Skip to main content
SpringerLink
Log in

The distribution of psychiatric morbidity in black Americans: A review and suggestions for research

  • Articles
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

Despite extensive research, the epidemiologic literature is confusing and inconclusive in its assessment of how various forms of psychiatric morbidity are distributed within the black population. This article reviews empirical studies comparing rates of psychiatric morbidity between blacks and whites, focusing on findings from two types of epidemiologic research: treatment rate studies and community surveys. Two major conclusions are reached. The first is that no definitive conclusions can be drawn about black mental health status on the basis of treatment rate studies. The second is that community surveys, while methodologically superior to treatment rate studies, still fall short of answering important questions pertaining to black mental health status. It is argued that more epidemiologic research on representative all-black samples, discrete psychiatric disorders, and the validity/reliability of the NIMH's Diagnostic Interview Schedule is needed in order to adequately address issues of black mental health.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Adebimpe, V. Overview: White norms and psychiatric diagnosis of black patients.American Journal of Psychiatry, 1981 138, 279–85.

    Google Scholar 

  • Antunes, G., Gordon, C., Gaitz, C., & Scott J. Ethnicity, socioeconomic status and the etiology of psychological distress.Sociology and Social Research, 1974 58, 361–68.

    Google Scholar 

  • Bell, R., Leroy, J., Lin, E., & Schwab, J. Change and psychopathology: Epidemiologic considerations.Community Mental Health Journal, 1981 17, 203–13.

    Google Scholar 

  • Bloom, B. Prevention of mental disorders: Recent' advances in theory and practice.Community Mental Health Journal, 1979 15, 179–91.

    Google Scholar 

  • Cannon, M., & Locke, B. Being black is detrimental to one's mental health: Myth or reality?Phylon, 1977 38, 408–28.

    Google Scholar 

  • Derogatis, L., Covi, R., Lipman, Davis D. & Rickels, K. Social class and race as mediator variables in neurotic symptomatology.Archives of General Psychiatry, 1971 25, 31–40.

    Google Scholar 

  • Dohrenwend, B. P. Sociocultural and social psychological factors in the genesis of mental disorders.Journal of Health and Social Behavior, 1975 16, 365–92.

    Google Scholar 

  • Dohrenwend, B. P., & Crandell, D. Psychiatric symptoms in communitv, clinic and mental hospital groups.American Journal of Psychiatry 1970 126, 1611–21.

    Google Scholar 

  • Dohrenwend, B. P., & Dohrenwend, B. S.,Social Status and Psychological Disorder: A Causal Inquiry Wiley-Interscience, New York, 1969.

    Google Scholar 

  • Dohrenwend, B. P., & Dohrenwend, B. S. Social and cultural influences on psvchopathology.Annual Review of Psychology, 1974 25, 417–52.

    Google Scholar 

  • Dohrenwend, B. P., levan, I. & Shrout, P. Screening scales from the psychiatric epidemiology research interview (PERI). In J. Myers & M. Weissman (Eds.),Epidemiologic Community Surveys., Neale Watson Academic Publications. New York, 1980.

    Google Scholar 

  • Eaton, W. Demographic and social-ecological risk factors for mental disorder. In D. Regier & G. Allen (Eds.).Risk Factor Research in the Major Mental Disorders. National Institute of Mental Health. DHHS# (ADM) 81-1068. Washington, D.C., U.S. Government Printing Office, 1981.

    Google Scholar 

  • Eaton, W., & Kessler, L. Rates of symptoms of depression in a national sample.American Journal of Epidemiology, 1981 114, 528–38.

    Google Scholar 

  • Eaton, W., Regier, D., Locke, B., & Taube, C.The NIMH Catchment Area Program. National Institute of Mental Health, Division of Biometry and Epidemiology, Washington, D.C., 1980.

    Google Scholar 

  • Faris, R., & Dunham, H. W.Mental Disorders in Urban Areas. Chicago. University of Chicago Press, 1939.

