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Differing patterns of brain structural abnormalities between black and white patients with their first episode of psychosis

Published online by Cambridge University Press:  06 November 2009

K. D. Morgan ,
P. Dazzan ,
C. Morgan ,
J. Lappin ,
G. Hutchinson ,
X. Chitnis ,
J. Suckling ,
P. Fearon ,
P. B. Jones  and
J. Leff
...Show all authors
K. D. Morgan*
Affiliation:
Department of Psychology, University of Westminster, London, UK
P. Dazzan
Affiliation:
Institute of Psychiatry, Division of Psychological Medicine, King's College London, UK
C. Morgan
Affiliation:
Institute of Psychiatry, Division of Psychological Medicine, King's College London, UK
J. Lappin
Affiliation:
Institute of Psychiatry, Division of Psychological Medicine, King's College London, UK
G. Hutchinson
Affiliation:
University of West Indies, Department of Psychiatry, Trinidad and Tobago
X. Chitnis
Affiliation:
Institute of Psychiatry, Department of Neurology, King's College London, UK
J. Suckling
Affiliation:
University of Cambridge, Department of Psychiatry, Addenbrooke's Hospital, Cambridge, UK
P. Fearon
Affiliation:
Institute of Psychiatry, Division of Psychological Medicine, King's College London, UK
P. B. Jones
Affiliation:
University of Cambridge, Department of Psychiatry, Addenbrooke's Hospital, Cambridge, UK
J. Leff
Affiliation:
Institute of Psychiatry, Division of Psychological Medicine, King's College London, UK
R. M. Murray
Affiliation:
Institute of Psychiatry, Division of Psychological Medicine, King's College London, UK
*
*Address for correspondence: K. D. Morgan, Ph.D., Department of Psychology, University of Westminster, 309 Regent Street, LondonW1B 2UW, UK. (Email: k.d.morgan@wmin.ac.uk)
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Abstract

Background

African-Caribbean and black African people living in the UK are reported to have a higher incidence of diagnosed psychosis compared with white British people. It has been argued that this may be a consequence of misdiagnosis. If this is true they might be less likely to show the patterns of structural brain abnormalities reported in white British patients. The aim of this study therefore was to investigate whether there are differences in the prevalence of structural brain abnormalities in white and black first-episode psychosis patients.

Method

We obtained dual-echo (proton density/T2-weighted) images from a sample of 75 first-episode psychosis patients and 68 healthy controls. We used high resolution magnetic resonance imaging and voxel-based methods of image analysis. Two separate analyses were conducted: (1) 34 white British patients were compared with 33 white British controls; (2) 41 African-Caribbean and black African patients were compared with 35 African-Caribbean and black African controls.

Results

White British patients and African-Caribbean/black African patients had ventricular enlargement and increased lenticular nucleus volume compared with their respective ethnic controls. The African-Caribbean/black African patients also showed reduced global grey matter and increased lingual gyrus grey-matter volume. The white British patients had no regional or global grey-matter loss compared with their normal ethnic counterparts but showed increased grey matter in the left superior temporal lobe and right parahippocampal gyrus.

Conclusions

We found no evidence in support of our hypothesis. Indeed, the finding of reduced global grey-matter volume in the African-Caribbean/black African patients but not in the white British patients was contrary to our prediction.

Keywords

First-episode psychosismagnetic resonance imagingmisdiagnosisneuroanatomy
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 7 , July 2010 , pp. 1137 - 1147
Copyright
Copyright © Cambridge University Press 2009

