More research needed on racial bias in diagnosing oppositional defiant disorder
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Key takeaways:
- Psychotic and childhood disorder diagnoses were more likely assigned to Black patients vs. white patients.
- White patients were more likely to receive a diagnosis of ADHD or adjustment disorder.
NEW YORK — A literature review revealed that clinicians more often assigned psychotic and childhood disorder diagnoses to Black vs. white patients, according to a poster presented at the American Psychiatric Association annual meeting.
“We need to take a look at our own biases and biases that are systemic to the institution of medicine in the way we diagnose and what that means for patients,” Ashley Filbeck, a student at the University of Kentucky College of Medicine, told Healio.
To investigate the relationship between race and the diagnosis of oppositional defiant disorder (ODD), Filbeck and colleagues conducted a PubMed literature review for the search terms “oppositional defiant disorders” and “race,” “outcomes” and “bias.”
They found that clinicians more often assigned psychotic and childhood disorder diagnoses to Black patients vs. white patients, and that white patients were more likely diagnosed with adjustment disorder or ADHD.
“A patient who is Black may be diagnosed with ODD,” Filbeck said. “A patient with the same symptoms, who is white, might be diagnosed with ADHD and then they get better care, they get the medications they need and they get the school accommodations they need.”
Researchers wrote that “unconscious bias and underlying societal structures” may lead to Black patients receiving more severe diagnoses than their white counterparts.
“I think in psychiatry a lot of things are sometimes pathologized,” Rijah Chhapra, MBBS, study author and second-year resident in psychiatry at the University of Kentucky, told Healio. “There’s a lot of internalized and systemic racism, which is subconscious, and as health care providers, that was a big conversation we had.”
According to Filbeck and Chhapra, more research is necessary to understand discrepancies in psychiatric diagnoses between white and Black patients and how that affects the perception of those patients by teachers, health care workers and families.
“As psychiatrists we’re supposed to try to be just,” Chhapra said.