Social and Epidemiological Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
Acta Psychiatr Scand. 2014 Oct;130(4):257-68. doi: 10.1111/acps.12254. Epub 2014 Feb 28.
We sought to systematically review the literature on ethnic differences in the likelihood of general practitioner (GP) involvement, police involvement, and involuntary admission on the pathway to care of patients with first-episode psychosis (FEP).
We searched electronic databases and conducted forward and backward tracking to identify relevant studies. We calculated pooled odds ratios (OR) to examine the variation between aggregated ethnic groups in the indicators of the pathway to care.
We identified seven studies from Canada and England that looked at ethnic differences in GP involvement (n=7), police involvement (n=7), or involuntary admission (n=5). Aggregated ethnic groups were most often compared. The pooled ORs suggest that Black patients have a decreased likelihood of GP involvement (OR=0.70, 0.57-0.86) and an increased likelihood of police involvement (OR=2.11, 1.67-2.66), relative to White patients. The pooled ORs were not statistically significant for patients with Asian backgrounds (GP involvement OR=1.23, 0.87-1.75; police involvement OR=0.86, 0.57-1.30). There is also evidence to suggest that there may be ethnic differences in the likelihood of involuntary admission; however, effect modification by several sociodemographic factors precluded a pooling of these data.
Ethnic differences in pathways to care are present at the first episode of psychosis.
我们旨在系统地综述有关初发精神病患者就诊途径中全科医生（GP）参与度、警方介入度和非自愿入院的种族差异的文献。
我们检索了电子数据库，并进行了向前和向后的追踪，以确定相关研究。我们计算了汇总的优势比（OR），以检查就诊途径指标中聚合的种族群体之间的差异。
我们从加拿大和英国确定了 7 项研究，这些研究考察了 GP 参与度（n=7）、警方介入度（n=7）或非自愿入院（n=5）方面的种族差异。聚合的种族群体通常是比较对象。汇总的 OR 表明，与白人患者相比，黑人患者 GP 参与度降低（OR=0.70，0.57-0.86），而警方介入度增加（OR=2.11，1.67-2.66）。对于亚裔背景的患者，汇总的 OR 没有统计学意义（GP 参与度 OR=1.23，0.87-1.75；警方介入度 OR=0.86，0.57-1.30）。也有证据表明，在非自愿入院的可能性方面可能存在种族差异；然而，几个社会人口因素的效应修饰使这些数据无法进行汇总。
在精神病首次发作时，就诊途径存在种族差异。
