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Five-year illness trajectories across racial groups in the UK following a first episode psychosis
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Griffiths, Siân Lowri, Bogatsu, Tumelo, Longhi, Mia, Butler, Emily, Alexander, Beel, Bandawar, Mrunal, Everard, Linda, Jones, Peter B., Fowler, David, Hodgekins, Joanne, Amos, Tim, Freemantle, Nick, McCrone, Paul, Singh, Swaran P., Birchwood, Max and Upthegrove, Rachel (2023) Five-year illness trajectories across racial groups in the UK following a first episode psychosis. Social Psychiatry and Psychiatric Epidemiology, 58 . pp. 569-579. doi:10.1007/s00127-023-02428-w ISSN 0933-7954.
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Official URL: http://doi.org/10.1007/s00127-023-02428-w
Abstract
Purpose
Psychosis disproportionally affects ethnic minority groups in high-income countries, yet evidence of disparities in outcomes following intensive early intervention service (EIS) for First Episode Psychosis (FEP) is less conclusive. We investigated 5-year clinical and social outcomes of young people with FEP from different racial groups following EIS care.
Method
Data were analysed from the UK-wide NIHR SUPEREDEN study. The sample at baseline (n = 978) included White (n = 750), Black (n = 71), and Asian (n = 157) individuals, assessed during the 3 years of EIS, and up to 2 years post-discharge (n = 296; Black [n = 23]; Asian [n = 52] and White [n = 221]). Outcome trajectories were modelled for psychosis symptoms (positive, negative, and general), functioning, and depression, using linear mixed effect models (with random intercept and slopes), whilst controlling for social deprivation. Discharge service was also explored across racial groups, 2 years following EIS.
Results
Variation in linear growth over time was accounted for by racial group status for psychosis symptoms—positive (95% CI [0.679, 1.235]), negative (95% CI [0.315, 0.783]), and general (95% CI [1.961, 3.428])—as well as for functioning (95% CI [11.212, 17.677]) and depressive symptoms (95% CI [0.261, 0.648]). Social deprivation contributed to this variance. Black individuals experienced greater levels of deprivation (p < 0.001, 95% CI [0.187, 0.624]). Finally, there was a greater likelihood for Asian (OR = 3.04; 95% CI [2.050, 4.498]) and Black individuals (OR = 2.47; 95% CI [1.354, 4.520]) to remain in secondary care by follow-up.
Conclusion
Findings suggest variations in long-term clinical and social outcomes following EIS across racial groups; social deprivation contributed to this variance. Black and Asian individuals appear to make less improvement in long-term recovery and are less likely to be discharged from mental health services. Replication is needed in large, complete data, to fully understand disparities and blind spots to care.
Item Type: | Journal Article | ||||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Social Psychiatry and Psychiatric Epidemiology | ||||||||
Publisher: | Dr. Dietrich Steinkopff Verlag | ||||||||
ISSN: | 0933-7954 | ||||||||
Official Date: | April 2023 | ||||||||
Dates: |
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Volume: | 58 | ||||||||
Page Range: | pp. 569-579 | ||||||||
DOI: | 10.1007/s00127-023-02428-w | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||
Date of first compliant deposit: | 1 March 2023 | ||||||||
Date of first compliant Open Access: | 1 March 2023 |
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