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Published on: February 26, 2020
Inconsistencies in diagnosis and symptoms among bilingual and English-speaking Latinos and Euro-Americans
Esperanza Díaz1, Theresa Miskemen, William A Vega
1Department of Psychiatry, Yale University School of Medicine, Hispanic Clinic, New Haven, CT 06519, USA. esperanza.diaz@yale.edu
Objective:
Little information is available about accuracy of diagnoses in clinical care for affective and other major mental disorders experienced by Latino patients. This study addressed two central research questions: Do Latinos have disproportionate rates of clinical diagnoses of major depression based on structured diagnostic interviews? Are diagnostic patterns consistent with patient profiles and medical record information?
Methods:
A total of 259 bilingual Latino, monolingual English-speaking Latino, and Euro-American patients aged 18 to 45 years with a history of severe depression or psychotic symptoms were compared across three clinical sites by using structured interviews.
Results:
Compared with Euro-Americans, bilingual Latinos had significantly higher rates of major depression and significantly lower levels of mania. No significant differences were found between monolingual English-speaking Latinos and Euro-Americans.
Conclusions:
Results suggest that the diagnostic process is affected by an apparent association with cultural-linguistic influences, notably speaking English as a second language.
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Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
Diagnostic and Statistical Manual of Mental Disorders (DSM)
