To assess the reproducibility of psychiatric diagnoses made in immigration proceedings, the authors examined cases of 109 Cuban refugees who had appealed psychiatric diagnoses that precluded their admission to the United States according to the Immigration and Nationality Act. Medical review boards upheld only 23 (42%) of 55 initial diagnoses of antisocial personality disorder but affirmed exclusionary certifications in 39 (72%) of the 54 other cases. Failure to sustain a high proportion of diagnoses of antisocial personality disorder may reflect interviewer biases, cross-cultural inappropriateness of diagnostic criteria, or other deficiencies in the current system of psychiatric evaluation of potential refugees.

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personality disorder central nervous system antisocial personality disorder legislation refugee public health service psychological aspect human immigration Refugees psychosis priority journal geographic distribution Cuba ethnology Mental Disorders mental disease United States psychopathy Psychotic Disorders clinical article Article United States Public Health Service adult migration ethnic or racial aspects Emigration and Immigration