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Schizophrenia, social class and immigrant status: the epidemiological evidence

Published online by Cambridge University Press:  11 October 2011

Brian Cooper
Brian Cooper*
Affiliation:
Institute of Psychiatry, London, United Kingdom
*
Address for correspondence: Professor B. Cooper, Section of Old Age Psychiatry, Institute of Psychiatry, London SE5 8AF(United Kingdom). E-mail: spjubco@iop.kcl.ac.uk
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Summary

Background — By the mid-1960s, the importance of socio-economic status for schizophrenia had been demonstrated in terms of differences between social-class groups in prevalence and incidence rates, illness course and outcome, and treatment experience. In the causation – selection debate, however, opinion had swung in favour of the selection hypothesis. Aims — To reassess evidence on the social-class distribution of schizophrenia in Britain, and to compare this body of research with population-based studies of schizophrenia risk in socially disadvantaged ethnic minorities. Method — Systematic review of medical and psychological data-bases. Results — Epidemiological research, while confirming the importance of premorbid social decline, has also provided support for the environmental ‘breeder’ hypothesis. High psychosis rates have been confirmed in ethnic minori-ties; in particular among Afro-Caribbean and other Black immigrants whose low social status cannot be accounted for by selective downward social drift or segregation. Conclusions — There are striking parallels, both in the epidemiology of schizophrenia and in social characteristics, between the lower-class indigenous groups highlighted by earlier psychiatric surveys and African-Caribbean populations in Britain's inner cities today. These similarities underline the need for a broader perspective in the search for environmental risk factors.

Declaration of Interest: none.

Keywords

schizophreniapsychosissocial classsocio-economic statusethnic statusimmigrant mental health
Type
Invited Paper
Information
Epidemiology and Psychiatric Sciences , Volume 14 , Issue 3 , September 2005 , pp. 137 - 144
Copyright
Copyright © Cambridge University Press 2005

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