Clinically Identified Postpartum Depression in Asian American Mothers

Abstract

Objective To identify the clinical diagnosis rate of postpartum depression (PPD) in Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese) compared to non-Hispanic Whites. Design Cross-sectional study using electronic health records (EHR). Setting A large, outpatient, multiservice clinic in Northern California. Participants A diverse clinical population of non-Hispanic White (N = 4582), Asian Indian (N = 1264), Chinese (N = 1160), Filipino (N = 347), Japanese (N = 124), Korean (N = 183), and Vietnamese (N = 147) mothers. Methods Cases of PPD were identified from EHRs using physician diagnosis codes, medication usage, and age standardized for comparison. The relationship between PPD and other demographic variables (race/ethnicity, maternal age, delivery type, marital status, and infant gender) were examined in a multivariate logistic regression model. Results The PPD diagnosis rate for all Asian American mothers in aggregate was significantly lower than the diagnosis rate in non-Hispanic White mothers. Moreover, of the six Asian American subgroups, PPD diagnosis rates for Asian Indian, Chinese, and Filipino mothers were significantly lower than non-Hispanic White mothers. In multivariate analyses, race/ethnicity, age, and cesarean were significant predictors of PPD. Conclusion In this insured population, PPD diagnosis rates were lower among Asian Americans, with variability in rates across the individual Asian American subgroups. It is unclear whether these lower rates are due to underreporting, underdiagnosis, or underutilization of mental health care in this setting.

Cross-Cultural Approach of Postpartum Depression: Manifestation, Practices Applied, Risk Factors and Therapeutic Interventions

“…In the specific cultural groups of the U.S, the reported prevalence vary within 4.6-10.7 % in Asian-American [106,107], 6.4-16.7 % in Hispanic [107,108], 3.7-20.7 % in African-American and 2.6-14.8 % in Caucasian [107][108][109].…”

“…In U.S. despite increased awareness about the disease, Asian American women, even though have access to health systems through work, few of them will seek and receive help for their problem. In this way they utilize inefficiently their ability to use mental health services, thus contributing to underdiagnoses and underreporting of the prevalence of PPD among them [106]. The same elements have been found for African Americans, whose fear of stigma, lack of confidence and the negative attitudes about the psychiatric health services and the interventions which they provide, prevents them from seeking help from specialists [111].…”

“…Even though a study reports greater prevalence of the disease among Asian-American women compared with women from other ethnic groups [107], an other study revealed very low prevalence among them (about 4.6 %) [106]. This rate of prevalence is considerably lower compared with the relevant one in the native countries of these women and it has been attributed to the specific negative beliefs of these cultures concerning mental illness.…”

Postpartum Depression Among Asian Indian Mothers

“…Two studies to date have evaluated PPD rates among AI women living in the United States (Goyal et al, 2006;Goyal, Wang, Shen, Wong, & Palaniappan, 2012). Goyal et al (2006) conducted a quantitative, cross-sectional study including a convenience sample of 58 married AI mothers and noted 52% (n = 30) scored above the cutoff for depressive symptoms using the 35-item Postpartum Depression Screening Scale (PDSS) (Beck & Gable, 2001).…”

“…In a retrospective review of 7,952 electronic health records, Goyal et al (2012) identifi ed race-ethnic differences in clinical diagnosis rates of PPD. Findings indicated AI (n = 1264, 16%) mothers were less likely to be diagnosed with PPD compared with non-Hispanic White mothers (p < 0.001).…”