Discrimination of minority groups is likely to be associated with an increased risk of psychosis, according to a systematic review by University of Manchester and Lancaster psychologists.
The review suggests that people perceiving discrimination on the basis of race, age, religion, sexuality or gender orientation are more likely to experience hearing voices, paranoia as well as common problems such as anxiety and low mood.
The team examined the evidence from 24 studies published in scientific journals, which overall showed that discrimination is linked to the presence and severity of psychotic experiences in both patients and non-patients who were otherwise well.
They also found evidence showing that the more discrimination people experienced, the greater the risk of having psychotic experiences became.
Though they showed an association between discrimination and psychosis, the team do not rule out the possibility that there may also be some causal factors.
The study is published in the journal Social Psychiatry and Psychiatric Epidemiology
Lead author Dr Filippo Varese from The University of Manchester said: “Clearly, social rejection, the perception of being singled out and victimisation can have a negative impact on anyone.
“But it can also increase the likelihood of experiences that are commonly regarded as symptoms of severe mental health difficulties, such as paranoia and hearing voices”
According to Dr Varese, perceived discrimination – from the point of view of the individual –allowed the team to understand the complex circumstances that lead to mental health problems.
He said: “Once we tackle discrimination more fundamentally – then wider benefits will follow – though we clearly have a long way to go as a society before that can be achieved.
“But that should not preclude clinicians from exploring the impact of discrimination on their therapeutic practice. There is a great need for doctors and psychologists to understand the role discrimination has played on individuals’ lives.
“Screenings for various form of psychological trauma, such as various types of childhood maltreatment and neglect, by GPs and other health practitioners is routine in parts of the North America and other countries
“It’s a way of signposting specialist support and ensuring that we can better prevent and treat physical and mental health problems that are brought about by these adverse experiences.
“We think the UK should be no different, and there are important national initiatives moving in that direction.”
He added: “Psychosis is often thought to be a genetic condition but this review and other important work published in recent years shows that the environment we live in is also crucial.
“People can understandably become guarded and suspicious of others when they are constantly exposed to threatening social environments where they are likely to be discriminated or victimised. These feelings over time lead to more distressing ‘paranoid beliefs’, for example.
“And biologically, we know that discrimination – and experiences of severe or chronic stress in general – impacts on the human brain.
“For example, these experiences can result in the areas of the brain involved in the management of stress to be become over sensitised and that can make us more vulnerable to a range of mental health problems, including psychosis.”
Source: University of Manchester