Brian Cooper1. 1. Section of Old Age Psychiatry, Institute of Psychiatry, London, United Kingdom. spjubco@iop.kcl.ac.uk
Abstract
BACKGROUND: By the mid-1960s, the importance of socio-economic status for schizophrenia had been demonstrated in terms of differences between social-class groups in prevalence and incidence rates, illness course and outcome, and treatment experience. In the causation-selection debate, however, opinion had swung in favour of the selection hypothesis. AIMS: To reassess evidence on the social-class distribution of schizophrenia in Britain, and to compare this body of research with population-based studies of schizophrenia risk in socially disadvantaged ethnic minorities. METHOD: Systematic review of medical and psychological data-bases. RESULTS: Epidemiological research, while confirming the importance of premorbid social decline, has also provided support for the environmental 'breeder' hypothesis. High psychosis rates have been confirmed in ethnic minorities; in particular among Afro-Caribbean and other Black immigrants whose low social status cannot be accounted for by selective downward social drift or segregation. CONCLUSIONS: There are striking parallels, both in the epidemiology of schizophrenia and in social characteristics, between the lower-class indigenous groups highlighted by earlier psychiatric surveys and African-Caribbean populations in Britain's inner cities today. These similarities underline the need for a broader perspective in the search for environmental risk factors.
BACKGROUND: By the mid-1960s, the importance of socio-economic status for schizophrenia had been demonstrated in terms of differences between social-class groups in prevalence and incidence rates, illness course and outcome, and treatment experience. In the causation-selection debate, however, opinion had swung in favour of the selection hypothesis. AIMS: To reassess evidence on the social-class distribution of schizophrenia in Britain, and to compare this body of research with population-based studies of schizophrenia risk in socially disadvantaged ethnic minorities. METHOD: Systematic review of medical and psychological data-bases. RESULTS: Epidemiological research, while confirming the importance of premorbid social decline, has also provided support for the environmental 'breeder' hypothesis. High psychosis rates have been confirmed in ethnic minorities; in particular among Afro-Caribbean and other Black immigrants whose low social status cannot be accounted for by selective downward social drift or segregation. CONCLUSIONS: There are striking parallels, both in the epidemiology of schizophrenia and in social characteristics, between the lower-class indigenous groups highlighted by earlier psychiatric surveys and African-Caribbean populations in Britain's inner cities today. These similarities underline the need for a broader perspective in the search for environmental risk factors.
Authors: P Rucci; A Piazza; E Perrone; I Tarricone; R Maisto; I Donegani; V Spigonardo; D Berardi; M P Fantini; A Fioritti Journal: Epidemiol Psychiatr Sci Date: 2014-04-30 Impact factor: 6.892
Authors: Raimo K R Salokangas; Dorien H Nieman; Markus Heinimaa; Tanja Svirskis; Sinikka Luutonen; Tiina From; Heinrich Graf von Reventlow; Georg Juckel; Don Linszen; Peter Dingemans; Max Birchwood; Paul Patterson; Frauke Schultze-Lutter; Joachim Klosterkötter; Stephan Ruhrmann Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2012-07-15 Impact factor: 4.328