Differences in Psychopathology between Black and White Schizophrenics

Chu, Chung-Chou; Sallach, Harriet S.; Zakeria, Saleha A.; Klein, Helen E.

doi:10.1177/002076408503100402

Cited by 14 publications

(14 citation statements)

References 9 publications

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“…Previous investigators have shown that besides misdiagnosis of the AfricanAmerican patient, African-Americans are more likely to receive antipsychotic medications when they are not needed (Adebimpe, 1981;Chu et al, 1985;Flint, 1991). Additionally, African-Americans are more likely than Caucasians to receive asneeded (PRN) medication and higher doses of antipsychotics (Flaherty and Meagher, 1980;Strickland et al, 1991;Adebimpe, 1981;Chu et al, 1985;Flint, 1991). However, in this study, no signi®cant dierences were found in the type, dose of medication or side-eect pro®le between African-Americans and Caucasians.…”

Section: Discussionmentioning

confidence: 99%

“…It is now well established that African-Americans are more likely than Caucasians to be diagnosed with schizophrenia (Schoenberg et al, 1985;Jones and Gray, 1986;Fabrega et al, 1988;Adebimpe, 1981;Lawson et al, 1994;Strakowski et al, 1995) and consequently are more likely to be treated with antipsychotic medications (Chu et al, 1985) (see Table 2). A higher prevalence of hallucinations and delusions among African-American patients with schizophrenia (Heyman et al, 1991;Schoenberg et al, 1985;Jones and Gray, 1986;Fabrega et al, 1988;Adebimpe, 1981;Lawson et al, 1994;Strakowski et al, 1995;Chu et al, 1985) and mood disorder (Jones and Gray, 1986) has been reported. In a review of the literature, Flint (1991) reported a prevalence of delusional symptoms ranging from 15% to 56% in patients with Alzheimer's disease and from 27% to 60% in patients with vascular dementia.…”

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confidence: 99%

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Cross-cultural differences in demented geropsychiatric inpatients with behavioral disturbances

Akpaffiong

Kunik

Hale

et al. 1999

Int. J. Geriat. Psychiatry

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Objective Cross‐cultural differences in treatment and diagnosis exist in several psychiatric disorders. This study examines phenomenological and treatment differences between Caucasian and African‐American patients presenting to a geropsychiatric unit for treatment of behavioral disturbances associated with dementia. Methods One hundred and forty‐one Caucasian patients were compared to 56 African‐American patients consecutively admitted to a VA geropsychiatric inpatient unit. At admission, differences in behavior disturbances between the two groups were examined using the Mini‐Mental State Examination (MMSE), Cohen‐Mansfield Agitation Inventory (CMAI), Hamilton Rating Scale for Depression (HAM‐D), Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale for Schizophrenia (PANSS). Differences in treatment were assessed by comparing medication types and doses between the two groups. Results and Conclusion Results showed that Caucasian and African‐American patients with dementia and behavioral disturbances presented and responded similarly to like treatment on an inpatient geropsychiatric unit. The similarity between the two groups may be explained by the multi‐ethnic make‐up of the interdisciplinary treatment team and by the use of standardized scales to measure symptomatology and response. Copyright © 1999 John Wiley & Sons, Ltd.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Cross-cultural differences in demented geropsychiatric inpatients with behavioral disturbances

Akpaffiong

Kunik

Hale

et al. 1999

Int. J. Geriat. Psychiatry

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“…The expression of psychosis may vary with cultural background (Adebimpe et al, 1981, Arnold et al, 2004, 8 Barrio et al, 2003, Bauer et al, 2011, Chang et al, 2011, Chu et al, 1985, Littlewood and Lipsedge, 1981, 9 Maslowski et al, 1998, Radhakrishnan et al, 1983, Suhail and Cochrane, 2002, Thomas et al, 2007, Weisman 10 et al, 2000, Yamada et al, 2006. There may be cultural differences in the content of psychotic symptoms 11 (Maslowski et al, 1998, Viswanath and Chaturvedi, 2012, Weisman et al, 2000, Yamada et al, 2006 and/or 12 in the language with which these symptoms are expressed (Kleinman, 1987).…”

