scholarly journals Psychoses sans Frontieres: towards an interdisciplinary understanding of psychosis risk amongst migrants and their descendants

2018 ◽  
Vol 28 (2) ◽  
pp. 146-152 ◽  
Author(s):  
J. Dykxhoorn ◽  
J. B. Kirkbride
Keyword(s):  
Mental Health ◽  
Ethnic Minority ◽  
Psychotic Disorders ◽  
Minority Groups ◽  
Public Mental Health ◽  
Population Based ◽  
Ethnic Minority Groups ◽  
Region Of Origin ◽  
Psychosis Risk ◽  
Migrant Groups

AbstractUnderstanding the excess risk of psychotic disorders in migrant and ethnic minority groups has long been an important research focus in psychiatric epidemiology and public mental health. Heterogeneity between migrant groups based on the region of origin, minority status and other socioeconomic factors may provide clues as to the underlying aetiological mechanisms explaining this risk, as well as informing our general understanding of psychotic disorders. Nonetheless, disentangling the mechanisms underlying this association has been the focus of more speculation and theory to date than empirical research. Now more than ever, we need to move beyond studies which demonstrate excess rates in migrant and ethnic minority groups to novel population-based studies which identify the determinants and mechanisms through which this risk is shaped. In this paper, we review the main hypotheses proposed to explain these disparities and the current level of support for them. We then highlight recent evidence from epidemiology and neuroscience which provides important new clues in our understanding of the aetiology of psychotic disorders. We concluded with suggestions for future interdisciplinary research to prevent this public mental health inequality within a generation.

scholarly journals Community-centred interventions for improving public mental health among adults from ethnic minority populations in the UK: a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e041102
Author(s):  
Cleo Baskin ◽  
Geiske Zijlstra ◽  
Mike McGrath ◽  
Caroline Lee ◽  
Fiona Helen Duncan ◽  
...  
Keyword(s):  
Mental Health ◽  
Ethnic Minority ◽  
Minority Groups ◽  
Public Mental Health ◽  
Risk Of Bias ◽  
Minority Populations ◽  
Ethnic Minority Groups ◽  
Ethnic Minority Populations ◽  
The Uk ◽  
Intervention Description

ObjectivesUndertake a scoping review to determine the effectiveness of community-centred interventions designed to improve the mental health and well-being of adults from ethnic minority groups in the UK.MethodsWe searched six electronic academic databases for studies published between January 1990 and September 2019: Medline, Embase, PsychINFO, Scopus, CINAHL and Cochrane. For intervention description and data extraction we used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist and Template for Intervention Description and Replication guide. Quality was assessed using Cochrane risk of bias tools. Grey literature results were deemed beyond the scope of this review due to the large number of interventions and lack of available outcomes data.ResultsOf 4501 studies, 7 met the eligibility criteria of UK-based community interventions targeting mental health in adults from ethnic minority populations: four randomised controlled trials, one pre/post-pilot study, one cross-sectional study and one ethnographic study. Interventions included therapy-style sessions, peer-support groups, educational materials, gym access and a family services programme. Common components included a focus on tackling social isolation, using lay health workers from within the community, signposting and overcoming structural barriers to access. Four studies reported a statistically significant positive effect on mental health outcomes and six were appraised as having a high risk of bias. Study populations were ethnically heterogeneous and targeted people mainly from South Asia. No studies examined interventions targeting men.ConclusionsThere is a paucity of high-quality evidence regarding community-centred interventions focused on improving public mental health among ethnic minority groups. Decision makers need scientific evidence to inform effective approaches to mitigating health disparities. Our next steps are to map promising community activities and interventions that are currently being provided to help identify emerging evidence.

scholarly journals Understanding the excess psychosis risk in ethnic minorities: the impact of structure and identity

2021 ◽  
Author(s):  
Hannah E. Jongsma ◽  
Saffron Karlsen ◽  
James B. Kirkbride ◽  
Peter B. Jones
Keyword(s):  
Ethnic Minority ◽  
Ethnic Minorities ◽  
Psychotic Disorders ◽  
Minority Groups ◽  
Empirical Literature ◽  
Ethnic Minority Groups ◽  
The Social ◽  
Psychosis Risk ◽  
Identity Based ◽  
The Impact

