November 10, 2005

Ethnicity and Schizophrenia Diagnosis

The results of a recent study show that African American and Latino children and adolescents seen in the psychiatric emergency department are more likely to be diagnosed with schizophrenia than their white counterparts are. The study was conducted at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania and led by Dr. Gail A. Edelsohn, Director of Child and Adolescent Psychiatry. The researchers reviewed psychiatric emergency room visits to their facility between 1997-1998 of patients between 13-17 years of age. Each patient's ethnicity was taken into account as well as their age, sex, ethnicity, voluntary or involuntary arrival status, the involvement of child protection services, and violent behavior (used a weapon, fought with or without an implement, inflicted property damage, or made threats). According to the study, a diagnosis of schizophrenia or psychosis was 3.3 times more likely for African Americans and 2.9 times more likely for Latinos than for their white counterparts. Ethnicity and gender did not affect whether the patients were hospitalized or discharged. However, patients with a history of violence were more likely to be hospitalized. Substance abuse, violent behavior, and the involvement of child protective services did not affect the likelihood of a schizophrenia diagnosis.

The implications of this study are still not clearly understood and the cause of the discrepancy remains a mystery. It could be merely an imbalance in diagnoses or it could be due to deeper social and economic discrepancies (a greater percentage of minorities live in poverty) that make schizophrenia more frequent in certain ethnic groups. It is also possible that there are some genetic or biological factors involved. What the researchers do know is that, with the ethnic diversity of the U.S. steadily increasing, finding the reason for the diagnostic gap is vitally important. How an individual expresses the symptoms of a disease is largely affected by their cultural background. "We know that depression can look different based on the ethnic group," Dr. Edelsohn said. "Latins and Asians present with somatic complaints; Africans present with anger." For truly effective treatment, It is important for clinicians to understand these variables and be sensitive to them. That is why Dr. Edelsohn and her associates will continue to investigate the relationship between ethnicity and diagnosis.

Source: Moyer, Paula. ER Diagnosis of Schizophrenia More Likely in African American and Latino Children and Adolescents: Presented at AACAP Doctor's Guide Publishing Limited. Oct. 31, 2005

Related Articles:
Ethnicity Affects Antipsychotic Response
Overdiagnosis Among Minorities
Social Stress Has Link to Psychotic Disorders
Urban Living Increases SZ Risk


it seems as though white patients (as they are generally more well-off) would have the means to be diagnosed before schizophrenia reached a crisis point. blacks or latinos may just get diagnosed more often in the ER because they haven't gotten a chance to be diagnosed beforehand.

Posted by: jen at November 29, 2005 09:43 PM

That is another good hypothosis! Hopefully somebody will do more research into the matter.

Posted by: Megan at December 13, 2005 08:26 PM

I have been diagnosed with psychosis I am 17 years old I am suppose to meet a professor in London soon but I am about to go into a college with other teenagers who are also learning in the building trade and I am scared incase of the voices and I get angry and hurt anyone.

Posted by: Lloyd at May 22, 2006 10:44 AM

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