Racial and ethnic diagnostic patterns in Schizophrenia spectrum disorders

Kayla Gurak, Jessica Maura, Amy G Weisman, Ana Martinez De Andino, Irwin Rosenfarb

Research output: Chapter in Book/Report/Conference proceedingChapter

2 Scopus citations


The literature on racial and ethnic diagnostic patterns (as these pertain to schizophrenia spectrum disorders) is reviewed in this chapter. The chapter begins with a review of the literature on the diagnostic patterns among racial and ethnic minorities in the USA and abroad, followed by a review of racial/ethnic differences in symptom severity, symptom expression, and prevalence rates. This is then followed by a review of the empirical literature that offers explanations about why differential diagnostic patterns are observed. This review explores the question of whether differential patterns are due to inherent differences between racial/ethnic groups or if clinician biases and/or decision-making processes are contributing to differential diagnostic practices. Finally, literature that points to cultural mistrust, paranoia, and other environmental factors (e.g., stress) as potential variables that may contribute to the differential diagnostic patterns among racial/ethnic groups is reviewed. These reviews suggest that Black patients are three to four times more likely to receive a schizophrenia spectrum diagnosis. Findings also suggest that racial/ethnic variations may exist on a symptom level, with greater differences observed among positive symptom profiles. This review suggests that unawareness of cultural differences in symptom expression, cultural mistrust, and environmental factors (e.g., low SES) may be related to greater likelihood of receiving a schizophrenia spectrum diagnosis but do not fully account for the diagnostic discrepancies observed among racial/ethnic groups. To better understand these relationships, we conclude with recommendations to improve diagnostic accuracy and cultural competence (e.g., greater reliance on the Cultural Formulation Interview) and suggestions for future research that may further clarify the racial/ethnic diagnostic conundrum (e.g., using analog research studies).

Original languageEnglish (US)
Title of host publicationCultural Competence in Applied Psychology
Subtitle of host publicationAn Evaluation of Current Status and Future Directions
PublisherSpringer International Publishing
Number of pages15
ISBN (Electronic)9783319789972
ISBN (Print)9783319789958
StatePublished - Jan 1 2018


  • Clinical diagnosis
  • Clinical disorders
  • Cultural competence
  • Cultural differences
  • Racial/ethnic groups
  • Schizophrenia

ASJC Scopus subject areas

  • Psychology(all)
  • Social Sciences(all)


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