Effects of race on psychiatric diagnosis of hospitalized adolescents: A retrospective chart review

Background: Several studies have reported that patient ethnicity influences psychiatric diagnosis, although this has only been examined in adolescents in two prior studies. One study was based on an outpatient sample and the other was a retrospective study involving a relatively small sample of inpa tients. We hypothesized that, as reported in adults, African American adole scents would be diagnosed with schizophrenic spectrum disorders more freque ntly than Caucasians, and Caucasians correspondingly would receive more aff ective disorders diagnoses. Methods: We retrospectively examined the charts of all adolescents (ages 12 -18 years) admitted to the Adolescent Psychiatry Unit at Cincinnati Childre n's Hospital Medical Center (n = 1,001) between July 1995 and June 1998 for demographic information and discharge diagnoses. We used insurance status as a proxy for socioeconomic status. Results: African American males were more commonly diagnosed with schizophr enic spectrum disorders than were African American women, Caucasian women, and Caucasian men. There were significantly more African Americans diagnose d with conduct disorder than Caucasians. In contrast, Caucasians were diagn osed with alcohol use disorders and major depression more often. Conclusions: Patient race and sex may influence clinical psychiatric diagno ses of hospitalized adolescents. Further investigations using structured in terviews are necessary to determine whether the disparity in clinical diagn osis is secondary to actual gender and racial differences in the rates of i llnesses in hospitalized adolescents or due to other factors that may contr ibute to diagnostic practices.