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A Jamaican psychiatrist evaluates diagnoses at a London psychiatric hospital

Published online by Cambridge University Press:  03 January 2018

F. W. Hickling ,
K. McKenzie ,
R. Mullen  and
R. Murray
F. W. Hickling*
Affiliation:
Institute of Psychiatry and Kings College School of Medicine and Dentistry, London
K. McKenzie
Affiliation:
Institute of Psychiatry and Kings College School of Medicine and Dentistry, London
R. Mullen
Affiliation:
Institute of Psychiatry and Kings College School of Medicine and Dentistry, London
R. Murray
Affiliation:
Institute of Psychiatry and Kings College School of Medicine and Dentistry, London
*
Dr F.W. Hickling, Psychotherapy Associates International Ltd, Haverstock House, 81-83 Villa Road, Birmingham B19 INH. Tel: 0121-523-0145; Fax: 0121-523-5062; e-mail: [email protected]
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Abstract

Background

Authors have suggested that the high rate of schizophrenia reported for African–Caribbeans living in the UK is due to misdiagnosis by British psychiatrists.

Aims

To compare the diagnoses made by a Black Jamaican psychiatrist with those of White British psychiatrists.

Method

All in-patients on four wards at the Maudsley hospital were approached for the study; 66 participated: 24 White, 29 Black African–Caribbeans and 13 Blacks from other countries of origin. F. W. H., a Black Jamaican psychiatrist, conducted his standard clinical assessment and performed the Present State Examination (PSE) on these patients. His diagnoses were compared with the case note diagnoses made by British psychiatrists, and with the PSE CATEGO diagnoses.

Results

Of 29 African and African–Caribbean patients diagnosed with schizophrenia, the diagnoses of the British and the Jamaican psychiatrists agreed in 16 instances (55%) and disagreed in 13 (45%). Hence, interrater reliability was poor (κ=0.45). PSE CATEGO diagnosed a higher proportion of subjects as having schizophrenia than the Jamaican psychiatrist did (χ2=3.74, P=0.052)

Conclusions

Agreement between the Jamaican psychiatrist and his UK counterparts about which patients had schizophrenia was poor. PSE CATEGO may overestimate rates of schizophrenia.

Type
Preliminary Report
Information
The British Journal of Psychiatry , Volume 175 , Issue 3 , September 1999 , pp. 283 - 285
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

∗

See invited commentaries p. 286. this issue.

References

Cohan, J. (1940) A coefficient of agreement for nominal scales. Educational and Psychological measurement, 20, 37–46.CrossRefGoogle Scholar
Eagles, J. M. (1991) The relationship between schizophrenia and immigration. Are there alternatives to psychosocial hypotheses? British Journal of Psychiatry, 159, 783–789.CrossRefGoogle ScholarPubMed
Fernando, S. (1900) Race and Culture in Psychiatry. London: Croom Helm.Google Scholar
Gunaratham, Y. (1994) Health and Race. A Starting Point for Managers on Improving Services for Black Populations. London: King's Fund.Google Scholar
Harrison, G., Owens, D., Holton, A., et al (1900) A prospective study of severe mental disorder in Afro–Caribbean patients. Psychological Medicine, 18, 643–657.Google Scholar
Hickling, F. W. & Rodgers-Johnson, P. (1995) The incidence of first-contact schizophrenia in Jamaica. British Jounial of Psychiatry, 167, 193–196.CrossRefGoogle ScholarPubMed
King, M., Coker, E., Leavey, G., et al (1994) Incidence of psychotic illness in London: comparison of ethnic groups. British Medical Journal, 309, 115–119.CrossRefGoogle ScholarPubMed
Kirov, G. & Murray, R. (1999) Ethnic differences in the presentation of bipolar affective disorder. European Psychiatry, in press.CrossRefGoogle Scholar
Kreitman, N., Sainsbury, P., Morrissey, J., et al (1901) The reliability of psychiatric assessment: an analysis. Journal of Medical Science, 107, 887–908.Google Scholar
Lewis, G., Croft-Jeffereys, C. & David, A. (1990) Are British psychiatrists racist? British Journal of Psychiatry, 157, 410–415.Google Scholar
Littlewood, R. & Lipsodge, M. (1901) Some social and phenomenological characteristics of psychotic immigrants. Psychological Medicine, 11, 289–302.CrossRefGoogle Scholar
Shashidharan, S. P. (1993) Afro–Caribbeans and schizophrenia; the ethnic vulnerability hypothesis re-examined. International Review of Psychiatry 5, 129–144.Google Scholar
Van Os, J., Castle, D., Takel, N., et al (1996) Psychotic illness in ethnic minorities: clarification from the 1991 census. Psychological Medicine, 26, 203–208.CrossRefGoogle ScholarPubMed
Wessely, S., Castle, D., Der, G., et al (1991) Schizophrenia and Afro-Caribbeans. A case-control study. British Journal of Psychiatry, 159, 795–801.CrossRefGoogle ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) Measurement and Classification of Psychiatric Symptoms, Cambridge: Cambridge University Press.Google Scholar
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