Psychiatric Symptoms in Black Patients

Abstract

Dissatisfaction with psychiatric diagnosis dates back to the finding of Masserman and Carmichael (1938) that 40% of in-patients from a university hospital required a major revision in their diagnosis one year later. That report ushered in four decades of research into the reliability of various assessment procedures (Ash, 1949; Beck, 1962; Feighner, Robins, Guze, Woodruff, Winokur, & Munoz, 1972; Woodruff, Goodwin, & Guze, 1974), culminating in the third edition of the American Psychiatric Association’s Diagnostic and Statistical Manual (1980). The major novelty of this manual, (that is, the specification of defined criteria for each diagnostic category) is an attempt to minimize differences in the perceptual and conceptual habits of clinicians, and reflects the preoccupation of the antecedent research with this aspect of the general problem of diagnostic errors. This approach assumes that there is a relatively high degree of homogeneity among patients with regard to symptoms and the diagnostic criteria for any psychiatric illness or that such variations as might exist will be clinically insignificant and will not lead to misdiagnosis.