Skip to main content Accessibility help
×
Home

Differing patterns of brain structural abnormalities between black and white patients with their first episode of psychosis

  • K. D. Morgan (a1), P. Dazzan (a2), C. Morgan (a2), J. Lappin (a2), G. Hutchinson (a3), X. Chitnis (a4), J. Suckling (a5), P. Fearon (a2), P. B. Jones (a5), J. Leff (a2) and R. M. Murray (a2)...

Abstract

Background

African-Caribbean and black African people living in the UK are reported to have a higher incidence of diagnosed psychosis compared with white British people. It has been argued that this may be a consequence of misdiagnosis. If this is true they might be less likely to show the patterns of structural brain abnormalities reported in white British patients. The aim of this study therefore was to investigate whether there are differences in the prevalence of structural brain abnormalities in white and black first-episode psychosis patients.

Method

We obtained dual-echo (proton density/T2-weighted) images from a sample of 75 first-episode psychosis patients and 68 healthy controls. We used high resolution magnetic resonance imaging and voxel-based methods of image analysis. Two separate analyses were conducted: (1) 34 white British patients were compared with 33 white British controls; (2) 41 African-Caribbean and black African patients were compared with 35 African-Caribbean and black African controls.

Results

White British patients and African-Caribbean/black African patients had ventricular enlargement and increased lenticular nucleus volume compared with their respective ethnic controls. The African-Caribbean/black African patients also showed reduced global grey matter and increased lingual gyrus grey-matter volume. The white British patients had no regional or global grey-matter loss compared with their normal ethnic counterparts but showed increased grey matter in the left superior temporal lobe and right parahippocampal gyrus.

Conclusions

We found no evidence in support of our hypothesis. Indeed, the finding of reduced global grey-matter volume in the African-Caribbean/black African patients but not in the white British patients was contrary to our prediction.

Copyright

Corresponding author

*Address for correspondence: K. D. Morgan, Ph.D., Department of Psychology, University of Westminster, 309 Regent Street, London W1B 2UW, UK. (Email: k.d.morgan@wmin.ac.uk)

