Open AccessSymptoms of depression and psychological distress among hispanics with rheumatoid arthritis
Author(s) -
Escalante Agustín,
del Rincón Inmaculada,
Mulrow Cynthia D.
Publication year - 2000
Publication title -
arthritis care & research
Language(s) - English
Resource type - Journals
eISSN - 1529-0131
pISSN - 0004-3591
DOI - 10.1002/1529-0131(200006)13:3<156::aid-anr5>3.0.co;2-0
Subject(s) - medicine , psychosocial , depression (economics) , odds ratio , mental health , center for epidemiologic studies depression scale , confidence interval , rheumatoid arthritis , cohort , acculturation , demography , physical therapy , psychiatry , ethnic group , anxiety , depressive symptoms , sociology , anthropology , economics , macroeconomics
Abstract Objective To explore the roles played by Hispanic ethnic background andacculturation to the mainstream English language culture of the UnitedStates in the depressive symptoms and mental health of rheumatoidarthritis (RA) patients. Methods Members of a consecutive cohort of patients with RA were studiedcross‐sectionally. All underwent a comprehensive clinical andpsychosocial evaluation. Depressive symptoms were measured with theCenter for Epidemiologic Studies Depression Scale (CES‐D), andpsychological distress was measured with the Medical Outcomes StudyShort Form 36 (SF‐36) mental health scale. Results Two hundred thirty‐six patients were studied. Women had significantlyhigher median CES‐D scores than men (19 versus 14, P = 0.0004),Hispanics scored higher than non‐Hispanics (14 versus 8, P = 0.0002),and foreign‐born scored higher than US‐born patients (14 versus 10, P =0.009). Compared with those who were fully acculturated, patients whowere partially acculturated were more likely to have a score ≥ 16on the RA‐adjusted CES‐D (odds ratio [OR] = 1.79, 95% confidenceinterval [95% CI] 1.37 to 2.35, P ≤ 0.001). Among unacculturatedpatients, the likelihood of a score ≥ 16 increased 6‐fold(OR = 6.68; 95% CI 3.50 to 12.72; P ≤ 0.001). A similar, inversepattern was observed for the SF‐36 mental health scale. In multivariatemodels accounting for age, sex, education, income, articular pain,deformity, and the level of disability, low acculturation wasindependently associated with high depressive symptoms, and a Hispanicbackground was independently associated with lower SF‐36 mental health. Conclusions In this consecutive series of RA patients, Hispanics, particularlythose who are not fully acculturated to the mainstream Anglo society,had more depressive symptoms and psychological distress than didnon‐Hispanics.