Influence of race on diagnosis in adolescent psychiatric inpatients.
OBJECTIVE
To examine racial differences in 352 psychiatric inpatients, aged 12 to 18 years, at a state hospital facility that accepted admissions from throughout South Carolina. These were all the adolescent admissions during an entire calendar year (1988). There were 101 African-American and 251 white subjects.


METHODS
The data were abstracted from patients' hospital medical records and nursing incident reports. DSM-III-R discharge diagnoses were assigned to five non-mutually exclusive groupings (organic/psychotic, mood/anxiety, disruptive, personality, substance abuse). Racial differences were analyzed using chi 2, logistic regression, and T statistics.


RESULTS
African-Americans were more likely to be involuntarily committed at the time of admission (p = .010). Organic/psychotic diagnoses were much more frequent in African-Americans (odds ratio = 3.15, p < .003). Whites (p = .0347) were almost two times more likely to receive mood/anxiety diagnoses even when controlling for gender, type of admission, and comorbid diagnoses. Substance abuse was more often diagnosed in whites (odds ratio = 5.46, p < .0001).


CONCLUSIONS
This study identifies significant racial differences in the discharge diagnoses of psychiatrically hospitalized adolescents. African-Americans have fewer mood/anxiety and substance abuse diagnoses but significantly more organic/psychotic diagnoses. Some of these differences may reflect ethnocentric clinician bias in the diagnostic assessment of youth from differing cultural/racial backgrounds.
William S. Hall Psychiatric Institute, University of South Carolina School of Medicine, Columbia 29202.
M D
MD
Kilgus
A J
AJ
Pumariega
S P
SP
Cuffe
D000293:Adolescent; D000296:Adolescent Psychiatry; D001741:Black or African American / Q000523:psychology*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation; D019965:Neurocognitive Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation; D011569:Psychiatric Status Rating Scales; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology*