Racial differences in the diagnosis of psychosis

被引:129
作者
Strakowski, SM
Flaum, M
Amador, X
Bracha, HS
Pandurangi, AK
Robinson, D
Tohen, M
机构
[1] UNIV IOWA, DEPT PSYCHIAT, IOWA CITY, IA 52242 USA
[2] COLUMBIA UNIV, COLL PHYS & SURG, DEPT PSYCHIAT, NEW YORK, NY USA
[3] UNIV HAWAII, JOHN A BURNS SCH MED, DEPT PSYCHIAT, HONOLULU, HI 96822 USA
[4] VIRGINIA COMMONWEALTH UNIV, MED COLL VIRGINIA, DIV INPATIENT PSYCHIAT, RICHMOND, VA 23298 USA
[5] LONG ISL JEWISH MED CTR, HILLSIDE HOSP, NEW YORK, NY USA
[6] MCLEAN HOSP, BIPOLAR & PSYCHOT DISORDERS PROGRAM, BELMONT, MA 02178 USA
关键词
schizophrenia; psychosis; affective disorders; race; first-rank symptoms;
D O I
10.1016/0920-9964(96)00041-2
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
In clinical populations, it has been reported that African-American patients are more likely to receive a diagnosis of schizophrenia than similar Caucasian patients. Factors contributing to this racial discrepancy are poorly defined. The authors examined the hypothesis that racial differences in severity of first-rank symptoms of schizophrenia contribute to this diagnostic difference. Patients were recruited as part of the DSM-IV Field Trial for Schizophrenia and Other Psychotic Disorders, and evaluated using a structured rating instrument. Symptom and diagnostic comparisons were performed between black and white patients. Black patients were significantly more likely than white patients to be diagnosed with schizophrenia and less likely with psychotic depression. Racial differences in symptom profiles were observed with black patients demonstrating more severe psychotic symptoms, in general, and first-rank symptoms, specifically. There were no racial differences in rates of affective syndromes or severity of affective symptoms. Racial disparity in diagnosis of psychotic patients may be in part secondary to more severe first-rank symptoms in black patients, causing clinicians to stray from DSM-III-R criteria.
引用
收藏
页码:117 / 124
页数:8
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