THE EFFECTS OF RACE AND INFORMATION VARIANCE ON DISAGREEMENT BETWEEN PSYCHIATRIC EMERGENCY SERVICE AND RESEARCH DIAGNOSES IN FIRST-EPISODE PSYCHOSIS

Background: Previously, we reported that patient race was associated w ith disagreement between research and clinical diagnoses. To extend th is work, we studied whether disagreement was specifically due to assoc iations of patient race with information or criterion variance. Method : Ninety-nine patients consecutively admitted through the University o f Cincinnati Psychiatric Emergency Service (PES) for a first hospitali zation for psychosis were evaluated using the Structured Clinical Inte rview for DSM-III-R. Diagnoses made in the PES were compared with thos e obtained from the structured interview. We examined the contribution s of information variance and criterion variance to the association be tween race and diagnostic agreement of PES and research diagnoses. Res ults: Agreement in PES and research diagnoses was present in only 42% of patients. Diagnostic agreement was less common in non-white patient s than white patients, even after controlling for other sociodemograph ic and clinical variables. Information variance was the cause of diagn ostic disagreement in 58% of cases and was associated with patient rac e. Criterion variance, occurring in 42% of cases, was not associated w ith race. Conclusion: Patient race may contribute to the diagnostic pr ocess in the psychiatric emergency service by influencing the informat ion obtained from patients during clinical evaluations.