Skip to main content
Top
Published in: Social Psychiatry and Psychiatric Epidemiology 9/2019

Open Access 01-09-2019 | Delusional Disorder | Review

Perceived discrimination and psychosis: a systematic review of the literature

Authors: Josie Pearce, Sonya Rafiq, Jane Simpson, Filippo Varese

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 9/2019

Login to get access

Abstract

Purpose

Higher rates of psychosis have been reported in minority groups. Since individuals belonging to such groups are vulnerable to the experiences of discrimination, and in line with models proposing that social and life adversity may play a causal role in development and maintenance of psychotic experiences, it has been proposed that perceived discrimination may represent an important determinant of psychotic experiences. This paper reviews the literature examining the relationship between perceived discrimination and psychosis, examining whether discrimination is associated with an increased risk of psychosis, the severity of psychotic symptoms and whether there is an association with specific psychotic symptoms.

Methods

A systematic database search of PsycINFO, Embase and PubMed was conducted to identify quantitative cross-sectional and prospective studies that examined the association between discrimination and psychosis.

Results

Twenty-four studies met the inclusion criteria, four of which used prospective designs and twenty used cross-sectional designs. The main findings indicated that discrimination may be associated with an increased risk of psychosis (too few studies to determine whether discrimination is associated with severity). Some studies found associations between discrimination and positive psychotic experiences and/or specific psychotic experiences such as paranoia. A small number of studies found that greater exposure to discrimination was associated with a greater likelihood of reporting psychotic experiences, tentatively indicating a dose–response relationship.

