Journal article
Influence of Patient Race and Ethnicity on Clinical Assessment in Patients With Affective Disorders
Archives of general psychiatry, Vol.69(6), pp.593-600
06/01/2012
DOI: 10.1001/archgenpsychiatry.2011.2040
PMID: 22309972
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 (chi(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.
Details
- Title: Subtitle
- Influence of Patient Race and Ethnicity on Clinical Assessment in Patients With Affective Disorders
- Creators
- Michael A. Gara - Univ Med & Dent New Jersey, Robert Wood Johnson Med Sch, Univ Behav HealthCare, Piscataway, NJ 08855 USAWilliam A. Vega - Univ So Calif, Los Angeles, CA USAStephan Arndt - Univ Iowa, Iowa City, IA USAMichael Escamilla - Texas Tech Univ, Hlth Sci Ctr, Paul L Foster Sch Med, El Paso, TX USADavid E. Fleck - University of CincinnatiWilliam B. Lawson - Howard UniversityIra Lesser - Harbor UCLA Med Ctr, Los Angeles, CA USAHarold W. Neighbors - University of MichiganDaniel R. Wilson - University of FloridaLesley M. Arnold - University of CincinnatiStephen M. Strakowski - University of Cincinnati
- Resource Type
- Journal article
- Publication Details
- Archives of general psychiatry, Vol.69(6), pp.593-600
- DOI
- 10.1001/archgenpsychiatry.2011.2040
- PMID
- 22309972
- ISSN
- 0003-990X
- eISSN
- 1538-3636
- Publisher
- Amer Medical Assoc
- Number of pages
- 8
- Grant note
- AstraZeneca Dianippon Pfizer Janssen Pharmaceuticals; Johnson & Johnson; Johnson & Johnson USA; Janssen Biotech Inc MH068801; MH068795; MH068819; MH068797; MH068804; MH068807 / National Institute of Mental Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Mental Health (NIMH) Martek Biosciences Lilly Roche Wyeth; Pfizer Nutrition 21 Johnson Johnson; Johnson & Johnson; Johnson & Johnson USA
- Language
- English
- Date published
- 06/01/2012
- Academic Unit
- Psychiatry; Biostatistics; Nursing; Injury Prevention Research Center
- Record Identifier
- 9985132075202771
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