Purpose Higher rates of psychosis have been reported in minority groups. Since individuals belonging to such groups are vulnerable to the experiences of discrimination, and in line with models proposing that social and life adversity may play a causal role in development and maintenance of psychotic experiences, it has been proposed that perceived discrimination may represent an important determinant of psychotic experiences. This paper reviews the literature examining the relationship between perceived discrimination and psychosis, examining whether discrimination is associated with an increased risk of psychosis, the severity of psychotic symptoms and whether there is an association with specific psychotic symptoms. Methods A systematic database search of PsycINFO, Embase and PubMed was conducted to identify quantitative crosssectional and prospective studies that examined the association between discrimination and psychosis. Results Twenty-four studies met the inclusion criteria, four of which used prospective designs and twenty used cross-sectional designs. The main findings indicated that discrimination may be associated with an increased risk of psychosis (too few studies to determine whether discrimination is associated with severity). Some studies found associations between discrimination and positive psychotic experiences and/or specific psychotic experiences such as paranoia. A small number of studies found that greater exposure to discrimination was associated with a greater likelihood of reporting psychotic experiences, tentatively indicating a dose-response relationship. Conclusions This review indicates that discrimination plays an important role in the experience of psychosis; however, future research is required to clarify the nature of this relationship. Avenues for further research and clinical implications are proposed.

The relationship between childhood adversities and dissociation in severe mental illness: a meta-analytic review Rafiq S, Campodonico C, Varese F. The relationship between childhood adversities and dissociation in severe mental illness: a metaanalytic review Objective: Several studies have observed that dissociative experiences are frequently reported by individuals with severe mental illness (SMI), especially amongst patients that report a history of adverse/traumatic life experiences. This review examined the magnitude and consistency of the relationship between childhood adversity (sexual abuse, physical abuse, emotional abuse, neglect, bullying, natural disasters and mass violence) and dissociation across three SMI diagnostic groups: schizophrenia, bipolar disorder and personality disorders. Method: A database search (EMBASE, PubMed and PsycINFO) identified 30 eligible empirical studies, comprising of 2199 clinical participants. Effect sizes representing the relationship between exposure to childhood adversity and dissociation were examined and integrated using a random-effects meta-analysis. Results: The results indicated that exposure to childhood trauma was associated with heightened dissociation across SMIs. Positive significant associations were also found between specific childhood adversities and dissociation, with aggregated effect sizes in the small-to-moderate range. Conclusion: These findings support calls for the routine assessment of traumatic experiences in clients with SMIs presenting with dissociative symptoms and the provision of adequate therapeutic support (e.g. trauma-focused therapies) to manage and resolve these difficulties. Summations• Small-to-moderate relationship between childhood trauma and dissociation across SMIs. • Medium relationship between childhood trauma and dissociation in schizophrenia-spectrum disorders.• All forms of childhood traumatic experiences (e.g. sexual abuse, physical abuse, emotional abuse, emotional neglect, physical neglect) were found to be associated with dissociation in people diagnosed with SMI. Considerations• Only three studies were found eligible for the bipolar sample (i.e. low power); therefore, no strong conclusions can be drawn regarding the association between childhood trauma and dissociative experiences in bipolar disorder.• The relationship between childhood trauma and dissociation in SMI requires further corroboration using longitudinal designs to determine causality and directionality.• No firm conclusions can be drawn regarding which specific traumatic experience is most strongly associated with dissociation, as the studies included in the analysis were not independent (i.e. effects for sexual abuse and physical abuse estimated from the same sample of participants). 509Acta Psychiatr Scand 2018: 138: 509-525

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