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Cultural differences

How are cultural differences related to course and outcome of schizophrenia?

Cultural differences may influence the course and outcome of illness for people with schizophrenia. These may be the result of differences in understanding of mental illness, and different attitudes and treatment approaches towards these disorders. Some cultures may provide more accessible pathways to care than others, including ready access to treatment and family and social support that can assist the individual to better deal with symptoms and any associated distress. Negative cultural attitudes towards mental illness may exacerbate stigma and social isolation, and some cultures may focus more on “abnormal” behaviour than other cultures, potentially perpetuating it.

What is the evidence for cultural differences?

Overall, moderate quality evidence suggests rates of mortality, remission, relapse, social disability, marital status, and employment vary across studies conducted in different countries, both in the developing and the developed world.

There was a small increased risk of compulsory psychiatric admissions in migrant groups compared to native populations. Compared to white ethnic groups, there was a small increased risk of compulsory psychiatric admissions in Black Caribbean, Black African, South Asian, East Asian, and other minority groups. Black people in the UK were less likely to be hospitalised on first presentation to services, or to be referred to specialist services, but were more likely to have had involvement with the police during admission to hospital. The most common explanations for these findings include having psychotic symptoms, perceived risk of violence, police contact, absence of or mistrust of general practitioners, and ethnic disadvantages.

Moderate to low quality evidence indicates there may be fewer compulsory admissions for Asians in Canada with first-episode psychosis than for Whites, Blacks, or those of other ethnic backgrounds.

August 2020

Last updated at: 11:23 pm, 11th August 2020
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