Effects of race on psychiatric diagnosis of hospitalized adolescents: a retrospective chart review.
BACKGROUND
Several studies have reported that patient ethnicity influences psychiatric diagnosis, although this has only been examined in adolescents in two prior studies. One study was based on an outpatient sample and the other was a retrospective study involving a relatively small sample of inpatients. We hypothesized that, as reported in adults, African American adolescents would be diagnosed with schizophrenic spectrum disorders more frequently than Caucasians, and Caucasians correspondingly would receive more affective disorders diagnoses.


METHODS
We retrospectively examined the charts of all adolescents (ages 12-18 years) admitted to the Adolescent Psychiatry Unit at Cincinnati Children's Hospital Medical Center (n = 1,001) between July 1995 and June 1998 for demographic information and discharge diagnoses. We used insurance status as a proxy for socioeconomic status.


RESULTS
African American males were more commonly diagnosed with schizophrenic spectrum disorders than were African American women, Caucasian women, and Caucasian men. There were significantly more African Americans diagnosed with conduct disorder than Caucasians. In contrast, Caucasians were diagnosed with alcohol use disorders and major depression more often.


CONCLUSIONS
Patient race and sex may influence clinical psychiatric diagnoses of hospitalized adolescents. Further investigations using structured interviews are necessary to determine whether the disparity in clinical diagnosis is secondary to actual gender and racial differences in the rates of illnesses in hospitalized adolescents or due to other factors that may contribute to diagnostic practices.
DelBello
M P
MP
Department of Psychiatry, University of Cincinnati College of Medicine, Ohio 45267-0559, USA. delbelmp@email.uc.edu
Lopez-Larson
M P
MP
Soutullo
C A
CA
Strakowski
S M
SM
D000293:Adolescent; D000328:Adult; D044383:Black People; D005260:Female; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology; D044469:Racial Groups; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology; D012737:Sex Factors; D044465:White People; D001741:Black or African American