Conclusions

This review indicates that discrimination plays an important role in the experience of psychosis; however, future research is required to clarify the nature of this relationship. Avenues for further research and clinical implications are proposed.
Literature
1.
go back to reference Fearon P, Kirkbride JB, Morgan C, Dazzan P, Morgan K, Lloyd T, Hutchinson G, Tarrant J, Fung WL, Holloway J, Mallett R, Harrison G, Leff J, Jones PB, Murray RM, Group AS (2006) Incidence of schizophrenia and other psychoses in ethnic minority groups: results from the MRC AESOP Study. Psychol Med 36:1541–1550. https://doi.org/10.1017/s0033291706008774 CrossRefPubMed Fearon P, Kirkbride JB, Morgan C, Dazzan P, Morgan K, Lloyd T, Hutchinson G, Tarrant J, Fung WL, Holloway J, Mallett R, Harrison G, Leff J, Jones PB, Murray RM, Group AS (2006) Incidence of schizophrenia and other psychoses in ethnic minority groups: results from the MRC AESOP Study. Psychol Med 36:1541–1550. https://​doi.​org/​10.​1017/​s003329170600877​4 CrossRefPubMed
30.
48.
go back to reference Karlsen S, Nazroo JY (2002) Relation between racial discrimination, social class, and health among ethnic minority groups. Am J Public Health 92:624–631CrossRefPubMedPubMedCentral Karlsen S, Nazroo JY (2002) Relation between racial discrimination, social class, and health among ethnic minority groups. Am J Public Health 92:624–631CrossRefPubMedPubMedCentral
52.
53.
go back to reference Stowkowy J, Liu L, Cadenhead KS, Cannon TD, Cornblatt BA, McGlashan TH, Perkins DO, Seidman LJ, Tsuang MT, Walker EF, Woods SW, Bearden CE, Mathalon DH, Addington J (2016) Early traumatic experiences, perceived discrimination and conversion to psychosis in those at clinical high risk for psychosis. Soc Psychiatry Psychiatr Epidemiol 51:497–503. https://doi.org/10.1007/s00127-016-1182-y CrossRefPubMedPubMedCentral Stowkowy J, Liu L, Cadenhead KS, Cannon TD, Cornblatt BA, McGlashan TH, Perkins DO, Seidman LJ, Tsuang MT, Walker EF, Woods SW, Bearden CE, Mathalon DH, Addington J (2016) Early traumatic experiences, perceived discrimination and conversion to psychosis in those at clinical high risk for psychosis. Soc Psychiatry Psychiatr Epidemiol 51:497–503. https://​doi.​org/​10.​1007/​s00127-016-1182-y CrossRefPubMedPubMedCentral
62.
go back to reference Birchwood M, Meaden A, Trower P, Gilbert P, Plaistow J (2000) The power and omnipotence of voices: subordination and entrapment by voices and significant others. Psychol Med 30:337–344CrossRefPubMed Birchwood M, Meaden A, Trower P, Gilbert P, Plaistow J (2000) The power and omnipotence of voices: subordination and entrapment by voices and significant others. Psychol Med 30:337–344CrossRefPubMed
68.
go back to reference Michael B, Larry V, Julian H, Hannah R (2009) Introduction to meta-analysis. Wiley, UK, p 96 Michael B, Larry V, Julian H, Hannah R (2009) Introduction to meta-analysis. Wiley, UK, p 96
69.
go back to reference Lewis G, Pelosi AJ, Araya R, Dunn G (1992) Measuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers. Psychol Med 22:465–486CrossRefPubMed Lewis G, Pelosi AJ, Araya R, Dunn G (1992) Measuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers. Psychol Med 22:465–486CrossRefPubMed
75.
go back to reference Modood T, Berthoud R, Lakey J, Nazroo J, Smith P, Virdee S, Beishon S (1997) Ethnic minorities in Britain: diversity and disadvantage. Policy Studies Institute, London Modood T, Berthoud R, Lakey J, Nazroo J, Smith P, Virdee S, Beishon S (1997) Ethnic minorities in Britain: diversity and disadvantage. Policy Studies Institute, London
76.
go back to reference Smith P, Prior G (1997) The fourth national survey of ethnic minorities: technical report. Social and Community Planning Research, London Smith P, Prior G (1997) The fourth national survey of ethnic minorities: technical report. Social and Community Planning Research, London
77.
go back to reference Overall JE, Gorham DR (1962) The Brief Psychiatric Rating Scale. Psychol Rep 10:799–812CrossRef Overall JE, Gorham DR (1962) The Brief Psychiatric Rating Scale. Psychol Rep 10:799–812CrossRef
78.
go back to reference Derogatis LR, Melisaratos N (1983) The Brief Symptom Inventory: an introductory report. Psychol Med 13:595–605CrossRefPubMed Derogatis LR, Melisaratos N (1983) The Brief Symptom Inventory: an introductory report. Psychol Med 13:595–605CrossRefPubMed
79.
go back to reference Smitten MHSR, Van den Brink W (1998) Composite international diagnostic interview (CIDI) Version 2.1. World Health Organization, Amsterdam Smitten MHSR, Van den Brink W (1998) Composite international diagnostic interview (CIDI) Version 2.1. World Health Organization, Amsterdam
80.
go back to reference WHO (1990) Composite International Diagnostic Interview (CIDI) Version 1.0. World Health Organization, Geneva WHO (1990) Composite International Diagnostic Interview (CIDI) Version 1.0. World Health Organization, Geneva
81.
go back to reference Smeets R, Dingemans P (1993) Composite International Diagnostic Interview (CIDI) Version 1.1. World Health Organization, Amsterdam Smeets R, Dingemans P (1993) Composite International Diagnostic Interview (CIDI) Version 1.1. World Health Organization, Amsterdam
87.
go back to reference Ising HK, Veling W, Loewy RL, Rietveld MW, Rietdijk J, Dragt S, Klaassen RM, Nieman DH, Wunderink L, Linszen DH, van der Gaag M (2012) The validity of the 16-item version of the Prodromal Questionnaire (PQ-16) to screen for ultra high risk of developing psychosis in the general help-seeking population. Schizophr Bull 38:1288–1296. https://doi.org/10.1093/schbul/sbs068 CrossRefPubMedPubMedCentral Ising HK, Veling W, Loewy RL, Rietveld MW, Rietdijk J, Dragt S, Klaassen RM, Nieman DH, Wunderink L, Linszen DH, van der Gaag M (2012) The validity of the 16-item version of the Prodromal Questionnaire (PQ-16) to screen for ultra high risk of developing psychosis in the general help-seeking population. Schizophr Bull 38:1288–1296. https://​doi.​org/​10.​1093/​schbul/​sbs068 CrossRefPubMedPubMedCentral
88.
go back to reference Bebbington P, Nayani T (1995) The psychosis screening questionnaire. Int J Methods Psychiatr Res 5:11–19 Bebbington P, Nayani T (1995) The psychosis screening questionnaire. Int J Methods Psychiatr Res 5:11–19
89.
go back to reference McGlashan T, Walsh B, Woods S (2010) The psychosis-risk syndrome: handbook for diagnosis and follow-up. Oxford University Press, New York McGlashan T, Walsh B, Woods S (2010) The psychosis-risk syndrome: handbook for diagnosis and follow-up. Oxford University Press, New York
90.
go back to reference WHO (1994) Schedules for clinical assessment in neuropsychiatry: manual. World Health Organization, Geneva WHO (1994) Schedules for clinical assessment in neuropsychiatry: manual. World Health Organization, Geneva
92.
go back to reference Spitzer R, Williams J, Gibbon M, First M (1987) Structured Clinical Interview for DSM-III-R (SCID). New York State Psychiatric Institute, Biometrics Research, New York Spitzer R, Williams J, Gibbon M, First M (1987) Structured Clinical Interview for DSM-III-R (SCID). New York State Psychiatric Institute, Biometrics Research, New York
97.
go back to reference McNeilly MD, Anderson NB, Armstead CA, Clark R, Corbett M, Robinson EL, Pieper CF, Lepisto EM (1996) The Perceived Racism Scale: a multidimensional assessment of the experience of white racism among African Americans. Ethn Dis 6:154–166PubMed McNeilly MD, Anderson NB, Armstead CA, Clark R, Corbett M, Robinson EL, Pieper CF, Lepisto EM (1996) The Perceived Racism Scale: a multidimensional assessment of the experience of white racism among African Americans. Ethn Dis 6:154–166PubMed
Metadata
Title
Perceived discrimination and psychosis: a systematic review of the literature
Authors
Josie Pearce
Sonya Rafiq
Jane Simpson
Filippo Varese
Publication date
01-09-2019
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 9/2019
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-019-01729-3

Other articles of this Issue 9/2019

Social Psychiatry and Psychiatric Epidemiology 9/2019 Go to the issue