Ethnic density linked to psychosis risk

By Mark Cowen, Senior medwireNews Reporter

Reduced own-group ethnic density within a given geographic area is associated with an increased risk for psychotic experiences, results from a UK study show.

Jayati Das-Munshi (King's College London) and team found that, overall, each 10% reduction in own-group ethnic density was associated with a 1.07-fold increase in the risk for psychotic experiences.

"The findings from this study, using nationally representative data, largely confirm that for minority ethnic groups living in England, people living in areas of lower own-group density are more likely to have psychotic experiences," comment the researchers.

The team studied data from the Ethnic Minorities Psychiatric Illness Rates in the Community (EMPIRIC) survey - a cross-sectional, nationally representative survey of 4281 adults, aged 16-74 years, living in England in 2000. The survey included the main ethnic minority groups (Indian, Bangladeshi, Pakistani, Black Caribbean, and Irish) and a White British group.

Ethnic density was defined as the percentage of minority ethnic people living within middle super output areas - administrative areas with a minimum population of 5000.

Overall, 8% of the study population endorsed one or more items on the Psychosis Screening Questionnaire (PSQ), equivalent to a weighted total of 351 people. The weighted proportions of people endorsing one or more items on the PSQ by ethnic minority group were: Indian 9%; Bangladeshi 5%; Pakistani 10%; Black Caribbean 12%; and Irish 8%. In addition, 6% of White British respondents endorsed one or more items on the PSQ.

After adjustment for area-level deprivation, social class, education, marital status, age, and gender, the team found that in all ethnic groups, except the White British group, each 10% reduction in own-group density was associated with an increased risk for reporting one or more psychotic experiences in the previous year.

The association was strongest in people of Indian (odds ratio [OR]=1.38) and Bangladeshi (OR=1.26) ethnicity, the researchers report in the British Journal of Psychiatry.

They also found that experiences of racism, work-related discrimination, and low levels of social support were associated with an increased risk for psychotic experiences in ethnic minority groups.

"This study suggests strong evidence for area-level or 'contextual' associations with psychotic experiences in minority ethnic groups," Das-Munshi and team conclude.

They add: "Strong social effects mediated through the environment may account for varying susceptibilities to psychosis among minority ethnic people."

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