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Objective: To compare annual incidences of psychosis in people from different ethnic groups as defined in the 1991 census., Setting: Catchment area of district psychiatric hospital., Design: All people aged 16 to 54 years who made contact with a wide range of community and hospital services between 1 July 1991 and 30 June 1992 were screened for psychotic symptoms. Patients with such symptoms were interviewed face to face to collect information on demography, ethnic group, psychiatric history and symptoms, drug use, and how care had been sought. A key informant, usually a close relative, was also interviewed., Main Outcome Measures: Age standardised incidence of schizophrenia and non-affective psychosis according to the ninth edition of the International Classification of Diseases in each ethnic group., Results: Ninety three patients took part, of whom 38 were assigned a certain or very likely diagnosis of schizophrenia (15 in white population, 14 in black, seven in Asian, and two in others). The age standardised annual incidence of schizophrenia was 2.2 (95% confidence interval 1.5 to 2.9) per 10,000 of the population. The incidence ratio for schizophrenia in all ethnic minority groups compared with the white population was 3.6 (1.9 to 7.1); the corresponding figure for non-affective psychosis was 3.7 (2.2 to 6.2)., Conclusions: Raised incidences of schizophrenia were not specific to the African Caribbeans, which suggests that the current focus on schizophrenia in this population is misleading. Members of all ethnic minority groups were more likely to develop a psychosis but not necessarily schizophrenia. The personal and social pressures of belonging to any ethnic minority group in Britain are important determinants in the excess of psychotic disorders found.

Of 100 men and women interviewed at Crisis at Christmas, 34 were actively psychotic, and 12 of these had had no contact with psychiatric services. Of those also answering as to whether or not they had been in prison, 25 (81%) replied in the affirmative, including 1 who had been in Broadmoor for attempted murder. In the combined group of 46 who either had had previous psychiatric admissions or were actively psychotic, 32 (78%) admitted to having been to prison (2 declined to answer), which was significantly in excess of the figure (42%) for those with no serious psychopathology and no previous psychiatric history. About a third of those interviewed were not receiving their benefit entitlement, the proportions being similar for those with and without a history of psychiatric illness. These results show a deterioration since last year's survey.