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A meta‐analysis of ethnic differences in pathways to care at the first episode of psychosis
Author(s) -
Anderson K. K.,
Flora N.,
Archie S.,
Morgan C.,
McKenzie K.
Publication year - 2014
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.12254
Subject(s) - ethnic group , meta analysis , psychosis , odds ratio , medicine , demography , psychiatry , psychology , sociology , anthropology
Objective We sought to systematically review the literature on ethnic differences in the likelihood of general practitioner ( GP ) involvement, police involvement, and involuntary admission on the pathway to care of patients with first‐episode psychosis ( FEP ). Method We searched electronic databases and conducted forward and backward tracking to identify relevant studies. We calculated pooled odds ratios ( OR ) to examine the variation between aggregated ethnic groups in the indicators of the pathway to care. Results We identified seven studies from C anada and E ngland that looked at ethnic differences in GP involvement ( n = 7), police involvement ( n = 7), or involuntary admission ( n = 5). Aggregated ethnic groups were most often compared. The pooled OR s suggest that Black patients have a decreased likelihood of GP involvement ( OR = 0.70, 0.57–0.86) and an increased likelihood of police involvement ( OR = 2.11, 1.67–2.66), relative to White patients. The pooled OR s were not statistically significant for patients with A sian backgrounds ( GP involvement OR = 1.23, 0.87–1.75; police involvement OR = 0.86, 0.57–1.30). There is also evidence to suggest that there may be ethnic differences in the likelihood of involuntary admission; however, effect modification by several sociodemographic factors precluded a pooling of these data. Conclusion Ethnic differences in pathways to care are present at the first episode of psychosis.