References

Hide All
Aust, R, Smith, N (2003). Ethnicity and Drug Use: Key Findings from the 2001/2002 British Crime Survey. Findings 209. Home Office: London.
Bebbington, P, Nayani, T (1995). The Psychosis Screening Questionnaire. International Journal of Methods in Psychiatric Research 5, 1119.
Bullmore, ET, Suckling, J, Overmeyer, S, Rabe-Hesketh, S, Taylor, E, Brammer, MJ (1999). Global, voxel, and cluster tests, by theory and permutation, for a difference between two groups of structural MR images of the brain. IEEE Transactions on Medical Imaging 18, 3242.
Cahn, W, Pol, HEH, Lems, EBTE, van Haren, NEM, Schnack, HG, van der Linden, JA, Schothorst, PF, van Engeland, H, Kahn, RS (2002). Brain volume changes in first-episode schizophrenia – a 1-year follow-up study. Archives of General Psychiatry 59, 10021010.
Cantor-Graae, E, Selten, JP (2005). Schizophrenia and migration: A meta-analysis and review. American Journal of Psychiatry 162, 1224.
Corson, PW, O'Leary, DS, Miller, DD, Andreasen, NC (2002). The effects of neuroleptic medications on basal ganglia blood flow in schizophreniform disorders: A comparison between the neuroleptic-naive and medicated states. Biological Psychiatry 52, 855862.
Dazzan, P, Morgan, KD, Orr, KG, Hutchinson, G, Chitnis, X, Suckling, J, Fearon, P, Salvo, J, McGuire, PK, Mallett, RM, Jones, PB, Leff, J, Murray, RM (2004). The structural brain correlates of neurological soft signs in AESOP first-episode psychoses study. Brain 127, 143153.
Fannon, D, Chitnis, X, Doku, V, Tennakoon, L, O'Ceallaigh, S, Soni, W, Sumich, A, Lowe, J, Santamaria, M, Sharma, T (2000 a). Features of structural brain abnormality detected in first-episode psychosis. American Journal of Psychiatry 157, 18291834.
Fannon, D, Tennakoon, L, Sumich, A, O'Ceallaigh, S, Doku, V, Chitnis, X, Lowe, J, Soni, W, Sharma, T (2000 b). Third ventricle enlargement and developmental delay in first-episode psychosis: preliminary findings. British Journal of Psychiatry 177, 354359.
Fearon, P, Kirkbride, J, Morgan, C, Dazzan, P, Morgan, K, Lloyd, T, Hutchinson, G, Tarrant, J, Fung, WLA, Holloway, J, Mallett, J, Harrison, G, Leff, J, Jones, PB, Murray, RM (2006). Incidence of schizophrenia and other psychoses in ethnic minority groups: results from the MRC AESOP Study. Psychological Medicine 36, 15411550.
Gianaros, PJ, Jennings, JR, Sheu, LK, Greer, PJ, Kuller, LH, Matthews, KA (2007). Prospective reports of chronic life stress predict decreased grey matter volume in the hippocampus. Neuroimage 35, 795803.
Hickling, FW (2005). The epidemiology of schizophrenia and other common mental health disorders in the English-speaking Caribbean. American Journal of Public Health 18, 256262.
Hjern, A, Wicks, S, Dalman, C (2004). Social adversity contributes to high morbidity in psychoses in immigrants – a national cohort study in two generations of Swedish residents. Psychological Medicine 34, 10251033.
Job, DE, Whalley, HC, McConnell, S, Glabus, M, Johnstone, EC, Lawrie, SM (2002). Structural gray matter differences between first-episode schizophrenics and normal controls using voxel-based morphometry. Neuroimage 17, 880889.
Karlsen, S, Nazroo, J (2004). The relationship between racism, social class and physical and mental health among different ethnic groups in England. Ethnicity & Health 9, S46S47.
Lawrie, SM, Abukmeil, SS (1998). Brain abnormality in schizophrenia – A systematic and quantitative review of volumetric magnetic resonance imaging studies. British Journal of Psychiatry 172, 110120.
Littlewood, R (1992). Psychiatric diagnosis and racial bias: empirical and interpretive approaches. Social Science and Medicine 34, 141149.
Littlewood, R, Lipsedge, M (1981). Some social and phenomenological characteristics of psychotic immigrants. Psychological Medicine 11, 289302.
Marcelis, MC, Myin-Germeys, I, Suckling, J, Woodruff, P, Hofman, P, Bullmore, E, Delespaul, P, van Os, J (2003). Cerebral tissue alterations and daily life stress experience in psychosis. Schizophrenia Research 60, 201.
Marcelis, MC, Suckling, J, Hofman, P, Woodruff, P, Bullmore, E, van Os, J (2006). Evidence that brain tissue volumes are associated with HVA reactivity to metabolic stress in schizophrenia. Schizophrenia Research 86, 4553.
Pantelis, C, Velakoulis, D, McGorry, PD, Wood, SJ, Suckling, J, Phillips, LJ, Yung, AR, Bullmore, ET, Brewer, W, Soulsby, B, Desmond, P, McGuire, PK (2003). Neuroanatomical abnormalities before and after onset of psychosis: a cross-sectional and longitudinal MRI comparison. Lancet 361, 281288.
Sharpley, M, Hutchinson, G, McKenzie, K, Murray, RM (2001). Understanding the excess of psychosis among the African-Caribbean population in England – Review of current hypotheses. British Journal of Psychiatry 178, S60S68.
Sigmundsson, T, Suckling, J, Maier, M, Williams, SCR, Bullmore, ET, Greenwood, KE, Fukuda, R, Ron, MA, Toone, BK (2001). Structural abnormalities in frontal, temporal, and limbic regions and interconnecting white matter tracts in schizophrenic patients with prominent negative symptoms. American Journal of Psychiatry 158, 234243.
Suckling, J, Sigmundsson, T, Greenwood, K, Bullmore, ET (1999). A modified fuzzy clustering algorithm for operator independent brain tissue classification of dual echo MR images. Magnetic Resonance Imaging 17, 10651076.
WHO (1992). The ICD-10 Classification of Mental and Behavioural Disorders. World Health Organization: Geneva.
WHO (1994). Schedules for Clinical Assessment in Neuropsychiatry (SCAN 2.0). World Health Organization: Geneva.
Wing, JK, Sturt, E (1978). The PSE-ID-CATEGO System: Supplementary Manual. Medical Research Council: London.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed