / ethnology
  • Female
  • Humans
  • London / epidemiology
  • Male
  • Middle Aged
  • Psychotic Disorders / epidemiology*
  • Psychotic Disorders / ethnology
  • Risk Factors
  • Social Environment*
  • Socioeconomic Factors
  • West Indies / ethnology