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Changing Psychiatric Perception of African-Americans With Affective Disorders

Jarvis, G. Eric MD

The Journal of Nervous and Mental Disease: December 2012 - Volume 200 - Issue 12 - p 1031–1040
doi: 10.1097/NMD.0b013e318275cf43
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This article explored the origins and implications of the underdiagnosis of affective disorders in African-Americans. MEDLINE and old collections were searched using relevant key words. Reference lists from the articles that were gathered from this procedure were reviewed. The historical record indicated that the psychiatric perception of African-Americans with affective disorders changed significantly during the last 200 years. In the antebellum period, the mental disorders of slaves mostly went unnoticed. By the early 20th century, African-Americans were reported to have high rates of manic-depressive disorder compared with whites. By the mid-century, rates of manic-depressive disorder in African-Americans plummeted, whereas depression remained virtually nonexistent. In recent decades, diagnosed depression and bipolar disorder, whether in clinical or research settings, were inexplicably low in African-Americans compared with whites. Given these findings, American psychiatry needs to appraise the deep-seated effects of historical stereotypes on the diagnosis and treatment of African-Americans.

Culture and Mental Health Research Unit, Jewish General Hospital & McGill University, Montreal, Canada.

Send reprint requests to G. Eric Jarvis, MD, Culture and Mental Health Research Unit, Jewish General Hospital & McGill University, 4333 Côte Sainte Catherine Rd, Montreal, Quebec, Canada, H3T1E4. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.