Psychiatric symptoms in white and black inpatients. II: Follow-up study

Interracial and Intraracial Differences in Neuropsychiatric Symptoms, Sociodemography, and Treatment Among Nursing Home Patients With

“…Among nondemented patients, Blacks with affective disorders have been reported to be more likely than Whites to have hallucinations, delusions, somatization, and hostility (Adebimpe, 1981;Fabrega et al 1988;Mukherjee, Shukla, & Woodle, 1983;Weiner, Liss, & Robin, 1973). Although the use of nursing homes by Blacks is rising, their utilization rate is still lower than that of Whites.…”

Racial Differences in DSM Diagnosis Using a Semi-Structured Instrument: The Importance of Clinical Judgment in the Diagnosis of African Americans

“…Clinicians unaware of cultural variations in paranoia may view mistrust as evidence of psychosis instead of depression (Whaley 2002;Whaley 1997). Studies indicate that African Americans show less affect or more flat affect than whites, which may also increase the likelihood of receiving a diagnosis of schizophrenia Welner, Liss and Robins 1973;Welner et al 1972). Clinicians may see something that resembles "blunted affect" but may not assess the cultural accuracy of that perception by considering possible differences in the ways that African Americans and whites display emotions.…”

“…First, the concern is grounded in a particular line of reasoning in interpreting existing diagnostic evidence. Many studies that look at diagnosis within a hospital setting have found that schizophrenia is diagnosed more frequently among African Americans and that mood disorders are diagnosed more often among whites (Lipton and Simon 1985;Liss et al 1973;Mukherjee et al 1983;Neighbors et al 1999;Raskin, Crook and Herman 1975;Simon et al 1973;Snowden and Cheung 1990;Strakowski et al 1996;Tonks, Paykel and Klerman 1970;Welner, Liss and Robins 1973;Welner et al 1972). The term "over-diagnosis" has been used to refer to the findings related to schizophrenia while "under-diagnosis" has been used to describe the findings on mood disorders.…”

The influence of racial factors on psychiatric diagnosis: A review and suggestions for research

“…An analysis by Liss et al (1973) found no race differences in diagnosis, but there was a stronger degree of association between symptoms and diagnosis for whites than blacks. Welner et al (1973) followed up 92 patients who were given a computer-generated diagnosis. The results showed a higher rate of disagreement between the computer-generated diagnosis and the diagnosis based on clinical impression for blacks than whites.…”

“…A number of the studies reviewed found significant differences in the diagnosis of blacks when comparing structured, controlled clinical decision-making to an unstructured clinical interview (Vitols et al, 1963;Welner et al, 1973;Simon et al, 1973;Liss et al, 1973). While it cannot be concluded that structured instruments should be viewed as the ultimate criterion of validity, an unstructured interviewing procedure is more prone to influence by unsubstantiated clinical impressions (such as, ~blacks do not get depressed", or that '~hallu-cinations and delusions occur only in schizophrenia") than a more structured approach.…”