ELEIS Ethnic Density Study
Research type
Research Study
Full title
Ethnic Density and Psychosis in a British Pakistani Population: an investigation using data from the East Lancashire Early Intervention Service
IRAS ID
277114
Contact name
Victoria Vass
Contact email
Sponsor organisation
University of Liverpool
Duration of Study in the UK
0 years, 4 months, 31 days
Research summary
Summary of Research
Ethnic minority groups have an elevated risk of developing psychosis. However, it has been found that living in areas with a higher proportion of one's own ethnic minority group (ethnic density) protects against this risk, described as the ethnic density effect. Contrary to other ethnic groups, survey studies have indicated an absence, or potentially a reversed effect, of increased ethnic density on risk of psychosis for Pakistani groups in the UK. These findings are currently preliminary, and past studies have been limited by unreliable, self-report questionnaire measures of clinical diagnosis.
The current study aims to test the ethnic density effect in British Pakistani populations, using more clinically reliable data collected by the East Lancashire Early Intervention Service (ELEIS). The service accepts referrals for those experiencing psychosis for the first time (or are within their first three years of treatment).
The research questions are as follows:
1. Do British Pakistani people living in a region of Northern England have higher incidence rates of psychosis when compared to White British people living in the same region?
2. Does living an area with a high proportion of people of Pakistani heritage decrease the risk of psychosis for the British Pakistani population?
3. Is the ethnic density effect comparable between the British Pakistani population and other British South Asian groups?Data, which has been collected as part of routine practice by ELEIS relating to all referrals between 2005 and 2015, will be analysed to assess incidence rates of psychosis for Pakistani groups across different geographical regions in order to test whether increased ethnic density reduces risk of psychosis. Analyses will adjust incidence rates for age, gender, and neighbourhood social deprivation as well-established covariates in risk of psychosis. The study does not involve any further data collection, and only requires statistical analysis of existing data.
Summary of Results
The study examined incident rates of first episode psychosis using data from an early intervention service in East Lancashire between 2012 and 2020. We compared rates of first episode psychosis between the White majority population and the Pakistani population. We found that Pakistani people in Lancashire had significantly higher risk of first episode psychosis after controlling for age, gender, and local area deprivation.
We also examined whether ethnic density (the proportion of people in an area from one's own ethnic group) influenced risk of developing first episode psychosis. We found that Pakistani people living in lower density areas (less Pakistani people compared to other groups including the White majority) were at significantly higher risk of developing a first episode psychosis compared to those living in higher density, diverse areas.
REC name
London - Central Research Ethics Committee
REC reference
20/LO/1279
Date of REC Opinion
4 Dec 2020
REC opinion
Favourable Opinion