Diagnostic, symptom, and functional assessments of Hispanic outpatients in community mental health practice.

With increased US Hispanic diversity come diagnostic challenges associated with culture, language, and expression of mental disorders. In a community-based clinic, we compared diagnostic agreement between Hispanic and non-Hispanic clinicians, and a structured diagnostic instrument, in live and videotaped interviews with Hispanic adults. Percentage agreement and kappas show low diagnostic reliability between clinicians, and between clinicians and instrument. Significant differences appeared in rates of various diagnoses. Non-Hispanic clinicians rated patients' functional capacity and symptom-severity as significantly worse than Hispanic clinicians. Findings match past research with Hispanic patients and raise questions about diagnostic reliability in multi-cultural community mental health practice.