Inconsistencies in diagnosis and symptoms among bilingual and English-speaking Latinos and Euro-Americans.
OBJECTIVE
Little information is available about accuracy of diagnoses in clinical care for affective and other major mental disorders experienced by Latino patients. This study addressed two central research questions: Do Latinos have disproportionate rates of clinical diagnoses of major depression based on structured diagnostic interviews? Are diagnostic patterns consistent with patient profiles and medical record information?


METHODS
A total of 259 bilingual Latino, monolingual English-speaking Latino, and Euro-American patients aged 18 to 45 years with a history of severe depression or psychotic symptoms were compared across three clinical sites by using structured interviews.


RESULTS
Compared with Euro-Americans, bilingual Latinos had significantly higher rates of major depression and significantly lower levels of mania. No significant differences were found between monolingual English-speaking Latinos and Euro-Americans.


CONCLUSIONS
Results suggest that the diagnostic process is affected by an apparent association with cultural-linguistic influences, notably speaking English as a second language.
Department of Psychiatry, Yale University School of Medicine, Hispanic Clinic, New Haven, CT 06519, USA. esperanza.diaz@yale.edu
Esperanza
E
Díaz
Theresa
T
Miskemen
William A
WA
Vega
Michael
M
Gara
Daniel R
DR
Wilson
Ira
I
Lesser
Michael
M
Escamilla
Harold W
HW
Neighbors
Stephan
S
Arndt
Stephen
S
Strakowski
D000293:Adolescent; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008499:Medical Records; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D008875:Middle Aged; D019303:Multilingualism; D010818:Practice Patterns, Physicians'; D014481:United States / Q000453:epidemiology; D055815:Young Adult