Potential for misdiagnosis amongTurkish migrants with psychotic disorders:a clinical controlled study in Germany

Objective: The elevated rate of schizophrenia among migrants has been explained in part by possible misdiagnosis. In this study an attempt is made to quantify the extent of potential misdiagnosis among migrants in comparison to non‐migrants. Method: One hundred patients of Turkish origin (Tr‐Pat) and a control group of 50 patients of German origin (G‐Pat), all with a paranoid‐hallucinatory syndrome upon admission, were examined by an interviewer of Turkish origin (Tr‐Int), an interviewer of German origin (G‐Int) and the clinican. The diagnostic evaluation was then compared. Results: Nineteen per cent of Tr‐Pat and 4% of G‐Pat showed diagnostic disagreement between the three raters, while in 8% of Tr‐Pat and 0% of G‐Pat the two research diagnoses disagreed. In Tr‐Pat with ‘bad’ German knowledge showed tendentially more (29%) diagnostic disagreement than Tr‐Pat with ‘good’ German knowledge (17%). Conclusion: The rate of potential misdiagnosis is higher among migrants, yet not strongly correlated to poor second language proficiency.

[1]  J. Selten,et al.  First admission rates for schizophrenia in immigrants to the Netherlands , 1994, Social Psychiatry and Psychiatric Epidemiology.

[2]  M. Lambert,et al.  Impact of ethnicity on the prevalence of psychiatric disorders among migrants in Germany. , 1998, Ethnicity & health.

[3]  E. Cantor-Graae,et al.  Increased rates of schizophrenia among immigrants: some methodological concerns raised by Danish findings , 1997, Psychological Medicine.

[4]  M. Lambert,et al.  Psychiatric disorders among migrants in Germany: prevalence in a psychiatric clinic and implications for services and research , 1997, European Psychiatry.

[5]  J. Mendlewicz,et al.  Immigration and psychopathology: a clinical study , 1995, European Psychiatry.

[6]  G. Lewis,et al.  Are British Psychiatrists Racist? , 1990, British Journal of Psychiatry.

[7]  J. Westermeyer.  Resuming social approaches to psychiatric disorder: a critical contemporary need. , 1988, The Journal of nervous and mental disease.

[8]  A. Rosen,et al.  Misdiagnosis of schizophrenia in bipolar patients: a multiethnic comparison. , 1983, The American journal of psychiatry.

[9]  D. Walsh,et al.  First Admissions of Native-Born and Immigrants to Psychiatric Hospitals in South-East England 1976 , 1981, British Journal of Psychiatry.

[10]  E. Berkanovic.  The effect of inadequate language translation on Hispanics' responses to health surveys. , 1980, American journal of public health.

[11]  F. Kline,et al.  The misunderstood Spanish-speaking patient. , 1980, The American journal of psychiatry.

[12]  M. Kesselman,et al.  The effect of interview language on the evaluation of psychopathology in Spanishh-American schizophrenic patients. , 1973, The American journal of psychiatry.