Racial differences in paranoid ideation and psychoses in an older urban population.
OBJECTIVE
This study examined whether there are racial differences in the prevalence of paranoid ideation and psychotic symptoms in persons age >/=55 in an urban community.


METHODS
Using 1990 census data for Brooklyn, N.Y., the authors attempted to interview all cognitively intact persons age >/=55 in randomly selected blocks. The final group consisted of 206 whites and 821 blacks. The authors used George's Social Antecedent Model for analyzing 21 independent and three dependent variables: paranoid ideation, psychotic symptoms, and psychotic symptoms/paranoid ideation. The group was weighted by race and gender. To control for intrablock clustering effects without replacement sampling, the authors used SUDAAN for data analysis.


RESULTS
A significant difference in psychotic symptoms or paranoid ideation was found between blacks and whites (24% versus 10%) that was attenuated but not eliminated with logistic regression analyses. Blacks with psychotic symptoms or paranoid ideation, especially Caribbeans, had significantly lower receipt of mental health services and lower perceived service needs. With logistic regression, psychotic symptoms and paranoid ideation were associated with four variables among blacks and whites, although only one was significant in both groups.


CONCLUSIONS
Racial differences in psychotic symptoms and paranoid ideation persist even after control for various clinical, social, and attitudinal effects. Among blacks, response to stressors may be expressed through increased paranoid ideation and psychotic symptoms. Stronger beliefs in spiritualism increase this expression in both races. The high prevalence of psychotic symptoms or paranoid ideation among this aging urban population, especially blacks, highlights a potential public health issue.
Cohen
Carl I
CI
Division of Geriatric Psychiatry, SUNY Downstate Medical Center, Box 1203, 450 Clarkson Ave., Brooklyn, NY 11203, USA. cohen_c@hscbklyn.edu
Magai
Carol
C
Yaffee
Robert
R
Walcott-Brown
Lorna
L
D000367:Age Factors; D000368:Aged; D044383:Black People / Q000706:statistics & numerical data; D017691:Caribbean Region / Q000208:ethnology; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000208:ethnology; D010259:Paranoid Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology*; D011634:Public Health; D044469:Racial Groups / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American