title: Elevated rates of psychosis among treatment-seeking Hispanic patients with major depression.
abstract: It is unknown whether rates of psychosis differ among depressed patients of various races and ethnic groups. In the present study, we sought to determine whether Hispanic patients with major depression who present for treatment are more likely to report psychotic symptoms than whites, even after controlling for multiple potential confounding factors. Fifteen hundred patients presenting to the Rhode Island Hospital Department of Psychiatry's outpatient practice underwent standardized diagnostic evaluations. Rates of psychosis were compared among Hispanic patients diagnosed with a current major depressive disorder and a white control group closely matched on several key demographic and clinical variables. Comparison rates of psychosis were also made with other ethnic groups. Rates of psychosis were significantly higher in 22 Hispanic patients diagnosed with depression (27.3%) compared with a closely matched white control group (N = 44; 6.8%; chi = 5.2; df = 1; p = .02). Rates of psychosis were also significantly higher in Hispanics than in Portuguese patients, but not blacks, although the former cohort differed in several key demographic and clinical variables. The study suggests that Hispanic patients with major depression who present for treatment may be more likely than whites to report psychotic symptoms. It remains unclear whether these reports represent true psychosis or culturally influenced idioms of distress.
authors.affiliation: Department of Psychiatry and Human Behavior, Brown University School of Medicine, Rhode Island Hospital, Providence, Rhode Island, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Posternak
authors.forename: Mark
authors.initials: M
authors.lastname: Zimmerman
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D015897:Comorbidity; D003431:Cross-Cultural Comparison; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D011174:Portugal / Q000208:ethnology; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011647:Puerto Rico / Q000208:ethnology; D012237:Rhode Island / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data