    Google Scholar 

  • Fischer, J. Negroes and whites and rates of mental illness: Reconsideration of a myth.Psychiatry, 1969 32, 428–46.

    Google Scholar 

  • Frerichs, R., Aneshensel, C., & Clark, V. Prevalence of depression in Los Angeles County.,American Journal of Epidemiology, 1981 113, 691–99.

    Google Scholar 

  • Fried, M. Social differences in mental health. In J. Kosa & I. Zola (Eds.),Poverty and Health (2nd ed.), Cambridge, MA, Harvard University Press, 1975.

    Google Scholar 

  • Frumkin, R. Race and major mental disorder,Journal of Negro Education, 1954 23, 97–98.

    Google Scholar 

  • Garrity, T., Marx, M., & Somes, G. Langner's 22 item measure of psychophysiological strain as an intervening variable between life change and health outcome.Journal of Psychosomatic Research, 1977 21, 195–99.

    Google Scholar 

  • Gross, H., Herbertt M., Knatterud, G., & Donner, L. The effect of race and sex on the variation of diagnosis and disposition in a psychiatric emergency room.Journal of Nervous and Mental Disease. 1969 148, 638–42.

    Google Scholar 

  • Gurin, G., Veroff, J., & Feld, S.Americans View Their Mental Health. New York, Basic Books, Inc. 1960.

    Google Scholar 

  • Health Resources Administration.Health of the disadvantaged. DHHS Pub. No. (HRA) 80-633. Public Health Service. Washington D.C. U.S.A Government Printing Office, 1980.

    Google Scholar 

  • Helzer, J. Bipolar affective disorder in black and white men.Archives of General Psychiatry, 1975 32, 1140–43.

    Google Scholar 

  • Hendricks, L., Bayton, J., Collins, J., Mathura, C., McMillan, S., & Montgomery, T. NIMH's Diagnostic Interview Schedule: A test of its concurrent validity in a population of black adults.Journal of the National Medical Association, 1983 75, 667–71.

    Google Scholar 

  • Ilfeld, F. Psychological status of community residents along major demographic dimensions.Archives of General Psychiatry, 1978 35, 716–24.

    Google Scholar 

  • Jackson, J., & Neighbors, H.Sociodemographics and Psychological Distress: A National Study., Paper presented at the 135th meeting of the American Psychiatric Association Toronto Canada. May 1982.

  • Jaco, E. G.The Social Epidemiology of Mental Disorders: A Psychiatric Survey of Texas. Russell Sage Foundation, New York, 1960.

    Google Scholar 

  • Jones, B., Robinson, W., Parson, E., & Gray, B. The clinical picture of mania in manic-depressive black patients.Journal of the National medical Association, 1982 74, 553–57.

    Google Scholar 

  • Katz, M., Cole, J., & Lowery, H. Studies of the diagnostic process: The influence of symptom perception past experience, and ethnic background on diagnostic decisions.American Journal of Psychiatry, 1969 125, 937–47.

    Google Scholar 

  • Kessler, R. Stress, social status, and psychological distress.Journal of Health and Social Behavior, 1979 20, 259–72.

    Google Scholar 

  • Kessler, R., & Neighbors, H.Special Issues Related to Racial and Ethnic Minorities in the U.S. (A position paper submitted to NIMH). Institute for Social Research. University of Michigan Ann Arbor. MI, 1983.

    Google Scholar 

  • Klee, G., Spiro E., Bahn, A., & Gorwitz, K. An ecological analysis of diagnosed mental illness in Baltimore. In R. R. Monroe, et al. (Eds.),Psychiatric Epidemiology and Mental Health Planning. Washington, D.C., American Psychiatric Association, 1967.

    Google Scholar 

  • Kramer, M., Rosen, B., & Willis, E. Definitions and distributions of mental disorders in a racist society. In C. Willie, B. Kramer, & B. Brown (Eds.),Racism and Mental Health, University of Pittsburgh Press. Pittsburgh, PA, 1973.

