Depression and anxiety among Afro-Caribbean general practice attenders in Britain

Schizophrenia is diagnosed more frequently among Afro-Caribbeans in Britain than among white British controls. Studies among the general population indicate that non-psychotic disorders such as anxiety, depression and functional somatic symptoms are the commonest expression of psychiatric morbidity. Yet, among Afro-Caribbean primary care attenders, rates of anxiety and depression appear lower than in the general population. This finding is at odds with the reportedly higher rates of schizophrenia among this group. The majority of authors favour socio-cultural explanations to account for the higher rates of schizophrenia. Yet many of the factors that are evoked to account for the greater incidence of schizophrenia would be expected to lead to higher rates of non-psychotic disorders in primary care settings. Possible explanations for these apparently contradictory findings are discussed.