The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #63234

Estina Thompson, PhD, MPH¹, Harold Neighbors, PhD², Steven J. Trierweiler, PhD³, Cheryl Munday, PhD⁴, and Stacy Cohen¹. (1) Department of Public and Community Health, University of Maryland, 2364 HHP Bldg, College Park, MD 20742-2611, 301-405-2515, estina@wam.umd.edu, (2) Center for Research on Ethnicity, Culture and Health, University of Michigan, School of Public Health, 109 S. Observatory, Ann Arbor, MI 48109, (3) Program for Research on Black Americans, Research Center for Group Dynamics, University of Michigan, Institute for Social Research, 426 Thompson Street, Ann Arbor, MI 48106-1248, (4) Department of Psychology, University of Detroit Mercy, 8200 West Outer Drive, P.O. Box 19900, Detroit, MI 48219

There is much debate in the clinical literature about what accounts for the relatively lower rate of mood disorders and higher rates of schizophrenia among African Americans compared to Whites. Race differences in diagnostic rates may reflect true differences in the population, may be the result of clinician bias, differences in the way African Americans present symptoms, or some combination of the latter two explanations. To address these issues, this study examined the relationship between patient race and the diagnoses clinicians considered after completing a semi–structured diagnostic instrument. Results indicated no racial differences in the diagnoses clinicians considered (schizophrenia, mood disorder, schizoaffective, and other). However, African Americans were significantly less likely than White patients to receive a final diagnosis of mood disorder versus another diagnosis. The results show that among patients for whom clinicians considered a mood disorder, African Americans were almost 40% less likely than non–African Americans to receive a final diagnosis of mood disorder. Multivariate analysis results indicated that although considered diagnosis was a significant predictor of receiving a mood disorder diagnosis, it did not explain the race differences in mood disorder rates. Possible causes and consequences of these findings will be discussed.

Learning Objectives:

• Summarize the general concepts of differential diagnosis.
• Define the role of semi-structured instruments in differential diagnosis.
• Discuss the effects of symptom presentation and symptom interpretation on racial differences in diagnostic rates.
• Identify three ways in which symptom interpretation bias may be operating.

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: N/A
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.