South Birmingham Early Intervention Services, Birmingham and Solihull Mental Health NHS Foundation Trust.
Early Interv Psychiatry. 2013 Nov;7(4):399-406. doi: 10.1111/j.1751-7893.2012.00389.x. Epub 2012 Sep 5.
In the UK, there has been growing concern about the incidence and prognosis of psychosis in minority ethnic groups for a number of years. Negative self-appraisals after first-episode psychosis (FEP) are associated with post-psychotic depression, poor functioning and suicidality. In carers, appraisals of loss and decreased control are linked with high expressed emotion and relapse; however, as yet there has been no investigation as to how ethnicity and culture relate to these negative appraisals in FEP.
The study aims to investigate the occurrence of negative illness appraisals, for example, loss and shame, in FEP within different ethnic and social-cultural groups. In addition, it aims to explore influence of insight, recovery style and carers' appraisals in the development of negative appraisals.
There were 67 patients and 46 carers who completed reliable and valid measures on beliefs about illness, insight and recovery style. Data on ethnicity and deprivation were also collected.
Black patients experienced significantly less loss, lack of control and entrapment than White, Asian and mixed ethnicity patients, yet these were not explained by lower levels of insight or recovery style. Patient's and carer's appraisals were highly correlated.
Black patients, in spite of higher incidence and poorer outcome in FEP, experienced less loss and shame. Possible explanations, including a protective aspect of alternative health belief models, are explored. This area provides much scope for further investigation. Strong relationships between patient and carer appraisals indicate that family interventions are essential to improved clinical outcomes.
在英国，多年来，人们对少数族裔群体中精神病的发病率和预后越来越关注。首次精神病发作（FEP）后出现的自我负面评价与精神病后抑郁、功能不良和自杀意念有关。在照顾者中，对丧失和控制能力下降的评价与高表达情绪和复发有关；然而，迄今为止，尚未有研究探讨种族和文化与 FEP 中的这些负面评价有何关系。
该研究旨在调查不同族裔和社会文化群体中 FEP 患者出现的负面疾病评价，例如丧失和羞耻感。此外，还旨在探讨洞察力、恢复方式和照顾者的评价对负面评价的发展的影响。
共有 67 名患者和 46 名照顾者完成了关于疾病信念、洞察力和恢复方式的可靠和有效的测量。还收集了关于种族和贫困的数据。
黑人患者经历的丧失感、缺乏控制感和被困感明显低于白人、亚洲人和混血种族患者，但这并不是由洞察力或恢复方式水平较低解释的。患者和照顾者的评价高度相关。
尽管黑人患者在 FEP 中的发病率更高，预后更差，但他们经历的丧失感和羞耻感较少。探讨了可能的解释，包括替代健康信念模型的保护方面。这一领域为进一步研究提供了广阔的空间。患者和照顾者评价之间的紧密关系表明，家庭干预对于改善临床结果至关重要。
