RESUMO
Several studies have reported alarmingly high rates psychiatric morbidity among West Indians in Great Britain, in particular a high rate of schizophrenia in the Afro-Caribbean population. Studies done in the Caribbean have not been consistent in their findings. Therefore, a prospective study was done in Trinidad, with the aim of investigating every patient presenting to the psychiatric services with psychotic symptoms for the first time. The study does not confirm the high rates seen in Britain, though significant differences in incidence rates and diagnostic patterns between the two major ethnic groups were found. The incidence of psychosis was found to be 2.4 per 10,000 for males and 1.9 per 10,000 for females. In the Afro-Trinidadian population, the incidence rate was more than twice as high compared to the Indo-Trinidadians, 3.6 and 1.4 per 10,000 respectively. More than three times as many Indo-Trinidadians as compared to Afro-Trinidadian were diagnosed with a depressive psychosis, while all the manic and mixed affective psychoses were found among the Afro-Trinidadian population. Factors like maternal exposure to infectious agents, obstetrical complications, excess of compulsory admissions, misdiagnosis, social adversity, hostile behaviour and religious and persecutory delusions could not be confirmed in this study as valid explanations for these findings. Referral practices, health-seeking behaviour and illness presentation are more likely to explain the differences (AU)
Assuntos
Humanos , Masculino , Feminino , Transtorno Bipolar , Esquizofrenia/mortalidade , Negro ou Afro-Americano , Etnicidade , Transtorno Bipolar/mortalidade , Obstetrícia , Trinidad e TobagoRESUMO
The aim of the study was to describe the pattern of first admissions to a psychiatric outpatient clinic in Trinidad. During 1990 a prospective study was done on 147 consecutive new cases that presented at the Tacarigua Health Centre. An incidence of 1.2/1000 was found with an average of 12 new patients/month. There were no differences in sex distribution. The average age of males was 35.6 years and 38.8 for females. Fifty-five point seven per cent of the sample were of African origin and 36.7 percent were of East Indian origin (p<0.005). Mood disorders were almost twice as common in females (37.0 percent) as in males (21.6 percent) p<0.01. Schizophrenia was almost twice as common in males as females (16.2 percent vs 8.2 percent, p<0.1). Psychoactive substances use disorders were four times more common in organic mental disorders in the men (12.2 percent). Major differences in demographic and diagnostic data in the two major ethnic groups suggest a need for culturally relevant programmes. Community clinics at the moment are underutilised and there is a need for the use of these clinics as a first illness contact station. The treatment of substance abusers is a burden to the psychiatric services and ought to be separated (AU)