ArticleThe British journal of psychiatry : the journal of mental science2020
Ethnic disparities in psychotic experiences explained by area-level syndemic effects.
Article in The British journal of psychiatry : the journal of mental science, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Pooled it
- Testing syndemic models along pathways to psychotic spectrum disorder: implications for population-level preventive interventions.Psychological medicine · 2025Article
- Childhood Adversity Determines the Syndemic Effects of Violence, Substance Misuse, and Sexual Behavior on Psychotic Spectrum Disorder Among Men.Schizophrenia bulletin · 2024Article
- Article
- Trauma and mental disorder: multi-perspective depictions inFrontiers in psychiatry · 2024Article
- Establishing a business case for setting up early detection services for preventing psychosis.BJPsych bulletin · 2023Review
- Experience-based investigation and codesign of approaches to prevent and reduce Mental Health Act use (CO-PACT): a protocol.BMJ open · 2022Article
- Is psychosis a syndemic manifestation of historical and contemporary adversity? Findings from UK Biobank.The British journal of psychiatry : the journal of mental science · 2021Article
- The mental health of ex-prisoners: analysis of the 2014 English National Survey of Psychiatric Morbidity.Social psychiatry and psychiatric epidemiology · 2021Article
- A syndemic of psychiatric morbidity, substance misuse, violence, and poor physical health among young Scottish men with reduced life expectancy.SSM - population health · 2021Article
- Epidemiology of knife carrying among young British men.Social psychiatry and psychiatric epidemiology · 2021Article
- Gang membership and sexual violence: associations with childhood maltreatment and psychiatric morbidity.The British journal of psychiatry : the journal of mental science · 2020Article
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Authors and funding
8 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundEthnic inequalities in health outcomes are often explained by socioeconomic status and concentrated poverty. However, ethnic disparities in psychotic experiences are not completely attenuated by these factors.
aimsWe investigated whether disparities are better explained by interactions between individual risk factors and place-based clustering of disadvantage, termed a syndemic.
methodWe performed a cross-sectional survey of 3750 UK men, aged 18-34 years, oversampling Black and minority ethnic (BME) men nationally, together with men residing in London Borough of Hackney. Participants completed questionnaires covering psychiatric symptoms, substance misuse, crime and violence, and risky sexual health behaviours. We included five psychotic experiences and a categorical measure of psychosis based on the Psychosis Screening Questionnaire.
resultsAt national level, more Black men reported psychotic experiences but disparities disappeared following statistical adjustment for social position. However, large disparities for psychotic experiences in Hackney were not attenuated by adjustment for social factors in Black men (adjusted odds ratio, 3.24; 95% CI 2.14-4.91; P < 0.002), but were for South Asian men. A syndemic model of joint effects, adducing a four-component latent variable (psychotic experiences and anxiety, substance dependence, high-risk sexual behaviour and violence and criminality) showed synergy between components and explained persistent disparities in psychotic experiences. A further interaction confirmed area-level effects (Black ethnicity × Hackney residence, 0.834; P < 0.001).
conclusionsSyndemic effects result in higher rates of non-affective psychosis among BME persons in certain inner-urban settings. Further research should investigate how syndemics raise levels of psychotic experiences and related health conditions in Black men in specific places with multiple deprivations.
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