Psychiatric diagnosis of African Americans: Diagnostic divergence in clinician-structured and semistructured interviewing conditions

This study is a primary data collection that varied patient race and diagno sis and used two diagnostic interviewing conditions: one clinician-structur ed (phase one) and the other a semi-tructured diagnostic instrument (phase two). Four basic research questions are addressed: What is the relationship between race and the hospital diagnosis? How is race related to diagnosis in both research interviewing conditions? Why does diagnostic concordance b etween the hospital diagnosis and the research diagnosis vary by research i nterviewing condition? Is diagnostic concordance between he hospital and re search diagnosis influenced by patient race? A total of 291 patients comple ted an interview during phase one, while 665 patients completed an intervie w during phase two. Blacks were more likely to receive a hospital diagnosis of schizophrenia and less likely to be diagnosed with mood disorder. Patie nt race was similarly related to the research diagnoses produced in the cli nician-structured research condition (phase one). Although less pronounced, a higher percentage of African Americans than whites received a diagnosis of schizophrenia using the semi-structured DSM-III-R Symptom Checklist (pha se two). The black-white distribution for mood disorders showed that whites were more likely than blacks to be diagnosed with mood disorder.