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Articles   |    
Racial and Ethnic Differences in the Prevalence of Psychotic Symptoms in the General Population
Carl I. Cohen, M.D.; Leslie Marino, M.D., M.P.H.
Psychiatric Services 2013; doi: 10.1176/appi.ps.201200348
View Author and Article Information

Dr. Cohen is with the Department of Psychiatry, SUNY Downstate Medical Center, Box 1203, 450 Clarkson Ave., Brooklyn, NY 11203 (e-mail: carl.cohen@downstate.edu). Dr. Marino is with the Department of Psychiatry, Columbia University, New York City.

Copyright © 2013 by the American Psychiatric Association

Abstract

Objective  This study determined the prevalence of psychotic symptoms among racial-ethnic groups in a representative sample of American adults and explored the relationship of these symptoms with race-ethnicity, psychological distress, and dysfunction.

Methods  Data from the Collaborative Psychiatric Epidemiology Surveys were used, which combines three nationally representative surveys: the National Comorbidity Survey Replication, National Survey of American Life, and National Latino and Asian American Study. The sample comprised 16,423 respondents, and the analysis adjusted for design effects.

Results  The adjusted lifetime and 12-month prevalence rates of psychotic symptoms were 11.6% and 1.4%, respectively. Latinos and blacks had higher lifetime rates (13.6% and 15.3%, respectively) than whites (9.7%) and Asians (9.6%). In logistic regression analysis, lifetime reports of psychotic symptoms were associated with Latino ethnicity, a lifetime diagnosis of a substance use disorder or posttraumatic stress disorder, lifetime psychological distress, and current dysfunction (limitations in daily activities). Prevalence rates of psychotic symptoms among respondents with and without lifetime distress, respectively, were as follows: Asian, 5.4% and 6.4%; Latino, 19.9% and 8.2%; black, 21.1% and 9.9%; and white, 13.1% and 5.1%.

Conclusions  Race-ethnicity was differentially associated with psychotic symptoms, with Latinos reporting more lifetime symptoms than other groups after the analysis controlled for other factors. Little evidence was found that psychotic symptoms are “idioms of distress”; respondents who reported lifetime psychotic symptoms were prone to a higher lifetime prevalence of distress, and this association was not specific to any racial-ethnic group. Although psychotic symptoms are often transient, their presence appears to signal a propensity to experience distress.

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Table 1Characteristics of respondents (N=16,423) in the Collaborative Psychiatric Epidemiology Surveys, by percentage reporting psychotic symptomsa
Table Footer Note

a Data were adjusted for weighting and design effects.

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Table 2Psychological characteristics of respondents (N=16,423) in the Collaborative Psychiatric Epidemiology Surveys, by percentage reporting psychotic symptomsa
Table Footer Note

a Data were adjusted for weighting and design effects.

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Table 3Logistic regression analysis of characteristics associated with 12-month and lifetime prevalence of psychotic symptoms among respondents in the Collaborative Psychiatric Epidemiology Surveysa
Table Footer Note

a Data were adjusted for weighting and design effects.

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