Inconsistencies in Diagnosis and Symptoms Among Bilingual and English-Speaking Latinos and Euro-Americans

Objective: Little information is available about accuracy of diagnoses in clinical care for affective and other major mental disorders experienced by Latino patients. This study addressed two central research questions: Do Latinos have disproportionate rates of clinical diagnoses of major depression based on structured diagnostic interviews? Are diagnostic patterns consistent with patient profiles and medical record information? Methods: A total of 259 bilingual Latino, monolingual English-speaking Latino, and Euro-American patients aged 18 to 45 years with a history of severe depression or psychotic symptoms were compared across three clinical sites by using structured interviews. Results: Compared with Euro-Americans, bilingual Latinos had significantly higher rates of major depression and significantly lower levels of mania. No significant differences were found between monolingual English-speaking Latinos and Euro-Americans. Conclusions: Results suggest that the diagnostic process is affected by an apparent association with cultural-linguistic influences, notably speaking English as a second language. (Psychiatric Services 60: 1379-1382, 2009)