Table 1 Study characteristics

Mikton C. Grounds A. 2007

Examine cross-cultural clinical judgement bias in the diagnosis of PD in Afro-Caribbean men

Two vignettes of male patients, Afro-Caribbean or white, one suggestive of BPD the other suggestive of ASPD sent to psychiatrists. Participants chose diagnosis from list.

2 vignettes sent to each psychiatrist.

All consultants and specialist registrars in forensic psychiatry in the UK included.

Al-Saffar S. Borga P. Wicks S. Hallstrom T. 2004

Describe the distribution of different ethnic patient groups in Psych OPD and influence of ethnicity, on diagnosis.

Retrospective cohort study using outpatients documentation

Exploration of register for ethnicity and diagnosis

Patients over 18 years of age

Castaneda R. Franco H. 1985

Examine sex and ethnic distribution of BPD in a psychiatric inpatient sample

Retrospective study of 1,583 inpatients discharged in index year using patient notes.

Patients' charts reviewed, primary psychiatric diagnosis and demographics extracted.

Patients with co-existing axis I disorder diagnosis excluded.

Tyrer P. Merson S. Onyett S. Johnson T. 1994

To compare community-based and standard hospital psychiatric services, including PD as an outcome.

RCT of community EIS vs conventional hospital psychiatric services over 14 months for psychiatric emergency patients.

Pt assessed for PD before being randomly assigned to either treatment setting for 12 weeks

Age 16-65. No alcohol/drug dependence. No mandatory care necessary. Not in contact with psych services.

Trestman RL. Ford J. Zhang W. Wiesbrock V. 2007

To estimate percentage of undiagnosed prison inmates who meet diagnostic criteria for psychiatric illness.

Newly admitted patients in 5 prisons assessed for psychiatric illness.

All participants interviewed once for screening. Random sample further interviewed by 5 trained assessors

Excluded: under 18, high bonds, those in security restricted housing, already under medical/mental health care

Maden A. Friendship T. McClintock T. Rutter S. 1999

To test the hypothesis that there are systematic differences in clinical outcome in patients of different ethnic origin.

Longitudinal cohort study of discharges from a medium secure unit (average follow up 6.6 yrs)

Admission & short term data from MDT records. Long term info from all med records, Home Office Register, Prison records, Offenders index, NHS central record, Special Hospitals case register, & semi-structured interviews

All patients discharged from a first admission to The Denis Hill Unit of the Bethlem Royal Hospital from Oct 1980 till Oct 1994

Coid J. Petruckevitch A. Bebbington P. Brugha T. Bhugra D. et al 2002

To estimate population-based rates of imprisonment in different ethnic groups, & compare criminal behaviour & psychiatric morbidity

Examination of home office data on all inmates, and cross-sectional survey of remanded and sentenced prisoners in 1997

Survey comprised lay interviews/self administered, then every 5th participant had follow-up interview by clinician

All prisoners on remand or sentenced in England & Wales in 1997 included.

Coid J. Petruckevitch A. Bebbington P. Brugha T. Bhugra D. et al 2002

To compare early environmental risks, stressful daily living experiences & reported use of psych services in prisoners from diff ethnic grps

Examination of home office data on all inmates, and cross-sectional survey of remanded and sentenced prisoners in 1997

Survey comprised lay interviews/self administered, then every 5th participant had follow-up interview by clinician

All prisoners on remand or sentenced in England & Wales in 1997 included.

Coid J. Kahtan N. Gault S. Jarman B. 2000

To estimate population-based prevalence rates of treated mental disorder in different ethnic groups compulsorily admitted to secure forensic psychiatry services

Retrospective survey of 3155 first admissions from 1988 to 1994 from half of England and Wales with 1991 census data as the denominator adjusted for under-enumeration

Item sheets completed from case notes. Data collected by clinically trained research psychiatrist

Those with no fixed abode excluded

Coid J. Kahtan N. Gault S. Jarman B. 1999

To compare patients with PD and mental illness according to demography, referral, criminality, previous institutionalisation and diagnostic comorbidity

Retrospective survey of all admissions from 1988 to 1994 from 7 (of 14) regional health authority catchment areas in England & Wales

One researcher completed item sheet for every admission. recorded demography, nature of referral, legal status & catchment of origin

All admissions of pts with PD to special hospitals and MSU from a geographically representative area

Bender DS. Skodol AE. Dyck IR. Markowitz JC. Shea MT. et al 2007

To explore whether PD psychopathology raises particular challenges to treatment-seeking ethnic minorities receiving adequate mental health services

2 year prospective study: of patients recently treated or seeking treatment from clinical services. Follow up at 6, 12, 24 months.

Experienced research clinicians determined 1 of 4 PD Δ: Schizotypal (STPD), BPD, Avoidant (AVPD) & Obsessive-compulsive (OCPD) by interview

Treatment-seeking/recently treated pts 18-45. Exclusion: active psychosis, acute substance intoxication/withdrawalhistory of schizophrenia/schizoaffective/schizophreniform disorders

Chavira DA. Grilo CM. Shea T. Yen S. Gunderson JG. et al 2003

Compare the relative proportion of 4 PDs among 3 ethnic grps in a clinical sample & examine whether specific PD criteria accounted for difference in ethnic distribution

Survey/Questionnaire. Patients filled out Personality Screening Questionnaire: If +ve for 1 or more PDs they were referred for further assessment. Also completed Depression Screening Questionnaire: If +ve were referred as potential controls

Patients interviewed by trained & experienced interviewers using DSM-IV & Personality Assessment form. Patients also asked to fill in self-report questions. If DSM-IV supported by any instrument, patients were assigned to PD

Treatment-seeking/recently treated patients, aged 18-45. Exclusion: active psychosis, acute substance intoxication/withdrawal, history of schizophrenia/schizoaffective/schizophreniform disorders

Iwamasa GY. Larrabee AL. Merritt RD. 2000

Assess possible ethnicity criterion bias of DSM-III-R PDs using a lay sample of college undergraduates with no previous education on psychological disorders

Random card-based task with personality characteristics to be sorted by participants' own beliefs not stereotypes.

Participants sorted cards 3 separate times by ethnicity

College students unfamiliar with DSM-III-R excluded

Huang B. Grant BF. Dawson DA. Stinson FS. Chou SP. Et al 2006

Compare the current prevalence & co-occurrence of DSM-IV, alcohol & drug use disorders & mood, anxiety & PDs among whites, blacks, Native Americans, Asians & Hispanics in a large representative sample of the US population

Face-to-face survey of 43093 participants by National Epidemiological Survey on Alcohol and Related Conditions (NESARC).

Interview administered using laptop computer-assisted software. Used professional interviewers from US Bureau

Civilian non-institutionalised respondents aged 18+.

Compton WM. Cottler LB. Abdallah AR. Phelps DL. Spitznagel EL. & Horton JC. 2000

Determine the rates of specific psychiatric disorders among drug dependent persons in treatment and determine whether these rates vary by race (and gender)

Interview-based study of newly admitted patients. Two face-to-face interview sessions 12 months apart.

Subjects randomly selected from lists of newly admitted pts from the data from a longitudinal study of substance abusers 1^st

Substance abusers who were recently admitted to drug treatment facilities in St Louis.