The influence of racial factors on psychiatric diagnosis: A review and suggestions for research

@article{Neighbors2004TheIO,
  title={The influence of racial factors on psychiatric diagnosis: A review and suggestions for research},
  author={Harold W. Neighbors and James S. Jackson and Linn Campbell and Donald Williams},
  journal={Community Mental Health Journal},
  year={2004},
  volume={25},
  pages={301-311}
}
Research on race and diagnosis initially focused on black-white differences in depression and schizophrenia. Statistics showing a higher treated prevalence of schizophrenia and a lower prevalence of depression for blacks seemed to support the claim that blacks did not suffer from depression. Others argued, however, that clinicians were misdiagnosing depression in blacks. This article reviews empirical studies of racial differences in individual symptoms and summarizes the evidence on… 

Racial differences in DSM diagnosis using a semi-structured instrument: the importance of clinical judgment in the diagnosis of African Americans.

TLDR
Results indicate some significant race differences in diagnosis remain even when a semi-structured instrument and DSM criteria are used, and whites, were more likely than African Americans to receive a diagnosis of bipolar disorder and less likely to be diagnosed with schizophrenia.

Does racial bias influence psychiatric diagnoses assigned at first hospitalization?

  • N. SohlerE. Bromet
  • Medicine, Psychology
    Social Psychiatry and Psychiatric Epidemiology
  • 2003
TLDR
While there was evidence that hospital clinicians had more difficulty diagnosing black patients, the low concordance between hospital and research diagnoses for both black and white patients demonstrates the need to better understand the clinical diagnostic process for all patients with psychotic disorders at their first hospitalization.

Influence of Race and Symptom Expression on Clinicians’ Depressive Disorder Identification in African American Men

  • J. Payne
  • Psychology
    Journal of the Society for Social Work and Research
  • 2012
Studies show that depressed African Americans are more likely to be misdiagnosed than are depressed Caucasians. A randomized sample of 239 California licensed clinical social workers and licensed

Assessing Psychosis in African American Clients

TLDR
Archival data on major clinical rating scales used to assess symptoms of schizophrenia in large samples of African American and Caucasian clients suggested that the Scale for the Assessment of Positive Symptoms and Scale forThe Assessment of Negative Symptoms have good reliability and validity in both ethnic groups, supporting their use in African Americans with schizophrenia and other psychotic disorders.

Clinical depression in African American women: diagnoses, treatment, and research.

TLDR
This special series of papers will highlight the existing problem of depression in African American women with a focus on diagnostic, treatment, and research issues.

Ethnicity Effects on Clinical Diagnoses in Patients with Psychosis: Comparisons to Best Estimate Research Diagnoses

TLDR
Clinical and research diagnoses showed significantly greater agreement in Hispanic than in African American patients (Caucasian patients were intermediate), and diagnostic agreement for paranoid schizophrenia was likewise the best in Hispanic patients, while paranoid schizophrenia tended to be over-diagnosed in AfricanAmerican patients.

Ethnicity and diagnostic patterns in veterans with psychoses

TLDR
This study confirms continued ethnic disparities in diagnostic patterns, and highlights the importance of recognizing ethnic differences in symptom presentation while emphasizing greater cultural competency.

Racial Implicit Associations in Psychiatric Diagnosis, Treatment, and Compliance Expectations

TLDR
Racial implicit associations were measurable among medical students and psychiatric physicians and self-reported White race and higher level of training were the strongest predictors of associating faces of Black individuals with psychotic disorders, even after adjusting for participant's age.

Conceptualizing the Relationship Between Racism as a Psychosocial Stressor and the Disproportionate Rates of Schizophrenia Among Black Americans Using the Diathesis-Stress Model

TLDR
This paper draws upon the diathesis-stress model to elucidate a relationship between significant levels of stress endured by Black Americans due to racism and their elevated rates of schizophrenia.
...

References

SHOWING 1-10 OF 68 REFERENCES

Gender, race, and DSM-III: a study of the objectivity of psychiatric diagnostic behavior.

TLDR
It is premature to close the question of the influence of sex and race on diagnostic assessments, but results indicate that sex andRace of client and psychiatrist influence diagnosis even when clear-cut diagnostic criteria are presented.

Problems in diagnosing schizophrenia and affective disorders among blacks.

TLDR
Clinicians and researchers must pay more attention to the effects of cultural differences on diagnosis, and baseline behaviors and symptomatology for blacks must be established.

Depression and schizophrenia in hospitalized black and white mental patients.

TLDR
A comparison of the patterns of psychopathology exhibited by blacks and whites confirms the absence of any gross differences in abnormal behavior between them.

Psychiatric history and symptom difference in black and white depressed inpatients.

TLDR
Both black and white depressed patients were remarkably similar on presenting symptoms, especially the core symptoms of depression, when the groups were equated or controlled for age and social class differences, but some differences did emerge on a number of hostility variables.

Misdiagnosis of black patients with manic depressive illness: second in a series.

  • C. BellH. Mehta
  • Psychology, Medicine
    Journal of the National Medical Association
  • 1981
TLDR
In a survey of the outpatient psychiatric clinic at Jackson Park Hospital, it was found that black patients in this clinic have similar prevalence rates of manic depressive illness when compared to surveys of white patient populations.

Epidemiology of Schizophrenia: Some Diagnostic and Sociocultural Considerations.

TLDR
This report is concerned, more specifically, with sociocultural and diagnostic implications in relation to the etiology of schizophrenia.

Overview: white norms and psychiatric diagnosis of black patients.

  • V. Adebimpe
  • Psychology, Medicine
    The American journal of psychiatry
  • 1981
TLDR
It is concluded that greater awareness among clinicians and research into more appropriate diagnostic criteria for black patients are desirable.

Psychiatric symptoms in white and black inpatients. II. Follow-up study.

A comparison of clinical and diagnostic interview schedule diagnoses. Physician reexamination of lay-interviewed cases in the general population.

TLDR
Lay results showed a bias for only two diagnoses: major depression was significantly underdiagnosed and obsessive illness was overdiagnosed, and the implications for psychiatric epidemiologic research are discussed.

The clinical picture of mania in manic-depressive black patients.

TLDR
The authors found the clinical symptoms of manic-depressive illness in black patients to be essentially what one would expect as determined by criteria in the Diagnostic and Statistical Manual (DSM III), however, there were cultural and socioeconomic determinants of behavior that affected the clinical manifestations.
...