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Falling through the cracks: gaps in depression treatment among older Mexican‐origin and white men
Author(s) -
Hinton Ladson,
ApesoaVarano Ester Carolina,
González Hector M.,
AguilarGaxiola Sergio,
DwightJohnson Megan,
Barker Judith C.,
Tran Cindy,
Zuniga Ramiro,
Unützer Jürgen
Publication year - 2012
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.3779
Subject(s) - depression (economics) , medicine , ethnic group , psychiatry , observational study , referral , cross sectional study , mental health , demography , family medicine , pathology , sociology , anthropology , economics , macroeconomics
Objectives This study aims (i) to compare depression frequency and self‐reported depression treatment in Mexican‐origin and white men; (ii) to examine ethnic differences in self‐reported prior depression diagnosis and types of treatment; and (iii) to determine whether Mexican‐origin men (both English and Spanish language preferring) are less likely than white men to report receiving depression treatment after controlling for potential confounders. Methods This is a cross‐sectional, observational study of Mexican‐origin and white men (60 years old and over) presenting for primary care visits at six outpatient clinics in California's Central Valley. Clinical depression was assessed with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM‐IV), module for past‐year major depression and questions for chronic depression. Past year, self‐reported prior depression diagnosis and treatment (i.e., medication, psychotherapy, mental health referral) were assessed through a structured questionnaire. Results The frequency of past‐year clinical depression was similar for both ethnic groups, yet Mexican‐origin men were significantly less likely than whites to report receiving a prior diagnosis of depression or prior depression treatment. Compared with whites, the odds of untreated depression in Mexican‐origin men was 4.35 (95% CI 1.35–14.08) for those interviewed in English and 10.40 (95% CI 2.11–51.25) for those interviewed in Spanish. For both ethnic groups, the majority (i.e., approximately two‐thirds) of men receiving depression treatment also met criteria for past‐year clinical depression. Conclusions Mexican‐origin older men in primary care suffer from significant gaps in depression care (i.e., diagnosis and treatment) compared with whites. Delivering effective depression treatment (i.e., so that depression remits) remains elusive for both ethnic groups. Copyright © 2012 John Wiley & Sons, Ltd.