Studies have reported discrepant findings about the relationship between acculturation and mental health, often because of inattention to interethnic group differences. This 2003 exploratory study of various Latina ethnic groups attending the Women, Infant, and Children (WIC) Program compared five measures of acculturation and mental health status/utilization. The subgroups differed on language, immigration/migration history, and the prevalence of anxiety attacks and depressive syndrome. The prevalence of anxiety attacks was the highest among those who spoke primarily Spanish, the prevalence of the depressive syndrome was the highest among those with more traditional beliefs, and the use of mental health services was the highest among those with less traditional beliefs. Implications for practice are discussed.
Youths are using emergency departments (EDs) for behavioral health services in record numbers, even though EDs are suboptimal settings for service delivery. In this article, the authors evaluated a mobile crisis service intervention implemented in Connecticut with the aim of examining whether the intervention was associated with reduced behavioral health ED use among those in need of services.
The objective of this study is to test the hypotheses that bipolar disorders or depressive disorders, minority status, and the presence of pediatric inpatient psychiatric unit will be individual predictors of pediatric psychiatric inpatient admission, and to provide a model that will evaluate which individual and organizational characteristics predict pediatric psychiatric inpatient. For this purpose, a secondary analysis of the medical records of 1,520 pediatric patient visits between January 1, 2008 and June 30, 2008, was conducted using univariate and multivariate logistic regression. Independent predictors of pediatric psychiatric inpatient admission were presence of bipolar and depressive disorders, greater average daily census, and increasing operating margin. Minority status was a significant predictor of not being admitted, as was presence of an anxiety disorder, greater total margin and older age. The results indicate that both individual and organizational factors impact disposition outcomes in particular subsets of pediatric patients who present to emergency departments for psychiatric reasons.
Postpartum depression is a treatable but crippling mood disorder that can adversely affect new mothers and their children. This secondary analysis compared the ability of the Postpartum Depression Screening Scale (PDSS) and the Patient Health Questionnaire-9 (PHQ-9) to assess depressive symptoms in 80 low-income ethnically diverse mothers. The PDSS specifically measures postpartum depressive symptoms, while the PHQ-9 assesses general depressive symptoms. The data from both instruments had high internal consistency reliability (.97 for the PDSS and .88 for the PHQ-9); overall concordance was 58%. Most of the discordance occurred when the PHQ-9 scores were in the normal or mild depression range, whereas the PDSS scores ranged from minor depression to positive screen for postpartum depression. The need for future research is discussed highlighting the use of a gold standard of a diagnostic interview for major depression so that sensitivity and specificity of the scales can be determined.
This 1999 pilot study of 127 ethnically diverse mothers in the Women, Infants and Children (WIC) Program addressed mental health symptomatology using the PrimeMD tool and mental health care utilization. Prevalence of anxiety symptoms differed by presence of support and self-perceived health status. Prevalence of depressive symptoms differed by age. Mental health care utilization differed by ethnicity, age and presence of support. The ethnically diverse sample allowed investigation of the appropriateness of broad ethnic/racial categories. Differences between English and Spanish-speaking Puerto Ricans would have been obscured if analyses had been limited to broad ethnic/racial groupings.
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