Klimidis S, McKenzie D P, Lewis J, Minas I H
Victorian Transcultural Psychiatry Unit, University of Melbourne, St. Vincent's Hospital, Fitzroy, Australia.
Soc Psychiatry Psychiatr Epidemiol. 2000 Dec;35(12):554-63. doi: 10.1007/s001270050279.
Under-representation of ethnic minority groups in psychiatric services has been widely reported in Western nations. The present study examined whether there were differences between immigrant and Australian-born patients in their maintenance of contact with a statewide psychiatric service system.
Groups were selected on the empirical grounds that they are differently represented in this service system. Employing a form of case-control design, four groups of patients were compared: those born in Australia, the United Kingdom, Southern Europe, and South East/East Asia respectively (n = 79 for each). Groups were identically matched on sex, age, diagnosis (either schizophrenia or bipolar illness) and locality of service. The groups did not differ as to the timing of their first appearance in the 3-year period in which their psychiatric contact was examined.
Despite their different representation in the psychiatric service system, the four groups did not differ on measures of continuity of contact. Measures included number of contacts with mental health community services, number of admissions to inpatient wards, length of stay in hospital and the longest interval between any two successive service contacts.
The commonly reported underrepresentation of immigrant groups in the psychiatric service system does not appear to be due to greater discontinuation of contact with services. If the assumption of equal community prevalence of disorder is made, then the observed under-representation may be due to differential rates of access to (that is, initial contact with) psychiatric services.
西方国家广泛报道了少数族裔群体在精神科服务中的代表性不足。本研究调查了移民患者和澳大利亚出生的患者在与全州精神科服务系统保持联系方面是否存在差异。
根据这些群体在该服务系统中的不同代表性,凭经验选择研究对象。采用一种病例对照设计形式,比较了四组患者:分别出生于澳大利亚、英国、南欧以及东南亚/东亚的患者(每组n = 79)。在性别、年龄、诊断(精神分裂症或双相情感障碍)和服务地点方面对各组进行了相同匹配。在对其精神科接触情况进行检查的3年期间,各组首次出现的时间并无差异。
尽管这四组在精神科服务系统中的代表性不同,但在接触连续性指标方面并无差异。这些指标包括与精神健康社区服务的接触次数、住院病房的入院次数、住院时间以及任意两次连续服务接触之间的最长间隔时间。
精神科服务系统中普遍报道的移民群体代表性不足,似乎并非由于与服务的接触中断更多。如果假设社区中疾病患病率相等,那么观察到的代表性不足可能是由于获得(即首次接触)精神科服务的比例不同所致。