title: Disparities in diagnosis of bipolar disorder in individuals of African and European descent: a review.
abstract: BACKGROUND
  Over the past 3 decades, a wide range of studies in the United States and the United Kingdom has reported that white individuals are more likely to be diagnosed with bipolar and affective disorders, whereas black individuals appear to be at higher risk for schizophrenia spectrum diagnoses. Despite the pressing need for strategies aimed at eliminating racial and cultural disparities in diagnosis and treatment of bipolar disorder, no systematic review of the existing literature in this area has been done. This study draws together the disparate strands of information in a comprehensive overview of the research base in this area.
  
  
  METHODS
  An electronic literature search of the Medline and PsychINFO databases was conducted in October 2009, supplemented by a review of references in the identified articles, for a total of 51 articles included in this qualitative review.
  
  
  RESULTS
  Black patients have consistently been found to be more likely than white patients to be diagnosed with schizophrenia rather than bipolar disorder. Four factors were identified as potential contributors to racial disparities in diagnostic rates: clinical presentation and expression of symptoms, access to care, help-seeking behaviors, and clinician judgment.
  
  
  CONCLUSIONS
  Despite efforts to curtail the phenomenon, racial disparities in diagnosis of bipolar disorder persist. Racial and cultural elements may affect how patients manifest behaviors and symptoms and how these are interpreted and attributed by clinicians in the diagnostic process. As an appropriate diagnosis determines treatment options and is central to quality of care, incorrect diagnosis can potentially have a negative impact on treatment effectiveness and accuracy of prognosis.
authors: The New School, New York, USA.
authors: Sophia
authors: S
authors: Haeri
authors: Jenny
authors: J
authors: Williams
authors: Irina
authors: I
authors: Kopeykina
authors: Jamie
authors: J
authors: Johnson
authors: Alexis
authors: A
authors: Newmark
authors: Lisa
authors: L
authors: Cohen
authors: Igor
authors: I
authors: Galynker
mesh_terms: D001714:Bipolar Disorder / Q000175:diagnosis* / Q000208:ethnology* / Q000523:psychology; D044383:Black People / Q000523:psychology* / Q000706:statistics & numerical data*; D006801:Humans; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data*; D001741:Black or African American