TY - JOUR
T1 - Racial disparities in bipolar disorder treatment and research
T2 - a call to action
AU - Akinhanmi, Margaret O.
AU - Biernacka, Joanna M.
AU - Strakowski, Stephen M.
AU - McElroy, Susan L.
AU - Balls Berry, Joyce E.
AU - Merikangas, Kathleen R.
AU - Assari, Shervin
AU - McInnis, Melvin G.
AU - Schulze, Thomas G.
AU - LeBoyer, Marion
AU - Tamminga, Carol
AU - Patten, Christi
AU - Frye, Mark A.
N1 - Publisher Copyright:
Published 2018. This article is a U.S. Government work and is in the public domain in the USA.
PY - 2018/9
Y1 - 2018/9
N2 - Objectives: Health disparities between individuals of African and European ancestry are well documented. The disparities in bipolar disorder may be driven by racial bias superimposed on established factors contributing to misdiagnosis, including: evolving empirically based diagnostic criteria (International Classification of Diseases [ICD], Research Diagnostic Criteria [RDC] and Diagnostic and Statistical Manual [DSM]), multiple symptom domains (i.e. mania, depression and psychosis), and multimodal medical and additional psychiatric comorbidity. Methods: For this paper, we reviewed the phenomenological differences between bipolar individuals of African and European ancestry in the context of diagnostic criteria and clinical factors that may contribute to a potential racial bias. Results: Published data show that bipolar persons of African ancestry, compared with bipolar persons of non-African ancestry, are more often misdiagnosed with a disease other than bipolar disorder (i.e. schizophrenia). Additionally, studies show that there are disparities in recruiting patients of African ancestry to participate in important genomic studies. This gap in biological research in this underrepresented minority may represent a missed opportunity to address potential racial differences in the risk and course of bipolar illness. Conclusion: A concerted effort by the research community to increase inclusion of diverse persons in studies of bipolar disorder through community engagement may facilitate fully addressing these diagnostic and treatment disparities in bipolar individuals of African ancestry.
AB - Objectives: Health disparities between individuals of African and European ancestry are well documented. The disparities in bipolar disorder may be driven by racial bias superimposed on established factors contributing to misdiagnosis, including: evolving empirically based diagnostic criteria (International Classification of Diseases [ICD], Research Diagnostic Criteria [RDC] and Diagnostic and Statistical Manual [DSM]), multiple symptom domains (i.e. mania, depression and psychosis), and multimodal medical and additional psychiatric comorbidity. Methods: For this paper, we reviewed the phenomenological differences between bipolar individuals of African and European ancestry in the context of diagnostic criteria and clinical factors that may contribute to a potential racial bias. Results: Published data show that bipolar persons of African ancestry, compared with bipolar persons of non-African ancestry, are more often misdiagnosed with a disease other than bipolar disorder (i.e. schizophrenia). Additionally, studies show that there are disparities in recruiting patients of African ancestry to participate in important genomic studies. This gap in biological research in this underrepresented minority may represent a missed opportunity to address potential racial differences in the risk and course of bipolar illness. Conclusion: A concerted effort by the research community to increase inclusion of diverse persons in studies of bipolar disorder through community engagement may facilitate fully addressing these diagnostic and treatment disparities in bipolar individuals of African ancestry.
KW - African ancestry
KW - bipolar disorder
KW - health/racial disparities
KW - minority research participation
UR - http://www.scopus.com/inward/record.url?scp=85043534183&partnerID=8YFLogxK
U2 - 10.1111/bdi.12638
DO - 10.1111/bdi.12638
M3 - Review article
C2 - 29527766
AN - SCOPUS:85043534183
SN - 1398-5647
VL - 20
SP - 506
EP - 514
JO - Bipolar Disorders
JF - Bipolar Disorders
IS - 6
ER -