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Are Black Caribbean Patients More Likely to Receive an Incorrect Diagnosis of Very-Late-Onset Schizophrenia-Like Psychosis Than Their White British Counterparts?

Received March 18, 2003; revised August 25, 2003; accepted September 4, 2003. From the Section of Old Age Psychiatry, Institute of Psychiatry, London, UK. Send correspondence to Dr Suzanne Reeves, Section of Old Age Psychiatry, Institute of Psychiatry, De Crespigny Park, London SE5 8AF. e-mail: s.reeves{at}iop.kcl.ac.uk

Objective: Increased rates of schizophrenia and schizophrenia-like psychoses are repeatedly reported within migrant populations. The authors investigated whether some or all of an observed increase in service contact rates for very-late-onset schizophrenia-like psychosis in older black people of Caribbean origin could be explained by underdiagnosis of affective psychosis. Methods: The case-notes of 47 patients with very-late-onset schizophrenia-like psychosis were rated with a 44-point psychopathology checklist. Results: Black Caribbean patients with very-late-onset schizophrenia-like psychosis were younger and more likely to be male than their white British counterparts. Although there were some differences in symptoms between the groups, these did not reach levels of statistical significance. Conclusion: Further studies will be required to establish the diagnostic stability and outcome of very-late-onset schizophrenia-like psychosis in older black Caribbean migrants.

Key Words: cross-cultural psychiatry • schizophrenia • psychosis • delusions • hallucinations