Washington E, Shen JJ; AcademyHealth. Meeting (2005 : Boston, Mass.).

Abstr AcademyHealth Meet. 2005; 22: abstract no. 4315.

Aunt Martha's Youth Service Center, , 233 W. Joe Orr Rd, Chicago Heights, IL 60411 Tel. (708) 709-7610 Fax (708) 747-3497

RESEARCH OBJECTIVE: To evaluate patterns of care for affective psychosis across diverse ethnicities over time and to determine potential environmental effects on patterns of care and severity of disease. STUDY DESIGN: Comorbidities across all populations were evaluated and included personality disorders and all medical conditions that may have an impact on the clinical outcomes. In addition, complicating conditions; defined as complications resulting potentially from inadequate access to timely care; were evaluated. These conditions included overdose or medication error resulting from carelessness (codes 960-969), drug or alcohol abuse or dependence (codes 303 - 305), suicide attempt or self inflicted injury (E950-E959), homicide or injury inflicted upon another (E960-E969), legal intervention contributing to an injury (E970-E978), and physiologic malfunctioning caused by a mental disorder (306). Discharges with the diagnostic code 296 for all categories of affective psychosis were abstracted and analyzed for differences in comorbidities and complicating conditions across diverse ethnicities. POPULATION STUDIED: Data was obtained on patients admitted with a diagnosis of affective psychosis to hospitals that participated in the National Inpatient Sample during 1995, 1997, 1999, 2000, and 2001. Sample sizes were 73,745 in 1995, 85,840 in 1997, 83,105 in 1999, 91,551 in 2000, and 95,260 in 2001. Ethnicities included white (79.3%), African American (13.8%), Hispanic (5.9%), and Asian-Pacific Islander (.9%) PRINCIPAL FINDINGS: White patients were older with higher risk of having comorbid conditions (RR ranging from 1.02 to 1.19) compared to the other minority groups. Compared to both African Americans and whites, Hispanics and Asians had lower risk of experiencing complicating conditions (RRs ranging from 0.77 to 0.89 for Hispanics and from 0.43 to 0.69 for Asians). CONCLUSIONS: Further research is needed to determine the factors underlying lower risk of complicating conditions among Asians and Hispanics. Several hypotheses including levels of group cohesion, the role of extended family, and various culturally based explanations merit further investigation. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: Public policy should encourage formation of support systems in areas where unemployment levels increase significantly given the existing body of research demonstrating the effectiveness of such systems.

Publication Types:

• Meeting Abstracts

Keywords:

• Affective Disorders, Psychotic
• African Americans
• Alcoholism
• Asian Continental Ancestry Group
• Community Mental Health Services
• Comorbidity
• Diabetes Mellitus
• Disease Progression
• Ethnic Groups
• European Continental Ancestry Group
• Hispanic Americans
• Humans
• Mental Disorders
• Minority Groups
• Oceanic Ancestry Group
• Substance-Related Disorders
• Suicide, Attempted
• complications
• ethnology
• hsrmtgs

UI: 103623778

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