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U.S. Study Finds Black Patients to Receive the Highest Rates of Psychotic Disorder Diagnoses
Scientists assess inequalities in the incidence of psychotic disorders among different racial and ethnic groups
Systemic racism is an ongoing issue within the U.S. and continues to place people of color at a disadvantage in the health care system. Previous studies have shown Black patients to be significantly more likely than White patients to be diagnosed with a psychotic disorder (e.g., schizophrenia).
Winston Chung, MD, and his research team at UCSF recently collaborated with the senior investigator and chief of the Genetic Epidemiology Research Branch of NIMH, Kathleen Merikangas, PhD, and the Child Mind Institute’s vice president and director of Research, Mike Milham, MD, PhD. Together, they conducted a study to examine the disparities in the incidence of both nonaffective (schizophrenia spectrum disorders) and affective (psychosis associated with depression or bipolar disorder) psychotic disorder diagnoses among different racial and ethnic groups within the U.S. They were able to do so by collecting data from the medical records of patients who received care within the Kaiser Permanente Northern California (KPNC) healthcare system between January 1, 2009, and December 31, 2019.
Results found Black patients to have received notably higher rates of psychosis diagnoses than any other racial/ethnic group included in the study. While American Indian or Alaskan Native (AIAN) and Black patients showed a higher risk of receiving a nonaffective psychotic disorder diagnosis than White patients, Asian patients consistently received the lowest rates of psychotic disorder diagnoses across the board. Study findings also noted that those who had been diagnosed with psychotic disorders were at a much higher risk of also having serious health issues, dying by suicide, or dying prematurely. The risk was even higher for those with both psychotic disorders and other psychiatric disorders like depression.
Researchers speculate that unequal distribution of resources, implicit bias, and differences in attitudes towards mental health care across racial/ethnic groups may be among the many factors that contributed to the study findings.
“I think this study underscores the importance of actively monitoring, understanding, and addressing inequalities in mental health and the provision of care. Inaction will allow disparities to persist or potentially worsen,” Dr. Milham concludes.
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