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The Influence of Ethnicity and Family Structure on Relapse in First-Episode Schizophrenia

A Comparison of Asian, Afro-Caribbean, and White Patients

Published online by Cambridge University Press:  02 January 2018

Max Birchwood ,
Ray Cochrane ,
Fiona Macmillan ,
Sonja Copestake ,
Jo Kucharska  and
Margaret Cariss
Max Birchwood*
Affiliation:
All Saints Hospital, Lodge Road, Birmingham B18 5SD; Honorary Senior Lecturer, University of Birmingham
Ray Cochrane
Affiliation:
School of Psychology, University of Birmingham
Fiona Macmillan
Affiliation:
University of Birmingham; Honorary Consultant Psychiatrist, All Saints Hospital
Sonja Copestake
Affiliation:
All Saints Hospital, Birmingham
Jo Kucharska
Affiliation:
All Saints Hospital, Birmingham
Margaret Cariss
Affiliation:
All Saints Hospital, Birmingham
*
∗Correspondence
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Abstract

There is overwhelming evidence that the outcome for people with schizophrenia in Western industrialised countries is inferior to that of those living in the Third World. Extended family structures, greater opportunities for social reintegration, and more positive constructions of mental illness have been offered as possible explanations for this effect. The Asian community in the UK retains many of these features as well as strong links with native cultures of origin. The issue arises as to whether similar differences in outcome may be observed in the UK. An exploratory study was undertaken, examining the early progress of schizophrenia in a first-episode sample (n=137), and based on systematic examination of case-note data. A lower rate of relapse/readmission in the first 12 months after discharge was found in the Asian (16%) as compared with white (30%) and Afro-Caribbean (49%) patients. Available evidence suggested that speed of access to care, living with a family, and employment may account for this effect. Medication compliance may have contributed to differences in relapse between white and Afro-Caribbeans but was not a factor influencing the low rate among Asians. The limitations and strengths of case-note studies are discussed at length, and it is concluded that a prospective study is warranted and would be highly instructive.

Type
Papers
Information
The British Journal of Psychiatry , Volume 161 , Issue 6 , December 1992 , pp. 783 - 790
Copyright
Copyright © 1992 The Royal College of Psychiatrists 

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