June 29, 2005

Overdiagnosis among Minorities

A study of one of the nation's largest databases of psychiatric cases reveals that cultural factors may be contributing to a much higher rate of psychiatric diagnoses among ethnic minorities.

For example, scientist John Zeber found that blacks in the United States were more than four times as likely to be diagnosed with schizophrenia, and Hispanics were more than three times as likely, despite the fact that schizophrenia appears to affect all ethnic groups at the same rate. Zeber reports that his findings could not be explained by differences in wealth, drug addiction, or tendency to seek treatment at different times during an illness course. "The only factor that was truly important was race," Zeber said.

The matter is not as simply as racism; cultural factors within ethnic communities may contribute to misdiagnoses. For example, explains Michael Smith, a psychiatrist at UCLA, "Some doctors think if you don't make eye contact, you can be diagnosed [with schizophrenia]. In some communities, eye contact is a sign of disrespect."

Darrel Regier, director of the division of research at the American Psychiatric Association, agrees. "I believe bias exists, and there is a risk a psychiatrist with a different cultural experience than a patient can misinterpret the expression of a psychiatric symptom...If you have a very religious group of patients and a very secular psychiatrist who thinks beliefs in spirits or hearing the voice of God is not normal, you are going to have misses."

Misdiagnosis can be dangerous in many ways - it may condemn someone to incorrect treatment for a condition they don't have, or it can cause someone to lose valuable years of their life due to incorrect, unhelpful treatment. You can help avoid misdiagnosis by being familiar with the signs and symptoms of schizophrenia (http://www.schizophrenia.com/diag.html) and bipolar disorder (http://www.moodswing.org/diagnosis.html#common), as well as ways in which these diseases are misdiagnosed most frequently. (http://www.schizophrenia.com/diag.html#misdiagnosis)

Source: "Racial Disparities Found in Pinpointing Mental Illness." Washington Post (http://www.washingtonpost.com), June 28 2005.


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