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confidence: 99%

Investigating ethnic variations in reporting of psychotic symptoms: a multiple-group confirmatory factor analysis of the Psychosis Screening Questionnaire

2018

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BackgroundEpidemiological evidence suggests risk for psychosis varies with ethnicity in Western countries. However, there is little evidence to date on the cross-cultural validity of screening instruments used for such comparisons.MethodsCombining two existing UK population-based cohorts, we examined risk for reporting psychotic symptoms across White British (n = 3467), White Irish (n = 851), Caribbean (n = 1899), Indian (n = 2590), Pakistani (n = 1956) and Bangladeshi groups (n = 1248). We assessed the psychometric properties of the Psychosis Screening Questionnaire (PSQ) with a multiple-group confirmatory factor analysis, assessing the equivalence of factor loadings, response thresholds and residual variances in an analysis of measurement non-invariance.ResultsCompared with prevalence among British Whites (5.4%), the prevalence of self-reported psychotic symptoms was greater in the Caribbean group (12.7%, adjusted OR = 2.38 [95% CI 1.84–3.07]). Prevalence was also increased among Pakistani individuals (8.3%, adjusted OR = 1.36 [1.01–1.84]) although this difference was driven by a greater likelihood of reporting paranoid symptoms. PSQ items for thought interference, strange experience and hallucination were measured in equivalent ways across ethnic groups. However, our measurement models suggested that paranoid symptoms were measured less reliably among ethnic minorities than among British Whites and appeared to exaggerate latent differences between Pakistani and White British groups when measurement non-invariance was not accounted for.ConclusionsNotwithstanding evidence for measurement non-invariance, the greater risk for reporting psychotic symptoms among Caribbean individuals is unlikely to be an artefact of measurement. Greater residual variance in the recording of paranoid symptoms among ethnic minority respondents warrants caution in using this item to investigate ethnic variation in psychosis risk.

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“…White patients with schizophrenia have been found to display more grandiosity in their delusional content and more severe excitement symptom scores than their Black counterparts, as measured by the Positive and Negative Symptom Scale (PANSS) (Barrio et al, 2003). Chu and colleagues (1985) reported that Black patients with schizophrenia showed more anger, disorientation, asocial behavior, and hallucinations, whereas White patients exhibited more symptoms of irrelevant speech. White patients have been reported to be more symptomatically impaired and show more emotional disturbance, behavioral problems, negative symptoms, and flat affect than their Black counterparts (Barrio et al, 2003; Fabrega, Mezzich, & Ulrich, 1988).…”

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confidence: 99%

Longitudinal treatment outcome of African American and Caucasian patients with first episode psychosis

Eack

Montrose

et al. 2011

Asian Journal of Psychiatry

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Our analyses examined the outcome differences between Black and White first-episode psychotic patients over the course of one year, and explored the interactive effects of gender, diagnosis, and race on treatment outcome. A consecutive series of patients who were experiencing a first episode of psychosis (n = 199) were recruited into our study from the inpatient and outpatient services at a psychiatric clinic. Global functioning, positive, negative, affective, and depression symptoms and treatment adherence were assessed at baseline prior to treatment and during follow-up up to one year. Linear mixed-effects models with random intercept parameters were employed to compute individual trajectories in symptom and functioning characteristics over the one-year course of the study. Black patients (n = 62) were found to experience significantly less improvement in symptoms, bizarre behavior, avolition, anhedonia, and functional performance, and affective symptoms than their White counterparts (n = 137). In addition, Black female patients experienced less improvement in affective flattening. Black patients also had significantly lower adherence scores than their White counterparts both at six month and one-year follow-up. While both groups of patients have experienced significant improvement during the one-year treatment, that of the Black patients is less optimal.

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Differences in Psychopathology between Black and White Schizophrenics

Cited by 14 publications

References 9 publications

Cross-cultural differences in demented geropsychiatric inpatients with behavioral disturbances

Cross-cultural differences in demented geropsychiatric inpatients with behavioral disturbances

Investigating ethnic variations in reporting of psychotic symptoms: a multiple-group confirmatory factor analysis of the Psychosis Screening Questionnaire

Longitudinal treatment outcome of African American and Caucasian patients with first episode psychosis

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