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Are there racial differences in the way patients with psychotic disorders are treated at their first hospitalization?

Published online by Cambridge University Press:  21 April 2004

NANCY L. SOHLER
Affiliation:
Montefiore Medical Center and Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, USA; Department of Psychiatry and Behavioral Science, State University of New York at Stony Brook, Stony Brook, NY, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, NY, USA; Department of Veterans Affairs, Office of Quality and Performance, Washington, DC, USA
EVELYN J. BROMET
Affiliation:
Montefiore Medical Center and Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, USA; Department of Psychiatry and Behavioral Science, State University of New York at Stony Brook, Stony Brook, NY, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, NY, USA; Department of Veterans Affairs, Office of Quality and Performance, Washington, DC, USA
JANET LAVELLE
Affiliation:
Montefiore Medical Center and Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, USA; Department of Psychiatry and Behavioral Science, State University of New York at Stony Brook, Stony Brook, NY, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, NY, USA; Department of Veterans Affairs, Office of Quality and Performance, Washington, DC, USA
THOMAS J. CRAIG
Affiliation:
Montefiore Medical Center and Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, USA; Department of Psychiatry and Behavioral Science, State University of New York at Stony Brook, Stony Brook, NY, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, NY, USA; Department of Veterans Affairs, Office of Quality and Performance, Washington, DC, USA
RAMIN MOJTABAI
Affiliation:
Montefiore Medical Center and Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, USA; Department of Psychiatry and Behavioral Science, State University of New York at Stony Brook, Stony Brook, NY, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, NY, USA; Department of Veterans Affairs, Office of Quality and Performance, Washington, DC, USA

Abstract

Background. It is now well documented that both black and white patients with severe mental illness are likely to use different types of treatment facilities, have different lengths of hospital stays, and receive different types and dosages of psychotropic medications. It is still uncertain, however, whether these differences exist at the early stages of treatment.

Method. We examined treatment patterns for a countywide sample of patients with psychotic disorders recruited at their initial psychiatric hospitalization. Illness characteristics, prior treatment histories, admission conditions, and psychotropic medication use during this hospitalization were compared for both black and white patients.

Results. Black patients were less likely to have had out-patient treatment prior to their first hospitalization and were more likely to be hospitalized in public than in community psychiatric units than were white patients. Black patients were also more likely to be hospitalized primarily for a behavioral disturbance and escorted to the hospital by the emergency medical services or police, while white patients were more often hospitalized primarily for subjective suffering. These patterns were particularly significant for those with a non-schizophrenia diagnosis. However, there were few statistically significant differences between black and white patients on psychotropic medication use during the first hospitalization.

Conclusions. Differences during the early stages of treatment between black and white patients with psychotic disorders appear to arise most prominently before, rather than during, their first hospitalization.

Type
Research Article
Copyright
© 2004 Cambridge University Press

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