Do they see dead people? Cultural factors and sensitivity in screening for schizophrenia spectrum disorders.
MacKenzie R Peltier, Seandra J Cosgrove, Kelechi Ohayagha, Kathleen A Crapanzano, Glenn N Jones
Ethnicity & health June 16, 2016 DOI: 10.1080/13557858.2016.1196650 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational study Peer reviewed |
|---|---|
| Sample size | 471 |
| Population | African-American patients presenting for intake at an HIV outpatient clinic |
| Measures | Mini International Neuropsychiatric Interview-Plus (MINI-Plus) Screening Interview, MINI-Plus Psychotic Disorder Module |
| Keywords | Humans Hallucinations Logistic models Spirituality Mental disorders Adult Middle aged Female African-american Schizophrenia spectrum disorders Religious |
| Key findings | Endorsement of auditory or visual hallucinations predicted a schizophrenia spectrum disorder diagnosis (OR 41.6), but spiritual hallucinations were associated with much lower odds of such a diagnosis (OR 0.22). The authors argue that not all such hallucinations in African-American patients are symptomatic of psychotic disorder and that clinicians should assess content, meaning, and distress. |
Abstract
Objective: Schizophrenia spectrum disorders (SSDs), are diagnosed more frequently among African-Americans (AAs) than Caucasians. It has been suggested that cultural differences in symptom presentation and endorsement (including reporting spiritual/religious experiences) may influence this disparity. The current study investigated the relationship between endorsement of spiritual auditory and visual hallucinations and subsequent diagnosis of SSD among AA patients.
Design: Participants (N = 471 AAs) completed the Mini International Neuropsychiatric Interview-Plus (MINI-Plus) Screening Interview as part of their intake to a HIV outpatient clinic. Endorsement of auditory or visual (A/V) hallucinations was explored with the MINI-Plus Psychotic Disorder Module and questions regarding the content of the unusual experience.
Results: Logistic regression indicated that endorsement of A/V hallucinations significantly predicted a SSD (OR = 41.6, 95% CI 13.7-126.0, p < .001). However, when hallucinations were spiritual in nature, odds of an SSD fell dramatically (OR = 0.22, 95% CI 0.07-0.64, p < .001).
Conclusions: The current study indicates that not all visual and auditory hallucinations are symptomatic of a psychotic disorder in AA patients. Many of these experiences may be related to spirituality. Clinicians assessing AA patients need to query content of, meaning attributed to, and distress associated with A/V unusual experiences.