Five-year illness trajectories across racial groups in the UK following a first episode psychosis

Griffiths, Siân Lowri, Bogatsu, Tumelo, Longhi, Mia, Butler, Emily, Alexander, Beel, Bandawar, Mrunal, Everard, Linda, Jones, Peter B., Fowler, David, Hodgekins, Joanne, Amos, Tim, Freemantle, Nick, McCrone, Paul, Singh, Swaran P., Birchwood, Max and Upthegrove, Rachel (2023) Five-year illness trajectories across racial groups in the UK following a first episode psychosis. Social Psychiatry and Psychiatric Epidemiology, 58 (4). 569–579. ISSN 0933-7954

[thumbnail of s00127-023-02428-w]
PDF (s00127-023-02428-w) - Published Version
Available under License Creative Commons Attribution.

Download (894kB) | Preview


Purpose: Psychosis disproportionally affects ethnic minority groups in high-income countries, yet evidence of disparities in outcomes following intensive early intervention service (EIS) for First Episode Psychosis (FEP) is less conclusive. We investigated 5-year clinical and social outcomes of young people with FEP from different racial groups following EIS care. Method: Data were analysed from the UK-wide NIHR SUPEREDEN study. The sample at baseline (n = 978) included White (n = 750), Black (n = 71), and Asian (n = 157) individuals, assessed during the 3 years of EIS, and up to 2 years post-discharge (n = 296; Black [n = 23]; Asian [n = 52] and White [n = 221]). Outcome trajectories were modelled for psychosis symptoms (positive, negative, and general), functioning, and depression, using linear mixed effect models (with random intercept and slopes), whilst controlling for social deprivation. Discharge service was also explored across racial groups, 2 years following EIS. Results: Variation in linear growth over time was accounted for by racial group status for psychosis symptoms—positive (95% CI [0.679, 1.235]), negative (95% CI [0.315, 0.783]), and general (95% CI [1.961, 3.428])—as well as for functioning (95% CI [11.212, 17.677]) and depressive symptoms (95% CI [0.261, 0.648]). Social deprivation contributed to this variance. Black individuals experienced greater levels of deprivation (p < 0.001, 95% CI [0.187, 0.624]). Finally, there was a greater likelihood for Asian (OR = 3.04; 95% CI [2.050, 4.498]) and Black individuals (OR = 2.47; 95% CI [1.354, 4.520]) to remain in secondary care by follow-up. Conclusion: Findings suggest variations in long-term clinical and social outcomes following EIS across racial groups; social deprivation contributed to this variance. Black and Asian individuals appear to make less improvement in long-term recovery and are less likely to be discharged from mental health services. Replication is needed in large, complete data, to fully understand disparities and blind spots to care.

Item Type: Article
Additional Information: Funding Information: RU reports grants from Medical Research Council, grants from National Institute for Health Research: Health Technology Assessment, grants from European Commission—Research: The Seventh Framework Programme, and personal fees from Sunovion, outside the submitted work. M.B. and S.P.S are part funded by the National Institute for Health Research through the Applied Research Collaboration West Midlands (ARC-WM). P.B.J. is part funded by the NIHR ARC East of England. The views expressed in this publication are those of the authors and not necessarily those of the NHS, NIHR, or Department of Health. Birmingham and Solihull NHS Foundation Trust acted as study sponsor.
Uncontrolled Keywords: deprivation,early psychosis,ethnicity,inequities,outcomes,health(social science),psychiatry and mental health,social psychology,epidemiology,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/3300/3306
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Mental Health
Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
Related URLs:
Depositing User: LivePure Connector
Date Deposited: 03 Feb 2023 17:30
Last Modified: 19 Oct 2023 03:32
DOI: 10.1007/s00127-023-02428-w


Downloads per month over past year

Actions (login required)

View Item View Item