The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

3084.0: Monday, November 17, 2003 - 9:30 AM

Abstract #64225

Sociocultural and clinical factors in the diagnosis of schizophrenia and mood disorders: The role of patient race

Jordana Muroff, MSW, MA, School of Social Work, University of Michigan, 1080 South University, Ann Arbor, MI 48109-1106, (734) 763-7602, jmuroff@umich.edu

Literature indicates that African Americans are more likely to be diagnosed with schizophrenia and less likely to be diagnosed with mood disorders, the patterns being reversed for European Americans. These differential rates prompt concern due to the stigmatizing nature of schizophrenia and diagnostic tendencies. The use of specific attributions and the disregard of other critical information may affect diagnostic decisions. Prior research suggests that clinicians' ethnicity may affect their attribution styles. Are clinicians' consideration of sociocultural and clinical factors when making diagnostic decisions, influenced by the patient's race and ethnic matching between clinician and client? The present study examined clinicians' consideration of socio-cultural factors and clinical inferences in the diagnostic decision of mood versus schizophrenic type disorders among psychiatric inpatients from a predominantly low-income, African American community. After a Clinician Structured Diagnostic Interview (CSDI), clinicians completed an open-ended questionnaire describing their diagnostic decision-making process. Logistic regression analyses suggested clinicians differential application of diagnostic standards. Clinicians' clinical inferences and situational attributions differed when discussing their diagnostic decisions for African American compared to Non-African American patients. For example, clinicians' mentioning of psychotic symptoms was more frequent for African American clients and was associated with a schizophrenia diagnosis for this group.

Session participants will be able to: 1) articulate a better understanding of complexities characterizing the naturalistic diagnostic process; 2) describe findings examining the role of patient characteristics in specific clinical decisions and unpacking the influence of ethnic matching; and 3) discuss how cultural issues impact the judgment and assessment of mental health.

Learning Objectives:

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Financial, Racial and Ethnic Disparities of a Diverse Population

The 131st Annual Meeting (November 15-19, 2003) of APHA