It is reported that Latin Americans describe culturally normative experiences or express putative psychotic symptoms in medical and mental health treatment settings that complicate the diagnostic process. Previous research reported that Latinos were more likely than European Americans and African Americans to have their diagnoses changed from schizophrenia to other disorders. This study describes the prevalence and likelihood of putative psychotic symptoms being expressed independent of any psychiatric disorder or co-occurring with common disorders such as depression or anxiety within a Mexican American population sample. Epidemiologic data of the Mexican American Prevalence and Services Survey (N = 3012) were used to contrast rates and patterns of putatively psychotic features among adults by demographic variables and diagnostic status using DSM-III-R criteria and receipt of treatment. Putative psychotic symptoms were reported by 17% of US-born and 7% of immigrants without disorders, and by 38% of US-born and 28% of immigrants with lifetime disorders, totaling 18% lifetime prevalence for the entire study population of Mexican Americans. First-rank Schneiderian symptoms were higher in those with a disorder compared with those without a disorder for both sexes. The results of this study indicate that putative psychotic symptoms are common among Mexican Americans, and their presence is a strong precautionary signal for evaluating clinicians to correctly distinguish whether putative psychotic symptoms are indicators of nonorganic psychoses or other psychiatric disorders, or are simply cultural expressions. Research is needed to identify the determinants of misdiagnosis in clinical practice, and guidelines are needed to assist clinicians.
*Behavioral Research and Training Institute, University Behavioral HealthCare, UMDNJ, Piscataway, New Jersey; †Department of Psychiatry, Robert Wood Johnson Medical School, Piscataway, New Jersey; ‡Department of Internal Medicine, School of Medicine, University of California, Davis, Sacramento, California.
Supported by NIDA grant DA12167, W. A. Vega, PI, and University Behavioral HealthCare, UMDNJ.
Send reprint requests to William A. Vega, PhD, Director, Division of Research, Behavioral Research and Training Institute, University Behavioral Health Care, UMDNJ, 151 Centennial Ave., Piscataway, NJ 08854.