Table 1.
Study characteristics
| Author | Objective | Study Design | Procedure | Inclusion/exclusion |
|---|---|---|---|---|
| Mikton C. Grounds A. 2007 | Examine cross-cultural clinical judgement bias in the diagnosis of PD in Afro-Caribbean men | Two vignettes of male patients, Afro-Caribbean or white, one suggestive of BPD the other suggestive of ASPD sent to psychiatrists. Participants chose diagnosis from list. | 2 vignettes sent to each psychiatrist. | All consultants and specialist registrars in forensic psychiatry in the UK included. |
| Al-Saffar S. Borga P. Wicks S. Hallstrom T. 2004 | Describe the distribution of different ethnic patient groups in Psych OPD and influence of ethnicity, on diagnosis. | Retrospective cohort study using outpatients documentation | Exploration of register for ethnicity and diagnosis | Patients over 18 years of age |
| Castaneda R. Franco H. 1985 | Examine sex and ethnic distribution of BPD in a psychiatric inpatient sample | Retrospective study of 1,583 inpatients discharged in index year using patient notes. | Patients' charts reviewed, primary psychiatric diagnosis and demographics extracted. | Patients with co-existing axis I disorder diagnosis excluded. |
| Tyrer P. Merson S. Onyett S. Johnson T. 1994 | To compare community-based and standard hospital psychiatric services, including PD as an outcome. | RCT of community EIS vs conventional hospital psychiatric services over 14 months for psychiatric emergency patients. | Pt assessed for PD before being randomly assigned to either treatment setting for 12 weeks | Age 16-65. No alcohol/drug dependence. No mandatory care necessary. Not in contact with psych services. |
| Trestman RL. Ford J. Zhang W. Wiesbrock V. 2007 | To estimate percentage of undiagnosed prison inmates who meet diagnostic criteria for psychiatric illness. | Newly admitted patients in 5 prisons assessed for psychiatric illness. | All participants interviewed once for screening. Random sample further interviewed by 5 trained assessors | Excluded: under 18, high bonds, those in security restricted housing, already under medical/mental health care |
| Maden A. Friendship T. McClintock T. Rutter S. 1999 | To test the hypothesis that there are systematic differences in clinical outcome in patients of different ethnic origin. | Longitudinal cohort study of discharges from a medium secure unit (average follow up 6.6 yrs) | Admission & short term data from MDT records. Long term info from all med records, Home Office Register, Prison records, Offenders index, NHS central record, Special Hospitals case register, & semi-structured interviews | All patients discharged from a first admission to The Denis Hill Unit of the Bethlem Royal Hospital from Oct 1980 till Oct 1994 |
| Coid J. Petruckevitch A. Bebbington P. Brugha T. Bhugra D. et al 2002 | To estimate population-based rates of imprisonment in different ethnic groups, & compare criminal behaviour & psychiatric morbidity | Examination of home office data on all inmates, and cross-sectional survey of remanded and sentenced prisoners in 1997 | Survey comprised lay interviews/self administered, then every 5th participant had follow-up interview by clinician | All prisoners on remand or sentenced in England & Wales in 1997 included. |
| Coid J. Petruckevitch A. Bebbington P. Brugha T. Bhugra D. et al 2002 | To compare early environmental risks, stressful daily living experiences & reported use of psych services in prisoners from diff ethnic grps | Examination of home office data on all inmates, and cross-sectional survey of remanded and sentenced prisoners in 1997 | Survey comprised lay interviews/self administered, then every 5th participant had follow-up interview by clinician | All prisoners on remand or sentenced in England & Wales in 1997 included. |
| Coid J. Kahtan N. Gault S. Jarman B. 2000 | To estimate population-based prevalence rates of treated mental disorder in different ethnic groups compulsorily admitted to secure forensic psychiatry services | Retrospective survey of 3155 first admissions from 1988 to 1994 from half of England and Wales with 1991 census data as the denominator adjusted for under-enumeration | Item sheets completed from case notes. Data collected by clinically trained research psychiatrist | Those with no fixed abode excluded |
| Coid J. Kahtan N. Gault S. Jarman B. 1999 | To compare patients with PD and mental illness according to demography, referral, criminality, previous institutionalisation and diagnostic comorbidity | Retrospective survey of all admissions from 1988 to 1994 from 7 (of 14) regional health authority catchment areas in England & Wales | One researcher completed item sheet for every admission. recorded demography, nature of referral, legal status & catchment of origin | All admissions of pts with PD to special hospitals and MSU from a geographically representative area |
| Bender DS. Skodol AE. Dyck IR. Markowitz JC. Shea MT. et al 2007 | To explore whether PD psychopathology raises particular challenges to treatment-seeking ethnic minorities receiving adequate mental health services | 2 year prospective study: of patients recently treated or seeking treatment from clinical services. Follow up at 6, 12, 24 months. | Experienced research clinicians determined 1 of 4 PD Δ: Schizotypal (STPD), BPD, Avoidant (AVPD) & Obsessive-compulsive (OCPD) by interview | Treatment-seeking/recently treated pts 18-45. Exclusion: active psychosis, acute substance intoxication/withdrawalhistory of schizophrenia/schizoaffective/schizophreniform disorders |
| Chavira DA. Grilo CM. Shea T. Yen S. Gunderson JG. et al 2003 | Compare the relative proportion of 4 PDs among 3 ethnic grps in a clinical sample & examine whether specific PD criteria accounted for difference in ethnic distribution | Survey/Questionnaire. Patients filled out Personality Screening Questionnaire: If +ve for 1 or more PDs they were referred for further assessment. Also completed Depression Screening Questionnaire: If +ve were referred as potential controls | Patients interviewed by trained & experienced interviewers using DSM-IV & Personality Assessment form. Patients also asked to fill in self-report questions. If DSM-IV supported by any instrument, patients were assigned to PD | Treatment-seeking/recently treated patients, aged 18-45. Exclusion: active psychosis, acute substance intoxication/withdrawal, history of schizophrenia/schizoaffective/schizophreniform disorders |
| Iwamasa GY. Larrabee AL. Merritt RD. 2000 | Assess possible ethnicity criterion bias of DSM-III-R PDs using a lay sample of college undergraduates with no previous education on psychological disorders | Random card-based task with personality characteristics to be sorted by participants' own beliefs not stereotypes. | Participants sorted cards 3 separate times by ethnicity | College students unfamiliar with DSM-III-R excluded |
| Huang B. Grant BF. Dawson DA. Stinson FS. Chou SP. Et al 2006 | Compare the current prevalence & co-occurrence of DSM-IV, alcohol & drug use disorders & mood, anxiety & PDs among whites, blacks, Native Americans, Asians & Hispanics in a large representative sample of the US population | Face-to-face survey of 43093 participants by National Epidemiological Survey on Alcohol and Related Conditions (NESARC). | Interview administered using laptop computer-assisted software. Used professional interviewers from US Bureau | Civilian non-institutionalised respondents aged 18+. |
| Compton WM. Cottler LB. Abdallah AR. Phelps DL. Spitznagel EL. & Horton JC. 2000 | Determine the rates of specific psychiatric disorders among drug dependent persons in treatment and determine whether these rates vary by race (and gender) | Interview-based study of newly admitted patients. Two face-to-face interview sessions 12 months apart. | Subjects randomly selected from lists of newly admitted pts from the data from a longitudinal study of substance abusers 1st | Substance abusers who were recently admitted to drug treatment facilities in St Louis. |
PD: Personality Disorder
RCT: Randomised Control Trial
EIS: Early intervention Service
MSU: Medium Secure Unit