Abstract Purpose Psychotic disorders, which are associated with substantially increased morbidity and mortality, are up to five times more common in some ethnic minority groups compared with the white majority in Western countries. This long-standing and well-replicated public mental health disparity has hitherto largely eluded adequate explanation. We argue that this might have arisen in part due to the lack of attention given to theoretical work characterising the complex and multidimensional social nature of ethnicity by those epidemiological investigations that have dominated the literature. Methods To bridge this gap, we draw on theoretical and empirical literature from across the social sciences considering the ontological significance of ethnicity (as biology, migration, racialised structures and identity) and its relationships with psychotic disorders to illuminate probable drivers of excess psychosis risk. Results The largest gains in our theoretical understanding of excess psychosis risk among ethnic minority groups are to be made by considering ethnicity in relation to disempowerment resulting from structural and identity-based exclusion. The former is readily studied through the social gradient in health: socioeconomic disadvantage clusters in some ethnic minorities and increases the risk of poor health outcomes, including psychosis. Furthermore, limitations on identity acquisition and expression imposed by the ethnic majority can further contribute to alienate ethnic minorities and increase psychosocial disempowerment (a lack of control over one’s life). Conclusion We theorise that structural and identity-based exclusion act as the primary drivers shaping variation in rates of psychotic disorder by ethnic minority status.

scholarly journals Mental well-being of patients from ethnic minority groups during critical care: a qualitative ethnographic study

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e014075 ◽  
Author(s):  
Rose Lima Van Keer ◽  
Reginald Deschepper ◽  
Luc Huyghens ◽  
Johan Bilsen
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Critical Care ◽  
Ethnic Minority ◽  
Healthcare Professionals ◽  
Minority Groups ◽  
Mental Health Problems ◽  
Well Being ◽  
Ethnic Minority Groups ◽  
Mental Well Being

ObjectivesTo investigate the state of the mental well-being of patients from ethnic minority groups and possible related risk factors for the development of mental health problems among these patients during critical medical situations in hospital.DesignQualitative ethnographic design.SettingOneintensive care unit (ICU) of a multiethnic urban hospital in Belgium.Participants84 ICU staff members, 10 patients from ethnic-minority groups and their visiting family members.ResultsPatients had several human basic needs for which they could not sufficiently turn to anybody, neither to their healthcare professionals, nor to their relatives nor to other patients. These needs included the need for social contact, the need to increase comfort and alleviate pain, the need to express desperation and participate in end-of-life decision making. Three interrelated risk factors for the development of mental health problems among the patients included were identified: First, healthcare professionals’ mainly biomedical care approach (eg, focus on curing the patient, limited psychosocial support), second, the ICU context (eg, time pressure, uncertainty, regulatory frameworks) and third, patients’ different ethnocultural background (eg, religious and phenotypical differences).ConclusionsThe mental state of patients from ethnic minority groups during critical care is characterised by extreme emotional loneliness. It is important that staff should identify and meet patients’ unique basic needs in good time with regard to their mental well-being, taking into account important threats related to their own mainly biomedical approach to care, the ICU’s structural context as well as the patients’ different ethnocultural background.

scholarly journals Do sex differences in the prevalence of ECG abnormalities vary across ethnic groups living in the Netherlands? A cross-sectional analysis of the population-based HELIUS study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e039091
Author(s):  
Renee Bolijn ◽  
C Cato ter Haar ◽  
Ralf E Harskamp ◽  
Hanno L Tan ◽  
Jan A Kors ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sex Differences ◽  
Ethnic Minority ◽  
Ethnic Groups ◽  
South Asian ◽  
Minority Groups ◽  
Population Based ◽  
Secondary Outcome ◽  
Ethnic Minority Groups ◽  
Ecg Abnormalities

