The physical health and premature mortality of Indigenous Māori following first-episode psychosis diagnosis: A 15-year follow-up study.

First-episode psychosis Māori New Zealand cardiometabolic health cohort study health equity indigenous health physical health premature mortality

Journal

The Australian and New Zealand journal of psychiatry
ISSN: 1440-1614
Titre abrégé: Aust N Z J Psychiatry
Pays: England
ID NLM: 0111052

Informations de publication

Date de publication:
21 Aug 2024
Historique:
medline: 22 8 2024
pubmed: 22 8 2024
entrez: 22 8 2024
Statut: aheadofprint

Résumé

People experiencing psychosis are at greater risk of physical health conditions and premature mortality. It is likely that Indigenous Māori youth, who experience additional systemic inequities caused by settler-colonisation, face even greater physical health and mortality risks following a diagnosis of first-episode psychosis. Compare Māori and non-Māori for risk of hospitalisation and mortality for up to 15 years following first-episode psychosis diagnosis. A cohort ( In the 15 years following first-episode psychosis diagnosis, Māori had higher adjusted risk of all-cause mortality (hazard ratio = 1.21, 95% confidence interval = [1.01, 1.45]), hospitalisation with diabetes (hazard ratio = 1.44, 95% confidence interval = [1.15, 1.79]), injury/poisoning (hazard ratio = 1.11, 95% confidence interval = [1.05, 1.16]), general physical health conditions (hazard ratio = 1.07, 95% confidence interval = [1.02, 1.13]) and also appeared to be at greater risk of cardiovascular hospitalisations (hazard ratio = 1.34, 95% confidence interval = [0.97, 1.86]). Kaplan-Meier plots show hospitalisation and mortality inequities emerging approximately 4-7 years following first-episode psychosis diagnosis. Māori are at greater risk for hospitalisation and premature mortality outcomes following first-episode psychosis. Early screening and intervention, facilitated by culturally safe health service delivery, is needed to target these inequities early.

Sections du résumé

BACKGROUND UNASSIGNED
People experiencing psychosis are at greater risk of physical health conditions and premature mortality. It is likely that Indigenous Māori youth, who experience additional systemic inequities caused by settler-colonisation, face even greater physical health and mortality risks following a diagnosis of first-episode psychosis.
OBJECTIVE UNASSIGNED
Compare Māori and non-Māori for risk of hospitalisation and mortality for up to 15 years following first-episode psychosis diagnosis.
METHODS UNASSIGNED
A cohort (
RESULTS UNASSIGNED
In the 15 years following first-episode psychosis diagnosis, Māori had higher adjusted risk of all-cause mortality (hazard ratio = 1.21, 95% confidence interval = [1.01, 1.45]), hospitalisation with diabetes (hazard ratio = 1.44, 95% confidence interval = [1.15, 1.79]), injury/poisoning (hazard ratio = 1.11, 95% confidence interval = [1.05, 1.16]), general physical health conditions (hazard ratio = 1.07, 95% confidence interval = [1.02, 1.13]) and also appeared to be at greater risk of cardiovascular hospitalisations (hazard ratio = 1.34, 95% confidence interval = [0.97, 1.86]). Kaplan-Meier plots show hospitalisation and mortality inequities emerging approximately 4-7 years following first-episode psychosis diagnosis.
CONCLUSIONS UNASSIGNED
Māori are at greater risk for hospitalisation and premature mortality outcomes following first-episode psychosis. Early screening and intervention, facilitated by culturally safe health service delivery, is needed to target these inequities early.

Identifiants

pubmed: 39169471
doi: 10.1177/00048674241270981
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

48674241270981

Déclaration de conflit d'intérêts

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Auteurs

Nathan J Monk (NJ)

Department of Māori/Indigenous Health Innovation, University of Otago, Christchurch, New Zealand.

Ruth Cunningham (R)

Department of Public Health, University of Otago, Wellington, New Zealand.

James Stanley (J)

Department of Public Health, University of Otago, Wellington, New Zealand.

Sue Crengle (S)

Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Christchurch, New Zealand.

Julie Fitzjohn (J)

Specialist Mental Health Service, Te Whatu Ora - Waitaha Canterbury, Christchurch, New Zealand.

Melissa Kerdemelidis (M)

Population Health Gain, Service Improvement and Innovation, Te Whatu Ora - Waitaha Canterbury, Christchurch, New Zealand.

Helen Lockett (H)

Department of Public Health, University of Otago, Wellington, New Zealand.
Te Pou, Wellington, New Zealand.

Andre D McLachlan (AD)

Centre for Health and Social Practice, Waikato Institute of Technology, Hamilton, New Zealand.

Waikaremoana Waitoki (W)

Faculty of Māori and Indigenous Studies, The University of Waikato, Hamilton, New Zealand.

Cameron Lacey (C)

Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.

Classifications MeSH