“Jones and colleagues (Jones et al., 1981; Jones and Gray, 1986) have concerned themselves with differential diagnosis of affective disorder vs. schizophrenia among Blacks, arguing that studies of rates of disorder under treatment suggest that the former has been underdiagnosed and the latter overdiagnosed. Data from their study point toward higher rates of manic-depressive disorder than typically have been found among Blacks. Data from another study (Mukherjee, et al., 1983) indicated that Blacks with bipolar disorder were more likely than whites to have been previously diagnosed schizophrenic.”

“Problems of symptom expression and biased diagnosis have received virtually no attention among Asian and Native Americans. Overdiagnosis in some categories and underdiagnosis in others appears likely given cultural characteristics of these groups. Diagnostic errors potentially have grave consequences for the appropriate delivery of services and improved mental health.
As to Hispanics, questions have been raised about the DIS (Canino et al., 1987; Escobar et al., 1987). The finding of greater six-month prevalence for severe cognitive impairment among Mexican Americans, for example, has been attributed to bias in methods of assessment (Burnam et al., 1987). Vega et al. (1986) reported that certain items on the CESD failed to detect clinical levels of depression among Mexican American women who had recently immigrated.”

“A major concern must be an apparent overutilization of hospital care by Blacks. Studies are needed of decisions leading to hospitalization: are differential criteria employed on the basis of race?”