 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Harold Neighbors, PhD, Center for Research on Ethnicity, Culture and Health, University of Michigan, School of Public Health, 109 S. Observatory, Ann Arbor, MI 48109, 734-936-9868, woodyn@umich.edu
Studies showing that Bipolar Disorder is diagnosed less among African Americans than Whites raise questions about the clinical judgment across race. This study analyzed race differences in psychiatric diagnosis across three diagnostic outcomes in a hospital sample of 665 patients: 1) the Primary Diagnosis, made by clinicians upon completion of a semi-structured instrument; 2) the clinician's response to an item asking whether patients met criteria for Manic Episode; and 3) the diagnosis made on the basis of a computer algorithm (based on DSM-III-R decision rules) using symptoms only. Logistic regression analyses revealed that Whites were three times more likely than African Americans to receive a Primary Diagnosis of Bipolar Disorder and two times more likely to meet criteria for Manic Episode. No race differences were found using the algorithm. Clinician race had no effect on these results. Clinicians frequently assigned a diagnosis of Bipolar Disorder to patients even though they reported that criteria for Manic Episode had not been met. This happened more often for White than Black patients. African Americans were also more likely than Whites to receive a diagnosis of Schizophrenia even when they had met criteria for Manic Episode. There was higher agreement (kappa) between receiving a diagnosis of Bipolar and meeting criteria for Manic Episode among Whites than African Americans.
At the conclusion of the session, participants will be able to describe statistics on race and diagnosis, identify different procedures for making diagnoses, and articulate the role of cultural factors in clinical judgment.
Learning Objectives:
Keywords: African American, Depression
Presenting author's disclosure statement:
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.