Excess psychosis diagnoses amongst black and South Asian men in deprived urban areas could reflect a cluster of disadvantages in specific places, rather than individual experiences of deprivation alone, a study led by Queen Mary University of London researchers concludes.
The paper, published in the British Journal of Psychiatry, is the first to apply a syndemic approach to psychiatry.
The team performed a cross-sectional survey of 3750 UK men aged 18-34 years, oversampling black and minority ethnic men nationally, together with men residing in the London Borough of Hackney.
Although levels of diagnosed psychosis were significantly higher amongst black and South Asian men across Britain than for white men, the gap disappeared after taking account of socio-economic factors such as social class and unemployment.
However, a significant gap remained in diagnosed levels of psychosis and other health conditions amongst black and South Asian men living in Hackney, even after adjustment.
Synergy was found between a four-component latent variable of psychotic experiences and anxiety, substance dependence, high-risk sexual behaviour and violence and criminality and explained persistent disparities in psychotic experiences. Diagnosed levels of psychosis and anxiety were much more severe among men in Hackney who engaged in such behaviours.
The authors concluded that the wider challenges and social circumstances facing certain ethnic minorities in specific deprived urban areas can explain significant variation in rates of diagnosed psychosis.