Refining clinical phenotypes by contrasting ethnically different populations with schizophrenia from Australia, India and Sarawak

Abstract We contrasted demographic and clinical characteristics in transethnic schizophrenia populations from Australia ( n = 821), India ( n = 520) and Sarawak, Malaysia ( n = 298) and proposed cultural explanations for identified site differences. From these we aimed to identify candidate variable...

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Bibliographic Details
Published in:Psychiatry research 2012-04, Vol.196 (2), p.194-200
Main Authors: McLean, Duncan, John, Sujit, Barrett, Robert, McGrath, John, Loa, Peter, Thara, Rangaswamy, Mowry, Bryan
Format: Article
Language:English
Subjects:
Adult
Adult and adolescent clinical studies
Age Factors
Age of onset
Australia
Biological and medical sciences
Cross-Cultural Comparison
Culture
Ethnic Groups
Female
Humans
India
Malaysia
Male
Medical sciences
Middle Aged
Phenotype
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychoses
Psychotic disorders
Schizophrenia
Schizophrenia - epidemiology
Schizophrenia - ethnology
Schizophrenia - genetics
Sex Factors
Substance-Related Disorders - epidemiology
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Summary:Abstract We contrasted demographic and clinical characteristics in transethnic schizophrenia populations from Australia ( n = 821), India ( n = 520) and Sarawak, Malaysia ( n = 298) and proposed cultural explanations for identified site differences. From these we aimed to identify candidate variables free from significant cultural confounding that are hence suitable for inclusion in genetic analyses. We observed five phenomena: (1) more individuals were living alone in Australia than India or Sarawak; (2) drug use was lower in India than Australia or Sarawak; (3) duration of untreated psychosis (DUP) was longer in India than Australia or Sarawak; (4) the rate of schizoaffective disorder was lower in India than Australia or Sarawak; and (5) age at psychosis onset (AAO) was older in Sarawak than Australia or India. We suggest that site differences for living arrangements, drug use and DUP are culturally confounded. The schizoaffective site difference likely results from measurement bias. The AAO site difference, however, has no obvious cultural or measurement bias explanation. Therefore, this may be an ideal candidate for use in genetic studies, given that genetic variants affecting AAO have already been proposed.
ISSN:0165-1781
1872-7123
DOI:10.1016/j.psychres.2011.12.027