Migration, ethnicity, and psychosis: toward a sociodevelopmental model

There is consistent and strong evidence that the incidence of all psychoses is higher in many migrant and minority ethnic populations in a number of countries. The reasons for this are, however, unclear and a wide range of explanations have been proposed, from genetic to neurodevelopmental to psychosocial. In this article, we describe and evaluate the available evidence for and against each of these. What this shows is that: (1) there are few studies that have directly investigated specific risk factors in migrant and minority ethnic populations, with often only 1 or 2 studies of any relevance to specific explanations and (2) what limited research there has been tends to implicate a diverse range of social factors (including childhood separation from parents, discrimination and, at an area level, ethnic density) as being of potential importance. In an attempt to synthesize these disparate findings and provide a basis for future research, we go on to propose an integrated model--of a sociodevelopmental pathway to psychosis--to account for the reported high rates in migrant and minority ethnic populations. Aspects of this model will be directly tested in a new Europe-wide incidence and case-control study that we will conduct over the next 3 years, as part of the European Network of National Schizophrenia Networks studying Gene-Environment Interactions programme.

Behavioral problems and tobacco use among adolescents in Central America and the Dominican Republic

Objectives: The purpose of this study was to examine the association between behavioral problems and tobacco use among adolescent students in six countries of Central America and in the Dominican Republic. Methods: Data were drawn from a multinational collaborative study that included questionnaire surveys of between 451 and 1 170 school-attending adolescents in each of the seven countries studied. Assessments were based on an adapted, Spanish-language version of the Drug Use Screening Inventory (DUSI). The conditional form of logistic regression was employed for analysis, matching students on type of school and area, with further statistical adjustments for sex, age, and selected risk factors. Results: Occurrence of tobacco use was observed to vary dramatically from country to country. Nevertheless, for the combined group of countries, the estimated odds of tobacco use in youths at the highest levels of behavioral problems was more than five times that for youths at the lowest levels, after controlling for sex, age, lack of participation in recreational activities, level of irritability, and levels of problems with school, family, and mental health. Country-specific analyses show that youths at the highest levels of behavioral problems have a consistently greater occurrence of tobacco use as compared to youths at the lowest levels of behavioral problems. Conclusions: These findings are concordant with prior studies on tobacco use among adolescents with behavioral problems. Although the magnitude of observed associations varied according to the country of residence, the strength of these associations and their significance by conventional standards were observed in nearly all the countries sampled. This is the first study in these seven countries on potentially causal relationships such as these. More research is needed to augment our knowledge regarding the observed cross-country differences and ultimately to develop, implement, and evaluate effective tobacco preventative intervention programs (AU)

A comparison of the sociodemographic and clinical characteristics of first admissions to the psychiatric hospital and the psychiatric unit of the General Hospital in Barbados, over the period 1st September, 1996 to 28th February 1997: a project report submitted in fulfillment of the requirement for the Doctor of Medicine degree in Psychiatry

A comparison of the sociodemographic and clinical characteristics of first admissions to the Psychiatric Unit of the General Hospital in Barbados, over the period 1st September, 1996 to 28th February, 1997 (AU)

The effect of lunar phases on mental illness

To assess the lunar hypothesis as predictive of mental health emergencies and antisocial behaviour, the relation of lunar phases and the occurrence of psychiatric hospital admissions or aggressive behaviour by the inpatients of the hospital for the five-year period 1986-1990 were examined. The first admissions, readmissions and total admissions by gender during four lunar phases (New moon, First quarter, Full moon and Last quarter) were compared with each other, and with the average daily admissions during the rest of the lunar month. All agressive outbursts or fights whether resulting in any form of injury during these lunar phases were compared with each other and with those during the rest of the month. Chi-square analysis did not show any significant variation in admissions or aggressive behaviour during the various moon phases of the lunar cycle and the rest of the month. Variations by month followed no consistent pattern by gender, number of admissions, the year of study or a combination of these factors. The results of the study show that contrary to popular belief there is no scientific basis to support the view that the moon's phases play a significant role in an increase of first admissions or readmissions to the psychiatric hospital or that the phases of the moon predispose the mentally ill to violence or aggressive behaviour (AU)

Behaviour disorders among a sample of Jamaican adolescents

Most maladjusted children's behaviour is different in quantity rather than quality from the behaviour of other children. The prevalence of behaviour disorders among a sample of 13 and 14 year old Jamaican high school and all age school adolescents was examined. The identification of aetiological factors involved in behaviour disorders was also attempted. Teachers can improve their assessment of maladjustment in children through observations of children's behaviour. The Revised Behaviour Problem Checklist R.B.P.C. was found to be a useful measure of common behaviour disorders and showed that Jamaican adolescents had a higher prevalence of behaviour disorders than their North American counterparts. An instrument assessing the adolescent's psycological adjustment - the Personality Screening Inventory P.S.I. was also found to be an indicator of behaviour disorders, and it seems that the R.B.P.C. used in conjunction with the P.S.I. would provide a more complete picture of the adolescent's problems. Males scored higher on most subscales of the R.B.P.C. Maladjusted behaviour was also seen to be affected by long periods of separation from parents especially if the child was quite young. Adolescents from the lower social class groups were significantly higher on behaviour disorders than the middle social class groups. However, this finding may also have been a function of low intellectual level. These results suggest that identification of behaviour disordered children in Jamaica is imperative, so that literacy can be improved and more importantly the normal personality, behavioural and emotional development of tomorrow's adults can be assured (AU)

Differential use of psychiatric services by West Indians, West Africans and English in London

Two hundred and ninety West Indians and 73 West African patients were identified and matched against 204 and 53 English patients respectively. Significantly more migrant patients were: not referred to hospital by their GPs, showed disturbed behaviour prior to psychiatric contact, and were admitted formally. Studying consecutive attendances or admissions to one hospital may lead to an unrepresentative sample. (AU)

Psychiatric disorder in the children of Caribbean immigrants

The notes of 204 children of Caribbean immigrants attending a Child Guidance Unit were examined. Those children born in the West Indies were compared with those born in Britain. In addition a short term follow up study was carried out. A high proportion of disturbed girls and of boys with conduct disorders was found among the West Indian born children. The evidence suggests that, unlike the boys, conduct disorder in the girls is not associated with the disturbance of migration. The possible aetiology of the disorder is discussed (Summary)