African-Americans More Likely to be Misdiagnosed With Schizophrenia

William Kellogg
April 23, 2019

Schizophrenia is a serious mental health disorder in which affected individuals interpret reality abnormally. Schizophrenia may result in some combination of positive and negative symptoms including hallucinations, delusions, and extremely disordered thinking and behavior that impairs daily functioning, executive functioning, and decision-making which can be disabling.

People with schizophrenia will often require lifelong treatment and adequate monitoring. Early treatment may help get symptoms under control before serious complications develop and may help improve the long-term outlook. Hence it is important to diagnose schizophrenia early and begin treatment right on time. The symptoms of schizophrenia are usually classified into four categories namely;

  • Positive symptoms – This is also called psychotic symptoms. For instance, delusions and hallucinations.
  • Negative symptoms – these implies to elements that are taken away from the individual. Such as absence of facial expressions or lack of motivation.  In some situations sufferers may exhibit symptoms of anhedonia where sufferers rarely derive pleasure from normal pleasurable events.
  • Cognitive symptoms – these affect the person’s thought processes. They may be positive or negative symptoms, for example, poor concentration is a negative symptom.
  • Emotional symptoms – these are usually negative symptoms, such as blunted emotions, sadness, emotional outburst.

Recently, a new Rutgers study showed that African-Americans with severe depression are more likely to be misdiagnosed as having schizophrenia. The study, which appeared online prior to being published in the February 2019 issue of the journal Psychiatric Services, studied extensively and examined the medical records of 1,657 people at a community behavioral health clinic that included screening for major depression as part of its assessment for schizophrenia in new patients. Michael Gara, a professor of psychiatry at Rutgers Robert Wood Johnson Medical School and a faculty member at Rutgers University Behavioral Health Care explained that there has been a tendency for clinicians to overemphasize the relevance of psychotic symptoms and overlook symptoms of major depression in African-Americans compared with other racial or ethnic groups. No studies show that African-Americans with schizophrenia are more likely to also have major depression. This has been a long-standing reason for misdiagnosis of schizophrenia in clinical situations among the African-Americans. The study involved participants of about 599 blacks and 1,058 non-Latino whites. The results of their finding showed that clinicians often failed to effectively weigh mood symptoms when diagnosing schizophrenia among the African-Americans populations. The researchers suggested that racial bias, whether conscious or subconscious, is one factor in the diagnosis of schizophrenia in this population.

Furthermore, there are many other causes that may predispose an individual to depression including genetics and environmental concerns such as poverty which might cause an individual to display symptoms which might be misinterpreted as schizophrenia. There are also situations where clinicians put more emphasis on psychotic symptoms than depressive symptoms during the mental health evaluation of African Americans. This was confirmed by Professor Gara that “Individuals from a racial minority group also might feel hopelessness or mistrust when being assessed by someone from a racial majority group, which could affect how they act and how the clinician interprets symptoms,”

The researchers recommend that screening for major depression be required when assessing black patients for schizophrenia.

William Kellogg

William Kellogg is a veteran writer who's covered the subject of the intersection of technology, health and mental wellness for nearly two decades.

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