Changing the rates of misdiagnosis in psychiatry  (2020)

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In clinical settings in the United States, schizophrenia is diagnosed in African Americans significantly more often than in other racial and ethnic groups.

This tendency is typically attributed to problems in patient-clinician communication and inadequate or inappropriate use of diagnostic criteria in clinical evaluations. More specifically, evidence suggests that in African Americans psychotic symptoms are excessively weighted over mood and other symptoms during diagnostic processes so that exclusionary criteria in the diagnosis of schizophrenia are not correctly applied.

This research project will engage current clinicians at Integral Care to develop a clinical decision support tool in the electronic health record (EHR) to be used within Integral Care clinics. The goal of the project is to create a tool that will fit within the existing clinician workflow and will require attention to the appropriate weighting of critical psychiatric symptoms, thereby offering the promise of reducing excessive rates of diagnosis of schizophrenia in African American psychiatric patients.

This project has the potential to make multiple contributions to the field. Diagnostic accuracy is a continual problem in mental healthcare. It contributes to poor engagement and treatment outcomes. Individuals with a serious mental illness have a great potential for recovery, but when they are misdiagnosed they are directed to inappropriate treatments and prescribed unhelpful medications. In turn, these individuals drop out of treatment due to lack of progress and decompensate further. By improving the rate of accurate diagnosis, there is an increased chance for treatment success and decreased lifetime disability.