Treatment characteristics and illness burden among European Americans, African Americans, and Latinos in the first 2,000 patients of the systematic treatment enhancement program for bipolar disorder.
OBJECTIVE
Across ethnicity/race, prevalence rates of bipolar disorder are similar. However, African Americans and Latinos may receive less specialty mental health treatment and different medications, and may be less adherent to treatment regimens than European American patients. This study compared illness characteristics, treatment history, and overall functioning in a sample of European American, African American, and Latino patients with bipolar disorder.


METHODS
The samples were drawn from the first 2,000 patients enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder. There were 1,686 European Americans, 65 African Americans, and 77 Latinos. The data were collected upon study entry, with structured interviews, clinicianrated forms, and self report.


RESULTS
African Americans had a greater likelihood of psychosis and fewer psychiatric medication prescriptions than did European Americans. Latinos had greater alcohol comorbidity, fewer psychiatric medication prescriptions and specialty treatment visits, and more frequent religious service attendance than did European Americans. Depression and manic episode severity and functional outcomes were similar across groups.


CONCLUSIONS
Patients with bipolar disorder who are members of ethnic/racial minority groups continue to receive less intensive specialized mental health treatment than do European American patients. These findings may be related to provider, patient, or provider-patient relationship variables. Despite treatment differences and greater comorbidity and sympomatology, there were no differences among the three groups in overall functioning, suggesting additional outcome measurement is warranted.
Gonzalez
Jodi M
JM
University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA. gonzalezjm1@uthscsa.edu
Thompson
Peter
P
Escamilla
Michael
M
Araga
Mako
M
Singh
Vivek
V
Farrelly
Niamh
N
Thase
Michael E
ME
Miklowitz
David J
DJ
Bowden
Charles L
CL
D000328:Adult; D000437:Alcoholism / Q000208:ethnology; D018692:Antimanic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000208:ethnology*; D044383:Black People / Q000523:psychology*; D015897:Comorbidity; D017281:Cost of Illness; D005260:Female; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012069:Religion and Psychology; D012944:Social Support; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000208:ethnology; D044465:White People / Q000523:psychology*; D001741:Black or African American
D018692:Antimanic Agents