跨越美国精神病连续的种族风险变化:系统性审查和元分析
Els van der Ven1, Thomas M Olino2, Katharina Diehl1
1Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, the Netherlands.
JAMA psychiatry
|February 21, 2024
概括
这项研究发现,在美国,精神病风险存在显著的种族差异. 黑人和其他少数群体面临更高的精神分裂症和精神病体验风险,突出系统影响.
科学领域:
- 精神病学是一个精神病学.
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 现有研究表明,与白人相比,黑人美国人患精神分裂症的风险更高.
- 缺乏对精神病连续性的种族种族差异的全面调查,包括多种结果和群体.
研究的目的:
- 系统地识别美国精神病连续的三个关键结果的种族风险变化.
- 检查的结果包括精神分裂症和其他精神病障碍,临床精神病高风险 (CHR-P),精神病症状 (PSs) 和精神病经历 (PEs).
主要方法:
- 对观察性研究进行了系统性审查和元分析,搜索了PubMed,PsycINFO和Embase直到2022年12月.
- 遵循系统审查和元分析 (PRISMA) 准则的首选报告项目,采用随机效应模型来汇集估计并评估异质性和偏差风险.
主要成果:
- 分析包括47项研究 (54,929名精神分裂症患者;223,097名PS/PE患者).
- 与白人个人相比,黑人个人患精神分裂症 (OR,2.07) 和PSs/PE (SMD,0.10) 的风险增加.
- 拉丁人的PS/PE风险更高 (SMD,0.15),其他种族群体的精神分裂症风险更高 (OR,1.81). 在住院患者中,亚洲人患精神分裂症的风险增加 (OR,1.84),在大学样本中增加了PEs (SMD,0.16). CHR-P的结果是不一致的.
结论:
- 在美国,在多种精神病结果中存在广泛的种族风险变化.
- 除了诊断和测量偏见之外,结构性种族主义等系统因素是这些差异的关键驱动因素.
- 需要进一步的研究来解决现有研究中的异质性和偏见.
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