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Racial disparities in bipolar disorder treatment and research: a call to action
Author(s) -
Akinhanmi Margaret O,
Biernacka Joanna M,
Strakowski Stephen M,
McElroy Susan L,
Balls Berry Joyce E,
Merikangas Kathleen R,
Assari Shervin,
McInnis Melvin G,
Schulze Thomas G,
LeBoyer Marion,
Tamminga Carol,
Patten Christi,
Frye Mark A
Publication year - 2018
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/bdi.12638
Subject(s) - bipolar disorder , psychiatry , context (archaeology) , mania , health equity , research diagnostic criteria , clinical psychology , depression (economics) , medicine , schizophrenia (object oriented programming) , psychology , disease , ethnic group , public health , political science , pathology , paleontology , cognition , macroeconomics , law , economics , biology
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.