Here's some stuff from MEDLINE after searching for the terms "Caribbean
immigration psychosis". It reminds me that the book I mentioned was
written by Littlewood and Lipsedge, authors of one of the papers below.
Br J Psychiatry Suppl 2001 Apr;40:s60-8 Related Articles, Books, LinkOut
Understanding the excess of psychosis among the African-Caribbean
population in England. Review of current hypotheses.
Sharpley M, Hutchinson G, McKenzie K, Murray RM.
Department of Psychiatry, Institute of Psychiatry, King's College
London, UK.
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.
Publication Types:
* Review
* Review Literature
PMID: 11315227 [PubMed - indexed for MEDLINE]
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2: Psychol Med 1997 Jul;27(4):799-806 Related Articles, Books, LinkOut
Comment in:
* Psychol Med. 1998 Mar;28(2):496-7.
Increased incidence of psychotic disorders in migrants from the
Caribbean to the United Kingdom.
Harrison G, Glazebrook C, Brewin J, Cantwell R, Dalkin T, Fox R, Jones
P, Medley I.
Department of Psychiatry, University of Nottingham.
BACKGROUND: Several studies have replicated the finding of increased
incidence of schizophrenia and related psychoses in first and second
generation migrants from the Caribbean. The finding has remained
consistent in studies employing different methods, but concern has been
expressed about indirect methods of calculating the population at risk.
This study aims to overcome these short-comings. METHOD: A further
prospective study was undertaken in Nottingham assembling an inception
cohort of psychotic patients (N = 168) presenting from a defined
catchment area. The 1991 census, which includes codings for
self-ascribed ethnic origin, was used to calculate the denominator,
employing correction factors for potential under-enumeration.
Case-ascertainment was based upon all service contacts and subjects had
in-depth assessments including the SCAN. Collateral history was obtained
from informants. RESULTS: Subjects born in the Caribbean, or who had one
or both parents born in the Caribbean, had a greatly elevated risk
(incidence ratios above 7) for all psychotic disorders and for ICD-10
(DCR)-defined F20 Schizophrenia. CONCLUSIONS: The size of the increase
and the methodological safeguards employed support the validity of this
now highly replicated finding. A personal or family history of migration
from the Caribbean is a major risk factor for psychosis; the consistency
of this finding justifies a systematic evaluation of potential
aetiological factors. Any hypothesis derived from the evidence so far
must explain: increased incidence in first and second generation
migrants; increased risk for all psychoses (including affective
psychoses); and an effect specifically associated with a migration
history from the Caribbean to Northern Europe.
PMID: 9234458 [PubMed - indexed for MEDLINE]
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3: Br J Psychiatry 1995 Sep;167(3):362-9 Related Articles, Books,
LinkOut
Child and adolescent psychiatric presentations of second-generation
Afro-Caribbeans in Britain.
Goodman R, Richards H.
Department of Child and Adolescent Psychiatry, Institute of Psychiatry,
London.
BACKGROUND. A clinical sample was used to investigate whether
second-generation Afro-Caribbean children differed from other
British-born children in their psychiatric presentation or vulnerability
to risk factors. METHOD. Second-generation Afro-Caribbean patients (n =
292) were compared with a predominantly white group of patients (n =
1311) who lived in the same inner-city area and attended the same child
psychiatric clinic between 1973 and 1989. Data on psychiatric
presentation and background factors were systematically recorded at the
time of the initial clinical assessment. RESULTS. Afro-Caribbean
patients were exposed to more socio-economic disadvantage but less
family dysfunction. The ratio of emotional to conduct disorders was
lower among Afro-Caribbean than among the comparison patients--an effect
that was not evidently due to demographic factors or diagnostic bias.
Most risk factors for emotional or conduct disorders had comparable
effects on Afro-Caribbean and comparison patients. Psychotic and
autistic disorders were disproportionately common among the
Afro-Caribbean patients. CONCLUSIONS. Second-generation Afro-Caribbean
children differ somewhat from other British-born children in their
psychiatric presentation--a difference that has persisted over the 1970s
and 1980s and that deserves more investigation than it has received to
date.
