Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK.
Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.
Soc Psychiatry Psychiatr Epidemiol. 2019 Sep;54(9):1023-1044. doi: 10.1007/s00127-019-01729-3. Epub 2019 Jun 24.
Higher rates of psychosis have been reported in minority groups. Since individuals belonging to such groups are vulnerable to the experiences of discrimination, and in line with models proposing that social and life adversity may play a causal role in development and maintenance of psychotic experiences, it has been proposed that perceived discrimination may represent an important determinant of psychotic experiences. This paper reviews the literature examining the relationship between perceived discrimination and psychosis, examining whether discrimination is associated with an increased risk of psychosis, the severity of psychotic symptoms and whether there is an association with specific psychotic symptoms.
A systematic database search of PsycINFO, Embase and PubMed was conducted to identify quantitative cross-sectional and prospective studies that examined the association between discrimination and psychosis.
Twenty-four studies met the inclusion criteria, four of which used prospective designs and twenty used cross-sectional designs. The main findings indicated that discrimination may be associated with an increased risk of psychosis (too few studies to determine whether discrimination is associated with severity). Some studies found associations between discrimination and positive psychotic experiences and/or specific psychotic experiences such as paranoia. A small number of studies found that greater exposure to discrimination was associated with a greater likelihood of reporting psychotic experiences, tentatively indicating a dose-response relationship.
This review indicates that discrimination plays an important role in the experience of psychosis; however, future research is required to clarify the nature of this relationship. Avenues for further research and clinical implications are proposed.
少数民族群体的精神病发病率较高。由于属于这些群体的个体易受到歧视的影响，并且符合提出的社会和生活逆境可能在发展和维持精神病体验中起因果作用的模型，因此有人提出，感知到的歧视可能是精神病体验的一个重要决定因素。本文综述了检查感知歧视与精神病之间关系的文献，检验歧视是否与精神病风险增加、精神病症状严重程度以及与特定精神病症状是否存在关联有关。
对 PsycINFO、Embase 和 PubMed 进行了系统的数据库搜索，以确定检查歧视与精神病之间关系的定量横断面和前瞻性研究。
符合纳入标准的研究有 24 项，其中 4 项采用前瞻性设计，20 项采用横断面设计。主要研究结果表明，歧视可能与精神病风险增加有关（太少的研究来确定歧视是否与严重程度有关）。一些研究发现歧视与阳性精神病体验和/或特定精神病体验（如妄想）之间存在关联。少数研究发现，更多地受到歧视与报告精神病体验的可能性更大有关，这初步表明存在剂量-反应关系。
本综述表明，歧视在精神病体验中起着重要作用；然而，需要进一步的研究来阐明这种关系的本质。提出了进一步研究的途径和临床意义。
