Understanding the excess of psychosis among the African-Caribbean population in England

Abstract

Background: Increased rates of schizophrenia continue to be reported among the African - Caribbean population in England. Aims: To evaluate the competing biological, psychological and social explanations that have been proposed. Method: Literature review. Results: The African-Caribbean population in England is at increased risk of both schizophrenia and mania; the higher rates remain when operational diagnostic criteria are used. The excess of the two psychotic disorders are probably linked: African - Caribbean patients with schizophrenia show more affective symptoms, and a more relapsing course with greater social disruption but fewer chronic negative symptoms, than White patients. No simple hypothesis explains these findings. Conclusions: More complex hypotheses are needed. One such links cultural variation in symptom reporting, the use of phenomenological constructs by psychiatrists and social disadvantage. Declaration of interest: None.