PMID: 7496645 [PubMed - indexed for MEDLINE]
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4: Br J Psychiatry 1990 Oct;157:515-22 Related Articles, Books, LinkOut
The functional psychoses in Afro-Caribbeans.
Harvey I, Williams M, McGuffin P, Toone BK.
Institute of Psychiatry, DeCrespigny, Park, London.
When 54 Afro-Caribbean and 49 white British consecutive psychotic
in-patients were prospectively studied for clinical differences in
course of illness and pattern of symptoms, no major differences were
found. This does not support the hypothesis that misdiagnosis within the
psychoses can explain the higher admission rates of schizophrenia
calculated for Afro-Caribbean populations.
PMID: 2131132 [PubMed - indexed for MEDLINE]
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5: Can J Psychiatry 1990 Apr;35(3):251-3 Related Articles, Books
Bouffee delirante in Jamaican adolescent siblings.
Roberts N.
Inpatient Unit, Regional Children's Centre, Royal Ottawa Hospital,
Ontario.
The high incidence of brief schizophrenia-like psychosis in developing
countries is well documented in the literature. This paper presents two
cases of bouffee delirante found in Jamaican adolescent sibs who had
recently immigrated to Canada and discusses the importance of accurate
diagnosis, in view of prognosis and treatment, for this disorder.
PMID: 2340459 [PubMed - indexed for MEDLINE]
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6: Br J Psychiatry 1981 Dec;139:506-12 Related Articles, Books, LinkOut
First admissions of native-born and immigrants to psychiatric hospitals
in South-East England 1976.
Dean G, Walsh D, Downing H, Shelley E.
In the past, birthplace has frequently been omitted in completing the
Sheet, but in 1976, over 91 per cent of all first admissions to
psychiatric hospitals in South-East England were analysed by birthplace,
sex, age-groups and marital status. First admissions for schizophrenia
were five times the expected number for immigrants from new Commonwealth
America (the West Indies), four times the expected number for immigrants
from New Commonwealth Africa (mostly ethnic Asians) and three times the
expected number from India. Immigrants from Pakistan and the remaining
New Commonwealth Asian countries did not show a significantly higher
than expected number of admissions for schizophrenia, and their first
admissions for alcoholic psychosis and alcoholism, psychoneuroses and
personality and behaviour disorders were significantly fewer than
expected. First admissions for schizophrenia were also significantly
more than expected among immigrants from Ireland, Germany and Poland,
but not from italy.
PMID: 7332854 [PubMed - indexed for MEDLINE]
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7: Psychol Med 1981 May;11(2):289-302 Related Articles, Books
Some social and phenomenological characteristics of psychotic immigrants.
Littlewood R, Lipsedge M.
Various studies have shown: (i) increased rates of psychoses in
immigrants to Britain, and a particularly high rate of schizophrenia in
the West Indian- and West African-born; and (ii) a greater proportion of
atypical psychoses in immigrants. A retrospective study of psychotic
inpatients from a London psychiatric unit demonstrated increased rates
of schizophrenia in patients from the Caribbean and West Africa. These
patients included a high proportion of those with paranoid and religious
phenomenology, those with frequent changes of diagnosis, formal
admissions, and married women. The West Indian-born had been in Britain
for nearly 10 years before first seeing a psychiatrist and, if they had
an illness with religious symptomatology, were likely to have been in
hospital for only 3 weeks. Rates of schizophrenia without paranoid
phenomenology were similar in each ethnic group. It is suggested that
the increase in the diagnosis of schizophrenia in the West Indian-born,
and possibly in the West African-born, may be due in part to the
occurrence of acute psychotic reactions which are diagnosed as
schizophrenia.
PMID: 7267871 [PubMed - indexed for MEDLINE]
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8: Br J Psychiatry 1965 Sep;111(478):877-87 Related Articles, Books
Mentally ill West Indian immigrants.
Gordon EB.
PMID: 5889714 [PubMed - indexed for MEDLINE]
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