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References

Aust, R, Smith, N (2003). Ethnicity and Drug Use: Key Findings from the 2001/2002 British Crime Survey. Findings 209. Home Office: London.Google Scholar
Bebbington, P, Nayani, T (1995). The Psychosis Screening Questionnaire. International Journal of Methods in Psychiatric Research 5, 11–19.Google Scholar
Bullmore, ET, Suckling, J, Overmeyer, S, Rabe-Hesketh, S, Taylor, E, Brammer, MJ (1999). Global, voxel, and cluster tests, by theory and permutation, for a difference between two groups of structural MR images of the brain. IEEE Transactions on Medical Imaging 18, 32–42.CrossRefGoogle ScholarPubMed
Cahn, W, Pol, HEH, Lems, EBTE, van Haren, NEM, Schnack, HG, van der Linden, JA, Schothorst, PF, van Engeland, H, Kahn, RS (2002). Brain volume changes in first-episode schizophrenia – a 1-year follow-up study. Archives of General Psychiatry 59, 1002–1010.CrossRefGoogle ScholarPubMed
Cantor-Graae, E, Selten, JP (2005). Schizophrenia and migration: A meta-analysis and review. American Journal of Psychiatry 162, 12–24.CrossRefGoogle ScholarPubMed
Corson, PW, O'Leary, DS, Miller, DD, Andreasen, NC (2002). The effects of neuroleptic medications on basal ganglia blood flow in schizophreniform disorders: A comparison between the neuroleptic-naive and medicated states. Biological Psychiatry 52, 855–862.CrossRefGoogle ScholarPubMed
Dazzan, P, Morgan, KD, Orr, KG, Hutchinson, G, Chitnis, X, Suckling, J, Fearon, P, Salvo, J, McGuire, PK, Mallett, RM, Jones, PB, Leff, J, Murray, RM (2004). The structural brain correlates of neurological soft signs in AESOP first-episode psychoses study. Brain 127, 143–153.CrossRefGoogle ScholarPubMed
Fannon, D, Chitnis, X, Doku, V, Tennakoon, L, O'Ceallaigh, S, Soni, W, Sumich, A, Lowe, J, Santamaria, M, Sharma, T (2000 a). Features of structural brain abnormality detected in first-episode psychosis. American Journal of Psychiatry 157, 1829–1834.CrossRefGoogle ScholarPubMed
Fannon, D, Tennakoon, L, Sumich, A, O'Ceallaigh, S, Doku, V, Chitnis, X, Lowe, J, Soni, W, Sharma, T (2000 b). Third ventricle enlargement and developmental delay in first-episode psychosis: preliminary findings. British Journal of Psychiatry 177, 354–359.CrossRefGoogle ScholarPubMed
Fearon, P, Kirkbride, J, Morgan, C, Dazzan, P, Morgan, K, Lloyd, T, Hutchinson, G, Tarrant, J, Fung, WLA, Holloway, J, Mallett, J, Harrison, G, Leff, J, Jones, PB, Murray, RM (2006). Incidence of schizophrenia and other psychoses in ethnic minority groups: results from the MRC AESOP Study. Psychological Medicine 36, 1541–1550.CrossRefGoogle ScholarPubMed
Gianaros, PJ, Jennings, JR, Sheu, LK, Greer, PJ, Kuller, LH, Matthews, KA (2007). Prospective reports of chronic life stress predict decreased grey matter volume in the hippocampus. Neuroimage 35, 795–803.CrossRefGoogle ScholarPubMed
Hickling, FW (2005). The epidemiology of schizophrenia and other common mental health disorders in the English-speaking Caribbean. American Journal of Public Health 18, 256–262.Google ScholarPubMed
Hjern, A, Wicks, S, Dalman, C (2004). Social adversity contributes to high morbidity in psychoses in immigrants – a national cohort study in two generations of Swedish residents. Psychological Medicine 34, 1025–1033.CrossRefGoogle ScholarPubMed
Job, DE, Whalley, HC, McConnell, S, Glabus, M, Johnstone, EC, Lawrie, SM (2002). Structural gray matter differences between first-episode schizophrenics and normal controls using voxel-based morphometry. Neuroimage 17, 880–889.CrossRefGoogle ScholarPubMed
Karlsen, S, Nazroo, J (2004). The relationship between racism, social class and physical and mental health among different ethnic groups in England. Ethnicity & Health 9, S46–S47.Google Scholar
Lawrie, SM, Abukmeil, SS (1998). Brain abnormality in schizophrenia – A systematic and quantitative review of volumetric magnetic resonance imaging studies. British Journal of Psychiatry 172, 110–120.CrossRefGoogle ScholarPubMed
Littlewood, R (1992). Psychiatric diagnosis and racial bias: empirical and interpretive approaches. Social Science and Medicine 34, 141–149.CrossRefGoogle Scholar
Littlewood, R, Lipsedge, M (1981). Some social and phenomenological characteristics of psychotic immigrants. Psychological Medicine 11, 289–302.CrossRefGoogle ScholarPubMed
Marcelis, MC, Myin-Germeys, I, Suckling, J, Woodruff, P, Hofman, P, Bullmore, E, Delespaul, P, van Os, J (2003). Cerebral tissue alterations and daily life stress experience in psychosis. Schizophrenia Research 60, 201.CrossRefGoogle Scholar
Marcelis, MC, Suckling, J, Hofman, P, Woodruff, P, Bullmore, E, van Os, J (2006). Evidence that brain tissue volumes are associated with HVA reactivity to metabolic stress in schizophrenia. Schizophrenia Research 86, 45–53.CrossRefGoogle ScholarPubMed
Pantelis, C, Velakoulis, D, McGorry, PD, Wood, SJ, Suckling, J, Phillips, LJ, Yung, AR, Bullmore, ET, Brewer, W, Soulsby, B, Desmond, P, McGuire, PK (2003). Neuroanatomical abnormalities before and after onset of psychosis: a cross-sectional and longitudinal MRI comparison. Lancet 361, 281–288.CrossRefGoogle ScholarPubMed
Sharpley, M, Hutchinson, G, McKenzie, K, Murray, RM (2001). Understanding the excess of psychosis among the African-Caribbean population in England – Review of current hypotheses. British Journal of Psychiatry 178, S60–S68.CrossRefGoogle Scholar
Sigmundsson, T, Suckling, J, Maier, M, Williams, SCR, Bullmore, ET, Greenwood, KE, Fukuda, R, Ron, MA, Toone, BK (2001). Structural abnormalities in frontal, temporal, and limbic regions and interconnecting white matter tracts in schizophrenic patients with prominent negative symptoms. American Journal of Psychiatry 158, 234–243.CrossRefGoogle ScholarPubMed
Suckling, J, Sigmundsson, T, Greenwood, K, Bullmore, ET (1999). A modified fuzzy clustering algorithm for operator independent brain tissue classification of dual echo MR images. Magnetic Resonance Imaging 17, 1065–1076.CrossRefGoogle ScholarPubMed
WHO (1992). The ICD-10 Classification of Mental and Behavioural Disorders. World Health Organization: Geneva.Google Scholar
WHO (1994). Schedules for Clinical Assessment in Neuropsychiatry (SCAN 2.0). World Health Organization: Geneva.Google Scholar
Wing, JK, Sturt, E (1978). The PSE-ID-CATEGO System: Supplementary Manual. Medical Research Council: London.Google Scholar