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Published Online: 11 January 2024

Racial Disparities Among Clinical High-Risk and First-Episode Psychosis Multisite Research Participants: A Systematic Review

Timothy I. Michaels, Ph.D. [email protected], Laura Simon-Pearson, M.A., John M. Kane, M.D., and Barbara Cornblatt, Ph.D., M.B.A.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 75, Number 5
https://doi.org/10.1176/appi.ps.20230120
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Abstract

Objective:

The NIH has mandated equal representation of Black, Indigenous, and people of color (BIPOC) individuals in clinical research, but it is unclear whether such inclusion has been achieved in multisite research studies of individuals at clinical high risk for psychosis or with first-episode psychosis (FEP). An assessment of inclusion rates is important for understanding the social determinants of psychosis and psychosis risk that specifically affect BIPOC individuals.

Methods:

The authors conducted a systematic review of the literature published between 1993 and 2022 of multisite research studies of clinical high risk for psychosis and FEP in North America to determine ethnoracial inclusion rates. Using an online systematic review tool, the authors checked 2,278 studies for eligibility. Twelve studies met all inclusion criteria. Data were extracted, and demographic characteristics, socioeconomic status, study design, and recruitment strategies used by each study were analyzed.

Results:

Most (62%) of the participants in studies of clinical high risk for psychosis were White. Compared with national data, the demographic characteristics of individuals with clinical high risk were representative across most ethnoracial groups. Black participants (43%) made up the largest ethnoracial group in FEP studies and were overrepresented compared with their representation in the U.S. population. FEP studies were more likely to recruit participants from community mental health centers than were the studies of clinical high risk.

Conclusions:

Although these results suggest high representation of BIPOC individuals in psychosis research, opportunities exist for an improved focus on ethnoracial representation. The authors offer recommendations for practices that may increase ethnoracial diversity in future psychosis study samples.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Volume 75 • Number 5 • May 01, 2024
Pages: 451 - 460
PubMed: 38204372

History

Received: 9 March 2023
Revision received: 8 August 2023
Revision received: 2 October 2023
Accepted: 16 October 2023
Published online: 11 January 2024
Published in print: May 01, 2024

Keywords

  1. Clinical high risk for psychosis
  2. First-episode psychosis
  3. Racial-ethnic inclusion
  4. Social determinants
  5. Schizophrenia
  6. Service delivery

Authors

Details

Timothy I. Michaels, Ph.D. [email protected]
Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (Michaels, Simon-Pearson, Cornblatt); Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York (Michaels, Kane); Department of Psychology, Hofstra University, Hempstead, New York (Simon-Pearson); Institute of Behavioral Science (Kane) and Center for Psychiatric Neuroscience (Cornblatt), Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York.
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Laura Simon-Pearson, M.A.
Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (Michaels, Simon-Pearson, Cornblatt); Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York (Michaels, Kane); Department of Psychology, Hofstra University, Hempstead, New York (Simon-Pearson); Institute of Behavioral Science (Kane) and Center for Psychiatric Neuroscience (Cornblatt), Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York.
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John M. Kane, M.D.
Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (Michaels, Simon-Pearson, Cornblatt); Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York (Michaels, Kane); Department of Psychology, Hofstra University, Hempstead, New York (Simon-Pearson); Institute of Behavioral Science (Kane) and Center for Psychiatric Neuroscience (Cornblatt), Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York.
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Barbara Cornblatt, Ph.D., M.B.A.
Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (Michaels, Simon-Pearson, Cornblatt); Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York (Michaels, Kane); Department of Psychology, Hofstra University, Hempstead, New York (Simon-Pearson); Institute of Behavioral Science (Kane) and Center for Psychiatric Neuroscience (Cornblatt), Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York.
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Notes

Send correspondence to Dr. Michaels ([email protected]).

Competing Interests

Dr. Kane reports being a consultant to or receiving honoraria from Alkermes, Allergan, Boehringer-Ingelheim, Cerevel, Sumitomo, HealthRhythms, HLS, Indivior, Intracellular Therapies, Janssen Pharmaceutical, Johnson & Johnson, LB Pharmaceuticals, Lundbeck, Merck, Minerva, Neurocrine, Newron, Novartis, NW PharmaTech, Otsuka, Roche, Saladax, Sunovion, and Teva; serving on advisory boards for Boehringer-Ingelheim, Cerevel, Click Therapeutics, Lundbeck, Merck, Newron, Novartis, Otsuka, Sumitomo, and Teva; receiving grant support from Janssen, Lundbeck, Otsuka, and Sunovion; being a shareholder in LB Pharmaceuticals, Inc., MedinCell, North Shore Therapeutics, Sage, and Vanguard Research Group; and receiving royalties from UpToDate. The other authors report no financial relationships with commercial interests.

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