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Numbers are small

BMJ 1995; 310 doi: (Published 04 February 1995) Cite this as: BMJ 1995;310:331
  1. D Bhugra,
  2. J Leff,
  3. R Mallett
  1. Senior lecturer Director Scientific officer Medical Research Council Social and Community Psychiatry Unit, Institute of Psychiatry, London E5 8AF

    EDITOR,—We were not surprised that Michael King and colleagues found that the rates of psychosis were higher among the African Caribbean population than among the white population1—a finding well established by previous research. We would take issue with their assertion that rates are higher among all minority ethnic groups when they found only a limited number of cases. To conclude from seven Asian cases that rates are high among the Asian community is perilous. In a comparable study in Ealing conducted over a similar period we found 31 cases of first onset psychosis among Asians and that the rate of broad schizophrenia did not differ significantly from that of the white population of the same catchment area. Research into ethnic group and mental illness is beset with complexities, and generalisations on the basis of small numbers are not likely to clarify our understanding of this difficult subject.

    A second issue that raises our concern is the inclusion of European patients of Turkish-Cypriot origin in the white group. We would anticipate that their experiences of racism and cultural conflict would be different from those of the indigenous population. Therefore it is more appropriate to treat them as a separate minority ethnic group for the purpose of calculating incidence rates.


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