FIRST EPISODES OF PSYCHOSIS IN AFRO-CARIBBEAN AND WHITE PEOPLE - AN 18-YEAR FOLLOW-UP POPULATION-BASED STUDY

Background There have been few prospective studies of the long-term ou tcome of psychosis in people of Afro-Caribbean origin in the UK. Metho d We followed-up a population-based, consecutive series of 34 Afro-Car ibbean and 54 White people with psychosis who had been extensively inv estigated during their first admission in 1973/74. Diagnoses were made by direct interview using the Present State Examination at both first admission and follow-up. Results Ninety-seven percent of the original sample were traced. A slightly greater proportion of the Afro-Caribbe an people were assigned to the S+ Catego class (schizophrenia), both o n first assessment and at follow-up. No difference was found between t he two groups in the consistency of diagnosis over the 18 years or in the proportion of patients considered psychotic but Afro-Caribbean peo ple tended to have fewer negative symptoms at follow-up. There were st riking differences between the two groups in their experience of psych iatric care; Afro-Caribbean people were more likely to have been readm itted, to have experienced longer hospitalisations, and to have underg one more involuntary admissions than their White counterparts. Conclus ions Afro-Caribbean people who met clinical and research criteria for schizophrenia had a less satisfactory experience of, and response to, psychiatric care over 18 years than their White counterparts.