Comparison of the outcome and treatment of psychosis in people of Caribbean origin living in the UK and British Whites. Report from the UK700 trial.

Abstract

The comparative outcome of psychosis in British Whites and UK African-Caribbeans is unclear. Some report that African-Caribbeans have worse outcome, whereas others claim better symptomatic outcome and a more benign course. To compare the course, outcome and treatment of psychosis in African-Caribbeans and British Whites in a large multi-centre sample. A secondary analysis of 708 patients with research diagnostic criteria-defined psychosis from a 2-year, randomised controlled trial of case management. Outcome measures (hospitalisation, illness course, self-harm, social disability and treatment received) were adjusted for socio-economic and clinical differences between groups at baseline using regression analysis. African-Caribbeans were less likely to have a continuous illness and to receive treatment with antidepressant or psychotherapy. The outcome of psychosis is complex but differs between UK African-Caribbeans and British Whites. This may reflect risk factors that increase the rate of psychosis in UK African-Caribbeans. Treatment differences require further investigation.