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Black Heart Patients Treated Less for Depression

Only half as likely as white patients to receive therapy, study finds

WEDNESDAY, Oct. 29 (HealthDay News) -- Black patients with heart disease are only half as likely as white patients to receive treatment for depression, says a Duke University Medical Center study.

"This is an important finding because we know that depression is associated with a 2- to 4-fold increase in the risk of complications and death from heart disease. Under-treatment of depression is a serious clinical issue," study co-author and psychologist James Blumenthal said in a Duke news release.

The study of 727 white and 137 black patients with heart disease found that 35 percent of black patients and 27 percent of white patients had elevated symptoms of depression. About 21 percent of the white patients were receiving treatment for depression, compared with 11.7 percent of the black patients.

The researchers also noted important gender differences. Among patients with the most severe symptoms of depression, 43 percent of white men were taking antidepressants, compared with 22 percent of black men. In comparison, 67 percent of black women and 64 percent of white women were taking antidepressants.

The study was published online in the American Heart Journal.

"These findings suggest that depression in heart disease is under-treated, and it appears that black men are suffering the most," study author and cardiologist Dr. Silvina Waldman said in the news release. "It is sobering to realize that large numbers of patients are missing out on important and readily available therapeutic options."

The disparity in treatment rates may be due to a number of factors, Blumenthal said. He noted that some doctors may not be adept at recognizing depression in minority patients and some patients may not feel comfortable talking about depressive symptoms with their doctor. Insurance coverage and patients' ability to pay out-of-pocket expenses may also play a role.

"We clearly need to do a better job of recognizing and treating depression, especially in heart patients," Blumenthal said. "We need treatments that work, treatments that are acceptable to patients, and treatments that are actually incorporated into medical practice."

More information

Mental Health America has more about illness and depression.

-- Robert Preidt

SOURCE: Duke University Medical Center, news release, Oct. 22, 2008

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