{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T23:04:52Z","timestamp":1777071892317,"version":"3.51.4"},"reference-count":39,"publisher":"Royal College of Psychiatrists","issue":"4","license":[{"start":{"date-parts":[[2019,10,30]],"date-time":"2019-10-30T00:00:00Z","timestamp":1572393600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec id=\"S0007125019002034_sec_a1\" sec-type=\"other\"><jats:title>Background<\/jats:title><jats:p>Ethnic inequalities in health outcomes are often explained by socioeconomic status and concentrated poverty. However, ethnic disparities in psychotic experiences are not completely attenuated by these factors.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125019002034_sec_a2\" sec-type=\"other\"><jats:title>Aims<\/jats:title><jats:p>We investigated whether disparities are better explained by interactions between individual risk factors and place-based clustering of disadvantage, termed a syndemic.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125019002034_sec_a3\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>We performed a cross-sectional survey of 3750 UK men, aged 18\u201334 years, oversampling Black and minority ethnic (BME) men nationally, together with men residing in London Borough of Hackney. Participants completed questionnaires covering psychiatric symptoms, substance misuse, crime and violence, and risky sexual health behaviours. We included five psychotic experiences and a categorical measure of psychosis based on the Psychosis Screening Questionnaire.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125019002034_sec_a4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>At national level, more Black men reported psychotic experiences but disparities disappeared following statistical adjustment for social position. However, large disparities for psychotic experiences in Hackney were not attenuated by adjustment for social factors in Black men (adjusted odds ratio, 3.24; 95% CI 2.14\u20134.91; <jats:italic>P<\/jats:italic> &lt; 0.002), but were for South Asian men. A syndemic model of joint effects, adducing a four-component latent variable (psychotic experiences and anxiety, substance dependence, high-risk sexual behaviour and violence and criminality) showed synergy between components and explained persistent disparities in psychotic experiences. A further interaction confirmed area-level effects (Black ethnicity \u00d7 Hackney residence, 0.834; <jats:italic>P<\/jats:italic> &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec id=\"S0007125019002034_sec_a5\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>Syndemic effects result in higher rates of non-affective psychosis among BME persons in certain inner-urban settings. Further research should investigate how syndemics raise levels of psychotic experiences and related health conditions in Black men in specific places with multiple deprivations.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjp.2019.203","type":"journal-article","created":{"date-parts":[[2019,10,30]],"date-time":"2019-10-30T07:44:42Z","timestamp":1572421482000},"page":"555-561","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":18,"title":["Ethnic disparities in psychotic experiences explained by area-level syndemic effects"],"prefix":"10.1192","volume":"217","author":[{"given":"Jeremy","family":"Coid","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Gonzalez Rodriguez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constantinos","family":"Kallis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6515-9106","authenticated-orcid":false,"given":"Yamin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9205-2144","authenticated-orcid":false,"given":"Kamaldeep","family":"Bhui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bianca","family":"De Stavola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6030-7456","authenticated-orcid":false,"given":"Paul","family":"Bebbington","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Ullrich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"170","published-online":{"date-parts":[[2019,10,30]]},"reference":[{"key":"S0007125019002034_ref19","volume-title":"The English Indices of Deprivation 2010","author":"McLennan","year":"2011"},{"key":"S0007125019002034_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/S0920-9964(01)00352-8"},{"key":"S0007125019002034_ref28","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbx060"},{"key":"S0007125019002034_ref27","first-page":"1903","article-title":"Childhood adversities inverse the risk of psychosis: a meta-analysis of patient-control, prospective and cross-sectional cohort studies","volume":"42","author":"Viechtbauer","year":"2012","journal-title":"Schizophr Bull"},{"key":"S0007125019002034_ref18","doi-asserted-by":"publisher","DOI":"10.1159\/000081413"},{"key":"S0007125019002034_ref24","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbw003"},{"key":"S0007125019002034_ref30","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2013.12091188"},{"key":"S0007125019002034_ref10","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.publhealth.29.020907.090852"},{"key":"S0007125019002034_ref1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-015-1021-6"},{"key":"S0007125019002034_ref23","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000491"},{"key":"S0007125019002034_ref5","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.65.11.1250"},{"key":"S0007125019002034_ref29","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2016.15101293"},{"key":"S0007125019002034_ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijlp.2011.02.003"},{"key":"S0007125019002034_ref22","unstructured":"Office of Population Censuses and Surveys. 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