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Influence of Patient Race and Ethnicity on Clinical Assessment in Patients With Affective Disorders
- Source :
- Archives of General Psychiatry. 69
- Publication Year :
- 2012
- Publisher :
- American Medical Association (AMA), 2012.
-
Abstract
- Context Rates of clinical diagnoses of schizophrenia in African American individuals appear to be elevated compared with other ethnic groups in the United States, contradicting population rates derived from epidemiologic surveys. Objective To determine whether African American individuals would continue to exhibit significantly higher rates of clinical diagnoses of schizophrenia, even after controlling for age, sex, income, site, and education, as well as the presence or absence of serious affective disorder, as determined by experts blinded to race and ethnicity. A secondary objective was to determine if a similar pattern occurred in Latino subjects. Design Ethnicity-blinded and -unblinded diagnostic assessments were obtained in 241 African American individuals (mean [SD] age, 34.3 [8.1] years; 57% women), 220 non-Latino white individuals (mean [SD] age, 32.7 [8.5] years; 53% women), and 149 Latino individuals (mean [SD] age, 33.5 [8.0] years; 58% women) at 6 US sites. Logistic regression models were used to determine whether elevated rates of schizophrenia in African American individuals would persist after controlling for various confounding variables including blinded expert consensus diagnoses of serious affective illness. Settings Six academic medical centers across the United States. Participants Six hundred ten psychiatric inpatients and outpatients. Main Outcome Measure Relative odds of unblinded clinical diagnoses of schizophrenia in African American compared with white individuals. Results A significant ethnicity/race effect (χ 2 2 = 10.4, P = .01) was obtained when schizophrenia was narrowly defined, controlling for all other predictors. The odds ratio comparing African American with non-Latino white individuals was significant (odds ratio = 2.7; 95% CI, 1.5-5.1). Similar differences between African American and white individuals occurred when schizophrenia was more broadly defined (odds ratio = 2.5; 95% CI, 1.4-4.5). African American individuals did not differ significantly from white individuals in overall severity of manic and depressive symptoms but did evidence more severe psychosis. Conclusions African American individuals exhibited significantly higher rates of clinical diagnoses of schizophrenia than non-Latino white subjects, even after controlling for covariates such as serious affective disorder.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Population
Context (language use)
Comorbidity
Logistic regression
White People
Odds
Young Adult
Arts and Humanities (miscellaneous)
Interview, Psychological
medicine
Humans
Single-Blind Method
Young adult
education
Psychiatry
Psychiatric Status Rating Scales
education.field_of_study
Mood Disorders
Racial Groups
Hispanic or Latino
Odds ratio
Middle Aged
medicine.disease
United States
Black or African American
Psychiatry and Mental health
Logistic Models
Schizophrenia
Female
Psychology
Subjects
Details
- ISSN :
- 0003990X
- Volume :
- 69
- Database :
- OpenAIRE
- Journal :
- Archives of General Psychiatry
- Accession number :
- edsair.doi.dedup.....882e9997b0e44fa52995352f23717057