Disparities in Diagnosis of Bipolar Disorder in Individuals of African and European Descent

Abstract

Despite efforts to curtail the phenomenon, racial disparities in diagnosis of bipolar disorder persist. Racial and cultural elements may affect how patients manifest behaviors and symptoms and how these are interpreted and attributed by clinicians in the diagnostic process. As an appropriate diagnosis determines treatment options and is central to quality of care, incorrect diagnosis can potentially have a negative impact on treatment effectiveness and accuracy of prognosis.

Association between maternal serious mental illness and adverse birth outcomes

“…These differences have been observed in the general population before, and are likely due to differential presentation of symptomology, access to and participation in mental health care, and bias in diagnostic procedures for people of different race or ethnicity. 35…”

Moving upstream to address diagnostic disparities

“…While individual studies of both cardiovascular and neurologic symptoms demonstrated diagnostic disparities linked with ethnicity or insurance status, in pooled analysis, no consistent associations were identified. These findings add to the growing evidence base of diagnostic disparities across many clinical conditions such as delayed appendicitis diagnosis in Black children, overdiagnosis of schizophrenia in Black individuals, and delayed dementia diagnosis in Asian and Hispanic/Latinx individuals 4–9…”

Borderline personality disorder: Gender bias and diagnostic disparities

“…Validated by empirical data, disparities of race prevail in diagnosing acute types of psychopathologies (Becker et al, 2022) [4] . Haeri et al, 2011 [14] , indicated a higher prevalence of more severe personality disorders in individuals identifying as ethnic or racial minorities, while (Garb, 2021) [13] evidences different mental health conditions are diagnosed with racial bias. No exception, bias in BPD diagnosis can be marked within certain minority populations.…”

“…The stated results in black American women presenting with more acute and explicit symptoms such as lacking emotional and impulse control while white women with BPD are more likely to present with more illicit symptoms such as suicidal ideations/actions and self-harming behaviors. Consistent with the prognosis and treatment of healthcare conditions, factors such as race, socioeconomics, and the ensuing discriminatory encounters one endures, are often cause for the stated consequences of misdiagnosis and poor fit treatment practices to be marked with more frequency in populations with less power (Becker et al, 2022;Haeri et al, 201) [4,14] .…”

“…By comparison to more well-known and thus betterunderstood personality disorders, e.g., anxiety disorders or bipolar illnesses, BPD receives much less funding for research. This is the greatest contributor to the lack of knowledge and consequently lack of efficient and viable treatment options (Haeri et al, 2011) [14] . As evidenced by contemporary literature, there appears to be a significant disparity in gender and carrying a diagnosis of BPD, and it has been argued that because it is a disorder predominantly impacting women it is not given the resources or consideration it would if it was a disorder impacting men at a greater rate or both genders equally (Ellison et al, 2018) [10] .…”