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Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - Ethnicity and impact on the receipt of Cognitive Behavioural Therapy in people with psychosis or bipolar disorder
T2 - an English cohort study
AU - Morris, Rohan
AU - Sellwood, Bill
AU - Edge, Dawn
AU - Colling, Craig
AU - Stewart, Robert
AU - Cupitt, Caroline
AU - Das-Munshi, Jayati
PY - 2020/12/15
Y1 - 2020/12/15
N2 - Objectives: 1) To explore the role of ethnicity in receiving Cognitive Behavioural Therapy (CBT) for people with psychosis or bipolar disorder whilst adjusting for differences in risk profiles and symptom severity. 2) To assess whether context of treatment (inpatient versus community) impacts on the relationship between ethnicity and access to CBT.Design: Cohort study of case-register data from one catchment area (January 2007 to July 2017).Setting: A large secondary care provider serving an ethnically-diverse population in London.Participants: Data extracted for 30,497 records of people who had diagnoses of bipolar disorder (ICD Code F30-1) or psychosis (F20-F29 excluding F21). Exclusion criteria were: <15 years old, missing data, and not self-defining as belonging to one of the larger ethnic groups. The sample (N=20010) comprised the following ethnic groups: White British, n=10393; Black Caribbean, n=5481, Black African, n=2817; Irish, n= 570; and ‘South Asian’people (consisting of Indian, Pakistani, and Bangladeshi people) n=749.Outcome Assessments: Odds ratios for receipt of CBT (single session or full course) as determined via multivariable logistic regression analyses.Results: In models adjusted for risk and severity variables, in comparison to White British people; Black African people were less likely to receive a single session of CBT (OR 0.73, CI 0.66 to 0.82, p<.001); Black Caribbean people were less likely to receive a minimum of 16-sessions of CBT (OR 0.83, CI 0.71 to 0.98, p=.03); Black African and Black Caribbean people were significantly less likely to receive CBT whilst inpatients (respectively OR 0.76, CI 0.65 to 0.89, p=.001; OR 0.83, CI 0.73 to 0.94, p=.003).Conclusions: This study highlights disparity in receipt of CBT from a large provider of secondary care in London for Black African and Caribbean people and that the context of therapy (inpatient versus community settings) has a relationship with disparity in access to treatment.
AB - Objectives: 1) To explore the role of ethnicity in receiving Cognitive Behavioural Therapy (CBT) for people with psychosis or bipolar disorder whilst adjusting for differences in risk profiles and symptom severity. 2) To assess whether context of treatment (inpatient versus community) impacts on the relationship between ethnicity and access to CBT.Design: Cohort study of case-register data from one catchment area (January 2007 to July 2017).Setting: A large secondary care provider serving an ethnically-diverse population in London.Participants: Data extracted for 30,497 records of people who had diagnoses of bipolar disorder (ICD Code F30-1) or psychosis (F20-F29 excluding F21). Exclusion criteria were: <15 years old, missing data, and not self-defining as belonging to one of the larger ethnic groups. The sample (N=20010) comprised the following ethnic groups: White British, n=10393; Black Caribbean, n=5481, Black African, n=2817; Irish, n= 570; and ‘South Asian’people (consisting of Indian, Pakistani, and Bangladeshi people) n=749.Outcome Assessments: Odds ratios for receipt of CBT (single session or full course) as determined via multivariable logistic regression analyses.Results: In models adjusted for risk and severity variables, in comparison to White British people; Black African people were less likely to receive a single session of CBT (OR 0.73, CI 0.66 to 0.82, p<.001); Black Caribbean people were less likely to receive a minimum of 16-sessions of CBT (OR 0.83, CI 0.71 to 0.98, p=.03); Black African and Black Caribbean people were significantly less likely to receive CBT whilst inpatients (respectively OR 0.76, CI 0.65 to 0.89, p=.001; OR 0.83, CI 0.73 to 0.94, p=.003).Conclusions: This study highlights disparity in receipt of CBT from a large provider of secondary care in London for Black African and Caribbean people and that the context of therapy (inpatient versus community settings) has a relationship with disparity in access to treatment.
UR - https://www.google.com/search?q=%22Ethnicity+and+impact+on+the+receipt+of+Cognitive+Behavioural+Therapy+in+people+with+psychosis+or+bipolar+disorder%22&rlz=1C1GCEA_enGB893GB893&oq=%22Ethnicity+and+impact+on+the+receipt+of+Cognitive+Behavioural+Therapy+in+people+with+psychosis+or+bipolar+disorder%22&aqs=chrome.0.69i59.3811j0j4&sourceid=chrome&ie=UTF-8
U2 - 10.1136/bmjopen-2019-034913
DO - 10.1136/bmjopen-2019-034913
M3 - Journal article
VL - 10
JO - BMJ Open
JF - BMJ Open
SN - 2044-6055
IS - 12
M1 - e034913
ER -