Transcultural issues in cohorts at high risk of psychosis
Citation: Deriu V, Moro MR, Benoit L. Early intervention for everyone? A review of cross‐cultural issues and their treatment in ultra‐high‐risk (UHR) cohorts. Early Intervention in Psychiatry. 2018;12(5):796–810.
Language: Abstract and full text available in EN.
Free to view: No.
Funding sources: Nothing noted.
What is this? In this systematic review, the authors searched for articles on the assessment and discussion of transcultural issues in ultra-high-risk (UHR) cohorts. They restricted their searches to peer-reviewed articles published in English between 1995 and 2017. They included 79 prospective studies of UHR cohorts that used the Comprehensive Assessment of At-Risk Mental States (CAARMS) assessment method.
What was found: Transcultural data such as native language, ethnicity, place of birth, and migration status were rarely collected in these studies. When transcultural data were included, the CAARMS scores differed between some minority groups and the native-born majority group, indicating potential selection bias and lower validity of the CAARMS among these populations. Insufficient language skill was often an exclusion criterion for research participation, which contributed to selection bias.
Implications: The authors of the review stated that there was a need for improved access to participation in early intervention research for migrants and ethnic minorities. To address the barriers, the use of interpreters at recruitment and during the administration of CAARMS was recommended, along with the development of a guide for better collection of transcultural data. Stratified analyses should be conducted to ensure that the CAARMS results are similar between different minority and majority groups. Moreover, the external validity of diagnostic tools for At-Risk Mental States (ARMS) is crucial, as symptoms of psychosis may be expressed differently across cultural groups. This highlights the importance of bridging the gap between theoretical knowledge and clinical practice for diagnostic aids like CAARMS.
Other considerations: The authors of the review discussed their findings in the context of race, ethnicity, culture, and language.
This summary was prepared by Riwa Deghaim, checked by Grace Meng and finalized by William Summerskill.