    Google Scholar 

  • Leighton, D., Harding, J., Macklen, D., macMillan, A., & Leighton, A.The Character of Danger: Psychiatric Symptoms in Selected Communities Basic Books, Inc., New York, 1963.

    Google Scholar 

  • McLean, H. The emotional health of Negroes.Journal ofNegro Education., 1949 18, 283–90.

    Google Scholar 

  • Malzberg, B. Mental disease among Negroes in New York state, 1939–41.Mental Hygiene, 1953 37, 450–76.

    Google Scholar 

  • Malzberg, B. Mental disease among Negroes.Mental Hygiene, 1959 43, 457–59.

    Google Scholar 

  • Meile, R. The 22-item index of psychophysiological disorder: Psychological or organic symptoms.Social Science and Medicine, 1972 6, 125–35.

    Google Scholar 

  • Mirowsky, J., & Ross, C. Minority status, ethnic culture, and distress: A comparison of blacks, whites, Mexicans, and Mexican Americans.American Journal of Sociology 1980 86, 479–95.

    Google Scholar 

  • Mollica, R., Blum, J., & Redlich, F. Equity and the psychiatric care of the black patient, 1950 to 1975.Journal of Nervous and Mental Disease, 1980 168, 279–86.

    Google Scholar 

  • National Center for Health Statistics.Health, United States. 1979, DHHS Pub. No. (PHS) 80-1232. Public Health Service. U.S. Government Printing Office. Washington. D.C., 1980.

    Google Scholar 

  • Neff. A. Race differences in psychological distress: The effect of SES, urbanicity and measurement strategy.American Journal, of Community Psychology (in press).

  • Neff, J., & Husaini, B. Race, socio-economic status and psychiatric impairment: A research note.Journal of Community Psychology, 1980 8, 16–19.

    Google Scholar 

  • Neighbors. H. Professional help use among black Americans: Implications for unment need.American Journal of Community Psychology (in press).

  • Neighbors. H., & Jackson. J.Coping with Economic Problems: The National Survey of Black Americans. Paper presented at the Association of Black Psychologists. Cincinnati. OH. August, 1982.

  • Neighbors, H., Jackson J. Bowman, P., & Gurin, G. Stress coping and black mental health: Preliminary findings from a national study.Prevention in Human Services, 1983 2, 4–29.

    Google Scholar 

  • Pasamanick, B. Some misconceptions concerning differences in the racial prevalence of mental disease.American Journal of Orthopsychiatry, 1963 33, 72–86.

    Google Scholar 

  • Plunkett, R., & Gordon, J.:Epidemiology and Mental Illness. Basic Books. Inc., New York, 1960.

    Google Scholar 

  • Price, R.Michigan Prevention Intervention Center. Unpublished manuscript. University of Michigan. Institute for Social Research. Ann Arbor, MI.

  • Raskin, A., Crook, T., & Herman, K. Psychiatric history and symptom differences in black and white depressed inpatients.Journal of Consulting and Clinical Psychology, 1975 43, 73–80.

    Google Scholar 

  • Roberts, R., Stevenson, J., & Breslow L.. Symptoms of depression among blacks and whites in an urban community.Journal of Nervous and Mental Disease 1981 169, 774–79.

    Google Scholar 

  • Robins, L. The development and characteristics of the NIMH Diagnostic Interview, Schedule. In M. Weissman & J. Myers (Eds.),Epidemiologic Community Surveys. Prodist Neale Watson Academic Press, New York (in press).

  • Robins, L., Helzer, J., Crougham, J., & Ratcliff, K. National Institute of Mental Health diagnostic interview schedule: Its history, characteristics and validity.Archives of General Psychiatry, 1981 38, 381–89.

    Google Scholar 

  • Ruiz, D. Epidemiology of schizophrenia.Phylon 1982 43, 315–26.

    Google Scholar 

  • Schermerhorn, R. A. Psychiatric disorders among Negroes: A sociological note.American Journal of Psychiatry, 1956 112 878–82.

    Google Scholar 

  • Scott, J. & Gaitz, C. Ethnic and age differences in mental health measurements.Diseases of the Nervous System, 1975 36, 389–93.

