One study suggests screening for depression when assessing schizophrenia among African Americans

According to a new study by Rutgers, African Americans with severe depression are more likely to be confused with schizophrenia.

The study, which was published online before being published in the February 2019 issue of the journal Psychiatric services, reviewed the medical records of 1,657 individuals in a community-based behavioral health clinic that included screening for major depression as part of their badessment of schizophrenia in new patients.

"By definition, schizophrenia is a diagnosis of exclusion: clinicians must rule out other potential causes of symptoms, including mood disorders, before the diagnosis of schizophrenia is diagnosed." said Michael Gara, professor of psychiatry at the Robert Wood Johnson Rutgers Medical School. a faculty member of behavioral health care at Rutgers University. "However, clinicians tended to overemphasize the relevance of psychotic symptoms and overlook the symptoms of major depression among African Americans compared to other racial or ethnic groups." No studies have shown that African Americans with schizophrenia were more likely to have major depression. "

The study, which included 599 blacks and 1,058 non-Latino whites, found that clinicians did not adequately weigh mood symptoms when diagnosing schizophrenia among African Americans, suggesting that racial bias whether conscious or unconscious, were a diagnostic factor in this population.

Other factors include genetics, poverty and discrimination, as well as symptoms caused by infections and malnutrition at the beginning of life. "People belonging to a racial minority group may also experience hopelessness or mistrust when badessed by a racially majority group member, which could affect their way of acting and the ability to act. Interpretation of symptoms by the clinician, "Gara said.

The results suggest that clinicians place more emphasis on psychotic and depressive symptoms in African Americans, which directs diagnoses towards schizophrenia even when these patients experience depressive and manic symptoms similar to those of white patients.

"An inaccurate diagnosis can have serious consequences," said Gara. "Treatments for mood disorders differ from those in schizophrenia, and the prognosis for these conditions is generally more positive than that of schizophrenia.These patients may experience severe depression with psychotic or bipolar symptoms and a diagnosis of schizophrenia. errors in schizophrenia do not benefit from optimal treatment, expose them to an increased risk of aggravation of the underlying pathological process or suicide, and the side effects of drugs taken to treat schizophrenia, such as diabetes and stroke. weight gain, can be serious. "

The researchers recommend that screening for major depression be needed when badessing schizophrenia among blacks.