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Diagnosis, treatment of depression among elderly depend on racial, cultural factors
Date:12/20/2011

ences regarding health care quality and access for treatment of depression?" Akincigil asked. "If African Americans prefer psychotherapy over drugs, then accessing therapists for treatment in poorer neighborhoods is a lot more difficult than it is for whites, who generally have higher incomes and live in neighborhoods more likely for therapists and doctors to be located.

"Whites use more antidepressants than African Americans. We presume they have better access to doctors and pharmacies, and more money to spend on drugs."

The investigation focused on whether there are racial/ethnic differences in the rate of diagnosis of depression among the elderly, controlling for sociodemographic characteristics and depression symptoms (depressed mood, anhedonia) reported on a two-item screener, and also in treatment provided to those diagnosed with depression by a health care provider. Akincigil said there is evidence that help-seeking patterns differ by race/ethnicity, contributing to the gap in depression diagnosis rates. Stigma, patient attitudes and knowledge also may vary by race and ethnicity.

"African Americans might turn to their pastors or lay counselors in the absence of psychotherapists," she said. "Low-income African Americans who were engaged in psychotherapy reported that stigma, dysfunctional coping behavior, shame and denial could be reasons some African Americans do not seek professional help."

The nature of the patient-physician relationship also might contribute to disparities in depression diagnosis rates. "African Americans reported greater distrust of physicians and poorer patient-physician communication than do white patients," Akincigil explained. "Communication difficulties may contribute to lower rates of clinical detection of depression because the diagnosis of depression depends to a considerable degree on communication of subjective distress."

The researchers also noted that racial and ethnic differences
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Contact: Steve Manas
smanas@ur.rutgers.edu
732-932-7084 x612
Rutgers University
Source:Eurekalert

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