PSYCHOSIS WITH GOOD PROGNOSIS IN AFRO-CARIBBEAN PEOPLE NOW LIVING IN THE UNITED-KINGDOM

Objectives-To compare the course and outcome of psychotic illness in a group of Afro-Caribbean patients resident in the United Kingdom and a group of white British patients. Design-Cohort study of consecutive a dmissions followed up for four years. Subjects-113 patients with psych otic illness of recent onset admitted to two south London hospitals. M ain outcome measures-Course of illness, history of self harm, social d isability, treatment received, and hospital use adjusted for socio-eco nomic origin. Results-The Afro-Caribbean group spent more time in a re covered state during the follow up period (adjusted odds ratio 5.0; 95 % confidence interval 1.7 to 14.5), were less likely to have had a con tinuous illness (0.3; 0.1 to 0.8), were less at risk of self harm (0.2 ; 0.1 to 0.8), and were less likely to have been prescribed antidepres sant treatment (0.3; 0.1 to 0.9). There were no differences in hospita l use, but the Afro-Caribbean group had more involuntary admissions (8 .9; 2.1 to 35.6) and more imprisonments over the follow up period (9.2 ; 1.6 to 52.3). Conclusions-Afro-Caribbean patients in the United King dom have a better outcome after psychiatric illness than do white peop le. The combination of high incidence and more benign course of illnes s of psychotic illness in this group may be due, at least in part, to a greater exposure to precipitants in the social environment.