Differences in the diagnosis and treatment of immigrant and local psychiatric inpatients admitted to a general hospital in Spain: a controlled study

Abstract

Aim. This study has aimed to assess whether there are differences between immigrant and local psychiatric inpatients admitted to a general hospital in Spain in relation to diagnostic or treatment management.

Methods. We carried out a cohort study, with a sample of N=102 immigrant patients and N=102 local patients, matched by gender, age and diagnosis, admitted to the psychiatric ward of Hospital Universitario Miguel Servet, Zaragoza, Spain.

Results. Mean hospital stay was significantly shorter for immigrants (8.1 days) compared to local population (12.6 days). Use of security services (Odds ratio, OR= 5.13) and mechanical restraint (OR= 2.68) was greater for immigrants. Regression analyses for these three variables confirm that maximum explained variance is due to the “time in Spain” variable. After a period of 3 years in Spain, immigrants tended to receive diagnosis and treatment differing little from that offered to locals. Immigrants are offered fewer complex complementary tests such as EEG, CT scan or MRI. With regard to treatment, immigrants are administered more depot neuroleptics (OR= 4.7), but less clozapine or electroconvulsive therapy.

Discussion. These data seem to confirm that there is racial bias in health care professionals, similar to that found in other countries. Data are discussed in the light of related bibliography.