The black community has a held a distrust for the psychiatric filed for a long time, but only now is some tanglible proof surfacing that at least one disorder — schizophrenia — may be over-diagnosed among African-Americans. Schizophrenia is an incurable mental illness that may involve delusions, hallucinations, and patterns of destructive behavior and paranoia; there is no cure. Blacks are diagnosed as schizophrenic way more often than other races, with studies showing the rate of the disease to be between two to two-and-a-half times that of whites. But research now show that doctors are likely biased in making these conclusions, even if they do not know the race of the patient they are evaluating.

Even when African American patients showed significant signs of a mood disorder such as depression or bipolar disorder, it was the severity of their psychotic symptoms that jumped off the page to the color-blinded psychiatrists. For white patients, even psychiatrists blinded to race were more likely to balance signs of psychosis with signs of a mood disorder.

In other words, as the black community struggles to accept and handle the very real existence of depression among us, doctors are often viewing our illness as psychosis, warranting treatment plans that are incompatible with our real needs. It all comes down to the old “paranoid, fearful black person” trope that considers African-American suspicion of discrimination ridiculous.

“In African American subjects, psychotic symptoms may be overvalued by clinicians, skewing diagnoses toward schizophrenia-spectrum conditions,” the authors of the new study write. They suggest that “previous discriminatory experiences, and reactions to them, i.e. healthy paranoia,” may lead some African Americans to express their fears and anxieties in ways that are interpreted as more extremely psychotic, or that delays in seeking treatment may make their psychotic symptoms more prominent than evidence of their mood instability.

One can only hope that more African-Americans participate in the field of psychiatry and educate their colleagues about the way that people of different backgrounds communicate.

Read more at The LA Times.

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