Long-term follow-up of young Afro-Caribbean Britons and white Britons with a first admission diagnosis of schizophrenia.

In this follow-up study, a group of black and white patients were followed up between 4 years 9 months and 10 years after a first admission with a clinical diagnosis of schizophrenia. It was possible to trace 98% of the sample, and historical, clinical and social data were obtained from case notes and interviews with patients and informants. There was no evidence of greater misdiagnosis in black patients, but their outcome was poorer in terms of readmissions and allocation to schizophrenic catego classes on follow-up (almost significant at 5% level). On follow-up, no differences were found in physical treatments and after-care arrangements or contacts with services. However, more black patients were readmitted on forensic sections and from prison, and more were treated in secure units. Explanations for the increased contact with penal and forensic services are discussed. The poorer clinical outcome found in black patients was associated with four factors apparent before first admission; living alone, unemployment, conviction and imprisonment.