Talk 3: Do Symptom Dimensions Vary between Ethnic Groups at First Presentation to Early Intervention in Psychosis Services? Evidence from the SEPEA Study

Purpose: The risk of experiencing psychotic disorders is higher in several migrant and ethnic minority populations. We used data from a large cohort of people with first episode psychosis [FEP] to assess whether symptom dimensions at presentation to early intervention psychosis [EIP] services differ between these groups. Method: Participants (N=683, ages 16-35) with confirmed ICD-10 FEP (F10-33) were recruited from 6 EIP services over a 3.5 year period. Polychoric factor analysis identified 7 symptom dimensions (manic, depressive, disorganised, delusional, paranoid, thought disordered & hallucinatory symptoms). Linear regression analysis examined variation in symptom dimensions between 11 ethnic groups, first and later-generation migrants and age-at-migration, controlling for sociodemographic and clinical confounders. Results: Symptom dimension between ethnic minority groups and white British participants were similar, and patterns did not differ between generations or age-at-migration. Compared to white-British participants people of black African origin experienced more manic (β=0.24; 95%CI: 0.01, 0.47) and delusional (β=0.12; 95%CI: 0.01, 0.23) symptoms, and less depressive symptoms (β=-0.21; 95%CI: -0.36, -0.06). People of Indian origin experienced more manic (β=0.81; 95%CI: 0.05, 1.56), depressive (β=0.57; 95%CI: 0.08, 1.06) and disorganised (β=0.43; 95%CI: 0.03, 0.84) symptoms, but less delusional symptoms (β=-0.41; 95%CI: -0.78, -0.03). Conclusion: Most ethnic groups, regardless of generation status or age-at-migration, present to EIP services with similar symptomatic profiles in their first episode of psychosis. Nonetheless, differing symptom profiles in people of black African and Indian origins may warrant more nuanced treatment responses, and could underlie the relative excesses and absences of psychotic disorders observed in these populations.