ObjectivesMajor ECG abnormalities have been associated with increased risk of cardiovascular disease (CVD) burden in asymptomatic populations. However, sex differences in occurrence of major ECG abnormalities have been poorly studied, particularly across ethnic groups. The objectives were to investigate (1) sex differences in the prevalence of major and, as a secondary outcome, minor ECG abnormalities, (2) whether patterns of sex differences varied across ethnic groups, by age and (3) to what extent conventional cardiovascular risk factors contributed to observed sex differences.DesignCross-sectional analysis of population-based study.SettingMulti-ethnic, population-based Healthy Life in an Urban Setting cohort, Amsterdam, the Netherlands.Participants8089 men and 11 369 women of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan origin aged 18–70 years without CVD.Outcome measuresAge-adjusted and multivariable logistic regression analyses were performed to study sex differences in prevalence of major and, as secondary outcome, minor ECG abnormalities in the overall population, across ethnic groups and by age-groups (18–35, 36–50 and >50 years).ResultsMajor and minor ECG abnormalities were less prevalent in women than men (4.6% vs 6.6% and 23.8% vs 39.8%, respectively). After adjustment for conventional risk factors, sex differences in major abnormalities were smaller in ethnic minority groups (OR ranged from 0.61 in Moroccans to 1.32 in South-Asian Surinamese) than in the Dutch (OR 0.49; 95% CI 0.36 to 0.65). Only in South-Asian Surinamese, women did not have a lower odds than men (OR 1.32; 95% CI 0.96 to 1.84). The pattern of smaller sex differences in ethnic minority groups was more pronounced in older than in younger age-groups.ConclusionsThe prevalence of major ECG abnormalities was lower in women than men. However, sex differences were less apparent in ethnic minority groups. Conventional risk factors did not contribute substantially to observed sex differences.

Ethnic minority groups, learning disability and mental health

Psychiatry ◽  
2009 ◽  
Vol 8 (10) ◽  
pp. 405-407 ◽  
Author(s):  
Iqbal Singh ◽  
Adedamola Orimalade
Keyword(s):  
Mental Health ◽  
Ethnic Minority ◽  
Learning Disability ◽  
Minority Groups ◽  
Ethnic Minority Groups

Neighborhood ethnic density and psychotic disorders among ethnic minority groups in Utrecht City

2014 ◽  
Vol 49 (7) ◽  
pp. 1093-1102 ◽  
Author(s):  
Fabian Termorshuizen ◽  
Hugo M. Smeets ◽  
Arjan W. Braam ◽  
Wim Veling
Keyword(s):  
Ethnic Minority ◽  
Psychotic Disorders ◽  
Minority Groups ◽  
Ethnic Minority Groups ◽  
Ethnic Density

scholarly journals Incidence of schizophrenia and other psychoses in ethnic minority groups: results from the MRC AESOP Study

2006 ◽  
Vol 36 (11) ◽  
pp. 1541-1550 ◽  
Author(s):  
PAUL FEARON ◽  
JAMES B. KIRKBRIDE ◽  
CRAIG MORGAN ◽  
PAOLA DAZZAN ◽  
KEVIN MORGAN ◽  
...  
Keyword(s):  
Ethnic Minority ◽  
Psychotic Disorders ◽  
Minority Groups ◽  
Age Groups ◽  
Incidence Rates ◽  
Psychotic Symptoms ◽  
Ethnic Minority Groups ◽  
Black Africans ◽  
Increased Risk ◽  
Rate Ratios

Background. The incidence of schizophrenia in the African-Caribbean population in England is reported to be raised. We sought to clarify whether (a) the rates of other psychotic disorders are increased, (b) whether psychosis is increased in other ethnic minority groups, and (c) whether particular age or gender groups are especially at risk.Method. We identified all people (n=568) aged 16–64 years presenting to secondary services with their first psychotic symptoms in three well-defined English areas (over a 2-year period in Southeast London and Nottingham and a 9-month period in Bristol). Standardized incidence rates and incidence rate ratios (IRR) for all major psychosis syndromes for all main ethnic groups were calculated.Results. We found remarkably high IRRs for both schizophrenia and manic psychosis in both African-Caribbeans (schizophrenia 9·1, manic psychosis 8·0) and Black Africans (schizophrenia 5·8, manic psychosis 6·2) in men and women. IRRs in other ethnic minority groups were modestly increased as were rates for depressive psychosis and other psychoses in all minority groups. These raised rates were evident in all age groups in our study.Conclusions. Ethnic minority groups are at increased risk for all psychotic illnesses but African-Caribbeans and Black Africans appear to be at especially high risk for both schizophrenia and mania. These findings suggest that (a) either additional risk factors are operating in African-Caribbeans and Black Africans or that these factors are particularly prevalent in these groups, and that (b) such factors increase risk for schizophrenia and mania in these groups.

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