Bhugra D, Hilwig M, Mallett R, Corridan B, Leff J, Neehall J, Rudge S
Institute of Psychiatry, London, UK.
Acta Psychiatr Scand. 2000 Feb;101(2):135-41. doi: 10.1034/j.1600-0447.2000.90049.x.
Sociodemographic factors play an important role in the genesis of mental disorders. High rates of unemployment and other social factors have been reported previously among African-Caribbeans with schizophrenia in London. The aim of the present study was to compare these factors in Trinidad with London African-Caribbeans.
Using internationally defined criteria, patients with first-onset schizophrenia were recruited in both countries, and information on the onset of symptoms, help-seeking, pathways into care, premorbid personality and educational and employment status were collected. These two samples are compared on a number of these factors. A total of 56 cases of first onset of psychosis coming into contact with psychiatric services in Trinidad were studied. Of these, 46 cases were diagnosed as having schizophrenia using the CATEGO program. Over a period of 2 years, 38 African-Caribbean patients with schizophrenia were recruited in London.
African-Caribbean patients with schizophrenia in London were more likely to be admitted for perceived threat to others and to have shown loss of interest and serious neglect and to have assaulted others. A lower proportion were admitted via a psychiatrist and a higher proportion by the police. The unemployment rate among the London sample of African-Caribbeans was much higher than that in the general population, whereas this was not the case for the Trinidad patients.
These findings are discussed in the context of culture and aetiology of schizophrenia, and suggestions with regard to future research are made.
社会人口学因素在精神障碍的发生中起着重要作用。此前有报道称，伦敦患精神分裂症的非洲加勒比裔人群的失业率及其他社会因素发生率较高。本研究的目的是比较特立尼达和伦敦非洲加勒比裔人群的这些因素。
采用国际公认的标准，在两国招募首次发病的精神分裂症患者，并收集有关症状发作、寻求帮助、就医途径、病前人格以及教育和就业状况的信息。对这两组样本在多个此类因素上进行比较。共研究了特立尼达56例首次与精神科服务机构接触的精神病发作患者。其中，46例使用CATEGO程序被诊断为患有精神分裂症。在两年时间里，伦敦招募了38例非洲加勒比裔精神分裂症患者。
伦敦的非洲加勒比裔精神分裂症患者因被认为对他人构成威胁而入院的可能性更大，且表现出兴趣丧失、严重忽视及攻击他人的情况。通过精神科医生收治的比例较低，而通过警方收治的比例较高。伦敦非洲加勒比裔样本中的失业率远高于一般人群，而特立尼达患者并非如此。
在精神分裂症的文化和病因背景下对这些发现进行了讨论，并对未来研究提出了建议。
