Venkatesan Gayathri, Weich Scott, McBride Orla, Twigg Liz, Parsons Helen, Scott Jan, Bhui Kamaldeep, Keown Patrick
Tranwell Unit,Gateshead.
University of Warwick,Coventry.
BJPsych Bull. 2018 Aug;42(4):141-145. doi: 10.1192/bjb.2018.17. Epub 2018 May 11.
Aims and methodTo compare rates of admission for different types of severe mental illness between ethnic groups, and to test the hypothesis that larger and more clustered ethnic groups will have lower admission rates. This was a descriptive study of routinely collected data from the National Health Service in England.
There was an eightfold difference in admission rates between ethnic groups for schizophreniform and mania admissions, and a fivefold variation in depression admissions. On average, Black and minority ethnic (BME) groups had higher rates of admission for schizophreniform and mania admissions but not for depression. This increased rate was greatest in the teenage years and early adulthood. Larger ethnic group size was associated with lower admission rates. However, greater clustering was associated with higher admission rates.Clinical implicationsOur findings support the hypothesis that larger ethnic groups have lower rates of admission. This was a between-group comparison rather than within each group. Our findings do not support the hypothesis that more clustered groups have lower rates of admission. In fact, they suggest the opposite: groups with low clustering had lower admission rates. The BME population in the UK is increasing in size and becoming less clustered. Our results suggest that both of these factors should ameliorate the overrepresentation of BME groups among psychiatric in-patients. However, this overrepresentation continues, and our results suggest a possible explanation, namely, changes in the delivery of mental health services, particularly the marked reduction in admissions for depression.Declaration of interestNone.
目的与方法
为比较不同种族群体中不同类型严重精神疾病的住院率，并检验以下假设：规模较大且聚居程度更高的种族群体住院率更低。这是一项对从英格兰国民医疗服务体系常规收集的数据进行的描述性研究。
精神分裂症样障碍和躁狂症住院率在不同种族群体间存在8倍差异，抑郁症住院率存在5倍差异。平均而言，黑人和少数族裔（BME）群体在精神分裂症样障碍和躁狂症住院率方面较高，但抑郁症住院率并非如此。这种增加的比率在青少年时期和成年早期最为显著。较大的种族群体规模与较低的住院率相关。然而，更高的聚居程度与更高的住院率相关。
临床意义
较大的种族群体住院率较低。这是组间比较而非组内比较。我们的研究结果不支持聚居程度更高的群体住院率更低这一假设。事实上，它们表明相反的情况：聚居程度低的群体住院率更低。英国的黑人和少数族裔人口规模在增加且聚居程度在降低。我们的结果表明，这两个因素都应能改善黑人和少数族裔群体在精神科住院患者中的过高占比情况。然而，这种过高占比情况仍然存在，我们的结果提出了一种可能的解释，即心理健康服务提供方式的变化，尤其是抑郁症住院人数的显著减少。
利益声明
无。
