Flaskerud J H, Hu L T
School of Nursing, UCLA 90024-1702.
J Nerv Ment Dis. 1992 May;180(5):296-303. doi: 10.1097/00005053-199205000-00003.
The purpose of this study was to determine the relationship of ethnic identity to psychiatric diagnosis in white, black, Latino, and Asian clients of the Los Angeles County mental health system. The sample (N = 26,400) consisted of adult inpatient and outpatient clients seen in county mental health facilities between January 1983 and August 1988. Logistic regression analysis was used to determine the relationship of ethnicity to diagnosis in both outpatient and inpatient samples. The covariates included in the analysis were age, gender, socioeconomic status, and primary language. Ethnicity had a significant and consistent relationship to diagnosis in both outpatient and inpatient samples, with black and Asian clients having a greater proportion of psychotic diagnoses than whites, and Latinos a lesser proportion than whites. None of the covariates included in the analysis had a consistent relationship to diagnosis. Whites and Asians received more diagnoses of major affective disorders than blacks or Latinos; blacks and Asians received more diagnoses of schizophrenia and other psychoses than whites, and Latinos received fewer of these diagnoses than whites. Substance abuse was lower for Asians than for the other three groups. Based on the findings, it was concluded that there continues to be a difference in psychiatric diagnosis that is related to ethnicity. Clinical practice issues and recommendations for further research are considered in relationship to these findings.
本研究的目的是确定洛杉矶县心理健康系统中白人、黑人、拉丁裔和亚裔客户的种族认同与精神疾病诊断之间的关系。样本（N = 26,400）包括1983年1月至1988年8月期间在县心理健康机构就诊的成年住院和门诊客户。采用逻辑回归分析来确定门诊和住院样本中种族与诊断之间的关系。分析中纳入的协变量包括年龄、性别、社会经济地位和主要语言。种族在门诊和住院样本中与诊断都存在显著且一致的关系，黑人与亚裔客户的精神病诊断比例高于白人，拉丁裔的比例低于白人。分析中纳入的协变量与诊断均无一致关系。白人及亚裔比黑人或拉丁裔获得更多的重度情感障碍诊断；黑人与亚裔比白人获得更多的精神分裂症及其他精神病诊断，而拉丁裔获得的此类诊断比白人少。亚裔的药物滥用情况低于其他三组。基于这些发现，得出的结论是，与种族相关的精神疾病诊断差异仍然存在。结合这些发现对临床实践问题及进一步研究建议进行了探讨。
