Ethnicity and pathways to care during first episode psychosis: the role of cultural illness attributions

BMC Psychiatry

Research Article

Helen Parsons¹  Fatemeh Rabbie-Khan²  Rubina Jasani³  Ruchika Gajwani⁴  Zoebia Islam⁵  Swaran P. Singh⁶  Max Birchwood⁶  Luke Brown⁶  Catherine Winsper⁶ 

[1] Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK;Faculty of Health, Education & Life Sciences, Birmingham City University, Birmingham, UK;HCRI, University of Manchester, Manchester, UK;Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK;LOROS, Hospice Care for Leicester, Leicestershire and Rutland, Leicester, UK;De Montfort University, Leicester, UK;Mental Health and Well Being, Warwick Medical School, University of Warwick, CV4 7AL, Coventry, UK;

关键词: Ethnicity;    Illness attributions;    Compulsory detention;    Early intervention;    First episode psychosis;   

DOI  :  10.1186/s12888-015-0665-9

 received in 2015-07-30, accepted in 2015-10-28,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundStudies demonstrate ethnic variations in pathways to care during first episode psychosis (FEP). There are no extant studies, however, that have statistically examined the influence of culturally mediated illness attributions on these variations.MethodsWe conducted an observational study of 123 (45 White; 35 Black; 43 Asian) patients recruited over a two-year period from an Early Intervention Service (EIS) in Birmingham, UK. Sociodemographic factors (age; sex; education; country of birth; religious practice; marital status; living alone), duration of untreated psychosis (DUP), service contacts (general practitioner; emergency services; faith-based; compulsory detention; criminal justice) and illness attributions (“individual;” “natural;” “social;” “supernatural;” “no attribution”) were assessed.ResultsEthnic groups did not differ in DUP (p = 0.86). Asian patients were more likely to report supernatural illness attributions in comparison to White (Odds Ratio: 4.02; 95 % Confidence Intervals: 1.52, 10.62) and Black (OR: 3.48; 95 % CI: 1.25, 9.67) patients. In logistic regressions controlling for confounders and illness attributions, Black (OR: 14.00; 95 % CI: 1.30, 151.11) and Asian (OR: 13.29; 95 % CI: 1.26, 140.47) patients were more likely to consult faith-based institutions than White patients. Black patients were more likely to be compulsorily detained than White patients (OR: 4.56; 95 % CI: 1.40, 14.85).ConclusionIllness attributions and sociodemographic confounders do not fully explain the ethnic tendency to seek out faith-based institutions. While Asian and Black patients are more likely to seek help from faith-based organisations, this does not appear to lead to a delay in contact with mental health services.

【 授权许可】

CC BY   
© Singh et al. 2015