    Google Scholar 

  • Seiler, L. H. The 22-item scale used in field studies of mental illness.Journal of Health and Social Behavior 1973 14, 252–64.

    Google Scholar 

  • Seiler, L., & Summers, G. Toward an interpretation of items used in field studieds of mental illness.Social Science and Medicine. 1974 8, 459–67.

    Google Scholar 

  • Simon, R., Fleiss, J., Gurland, B., Stiller, P., & Sharpe, L. Depression and schizophrenia in hospitalized black and white mental patients.Archives of General Psychiatry 1973 28, 509–12.

    Google Scholar 

  • Srole, L., & Fischer, A. The midtown Manhattan longitudinal study vs. the “mental paradise lost” doctrine: A controversy joined.Archives of General Psychiatry, 1980 37, 209–21.

    Google Scholar 

  • Srole, L., Langner T., Michael, S., Opler, M., & Rennie, T.,Mental Health in the Metropolis: The Midtown Manhattan Study (Vol. 1). McGraw-Hill, New York. 1962.

    Google Scholar 

  • Thomas, A., & Sillen, S. The pitfalls of epidemiology. In A. Thomas & S. Sillen (Eds.),Racism and Psychiatry. Bruner/Mazel, New York, 1972.

    Google Scholar 

  • Tonks, C., Paykel, E., & Klerman, G. Clinical depression among Negroes.American Journal of Psychiatry. 1970 127, 329–35.

    Google Scholar 

  • Vernon, S., & Roberts, R. Measuring nonspecific psychological distress and other dimensions of psychopathology.Archives of General Psychiatry, 1981 38, 1239–47.

    Google Scholar 

  • Veroff, J., Douvan, E. & Kulka, R.The Inner American: A Self-portrait from 1957–1976, Basic Books. Inc., New York, 1981.

    Google Scholar 

  • Warheit, G., Holzer, C., & Arey, S. Race and mental illness: An epidemiological update.Journal of Health and Social Behavior, 1975 16, 243–56.

    Google Scholar 

  • Warheit, G., Holzer, C., & Schwab, J. An analysis of social class and racial differences in depressive symptomatology.Journal of Health and Social Behavior, 1973 14, 291–99.

    Google Scholar 

  • Weissman, M., & Klerman, G. Epidemiology of mental disorders: Emerging trends in the United States.Archives of General Psychiatry 1978 35, 705–12.

    Google Scholar 

  • Weissman, M., & Klerman, G. Psychiatric nosology and midtown Manhattan study.Archives of General Psychiatry, 1980 37, 229–30.

    Google Scholar 

  • Weissman, M., & Myers, J. Rates and risks of depressive symptoms in a United States urban community,Arta Psychiatrica Scandinavica, 1978 57, 219–31.

    Google Scholar 

  • Wilson, D., & Lantz, E. The effect of culture change on the Negro race in Virginia as indicated by a study of state hospital adminissions.American Journal of Psychiatry, 1957 114, 25–32.

    Google Scholar 

  • Yancey, W., Rigsby, L., & McCarthy, J. Social position and self-evaluation. The relative importance of race.American Journal of Sociology, 1972 78, 338–59.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Program for Research on Black Americans, Institute for Social Research, Room 5213, 48106, Ann Arbor, MI

    Harold W. Neighbors

Authors
  1. Harold W. Neighbors
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Work for this paper was supported by a grant from The National Institute for Mental Health (Minority Center and The Center for Prevention. Research). The author appreciates the comments of Linda Chatters, James Jackson, Andrea Leibson, and Rupert Nacoste on earlier drafts of this paper. Special thanks go to Jackie Pearlman and Beverly Williams for their help in the preparation of this manuscript.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Neighbors, H.W. The distribution of psychiatric morbidity in black Americans: A review and suggestions for research. Community Ment Health J 20, 169–181 (1984). https://doi.org/10.1007/BF00808105

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00808105

Keywords

Search

Navigation