The Acceptability of Treatment for Depression Among African-American, Hispanic, and White Primary Care Patients

Cooper, Lisa A.; Gonzales, Junius; Gallo, Joseph J.; Rost, Kathryn; Meredith, Lisa S.; Rubenstein, Lisa V.; Wang, Nae Yuh; Ford, Daniel E.

doi:10.1097/01.mlr.0000053228.58042.e4

Cited by 507 publications

(368 citation statements)

References 38 publications

Supporting

Mentioning

340

Contrasting

Unclassified

Order By: Relevance

“…Thus, the disparity in response to medication seen in African-Americans may therefore be due to cultural rather than biological or socioeconomic factors. Our observation that a significant number of African-American patients reported missing a dose of medication during the 6-week study period is consistent with other studies suggesting that African Americans may be less likely to accept antidepressant medication treatment (Cooper et al, 2003).…”

Section: Discussionsupporting

confidence: 91%

Predicting 6‐week treatment response to escitalopram pharmacotherapy in late‐life major depressive disorder

Saghafi

Brown

Butters

et al. 2007

Int J Geriat Psychiatry

View full text Add to dashboard Cite

SUMMARYObjective-Approximately half of older patients treated for major depressive disorder (MDD) do not achieve symptomatic remission and functional recovery with first-line pharmacotherapy. This study aims to characterize sociodemographic, clinical, and neuropsychologic correlates of full, partial, and non-response to escitalopram monotherapy of unipolar MDD in later life.Methods-One hundred and seventy-five patients aged 60 and older were assessed at baseline on demographic variables, depression severity, hopelessness, anxiety, cognitive functioning, coexisting medical illness burden, social support, and quality of life (disability). Subjects received 10 mg/d of open-label escitalopram and were divided into full (n =55; 31%), partial (n =75; 42.9%), and non-responder (n =45; 25.7%) groups based on Hamilton depression scores at week 6. Univariate followed by multivariate analyses tested for differences between the three groups.Results-Non-responders to treatment were found to be more severely depressed and anxious at baseline than both full and partial responders, more disabled, and with lower self-esteem than full responders. In general partial responders resembled full responders more than they resembled nonresponders. In multivariate models, more severe anxiety symptoms (both psychological and somatic) and lower self-esteem predicted worse response status at 6 weeks.Conclusion-Among treatment-seeking elderly persons with MDD, higher anxiety symptoms and lower self-esteem predict poorer response after six weeks of escitalopram treatment.

show abstract

Section: Discussionsupporting

confidence: 91%

Predicting 6‐week treatment response to escitalopram pharmacotherapy in late‐life major depressive disorder

Saghafi

Brown

Butters

et al. 2007

Int J Geriat Psychiatry

View full text Add to dashboard Cite

show abstract

“…In this study, we found significant associations with current use of antidepressants and with history of any treatment. A potential explanation is that concerns about stigma are greater in regard to antidepressant usage than psychotherapy, which seems supported by research on treatment preference (17,28). Overall, the SCMHC performed reasonably well, with the exception of its lack of relationship to wave 4 outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Understanding how stigma affects Latinos and persons from other U.S. racial-ethnic minority groups is a priority for reducing disparities in care (14,15) Latina, black, and immigrant women are more likely to endorse stigma concerns pertaining to depression treatment (12,16,17). Among Latinos, use of antidepressants is likely to be interpreted as a sign of severe depression, being “crazy” or weak, or as a sign of illicit drug use (18).…”

mentioning

confidence: 99%

Stigma and Depression Treatment Utilization Among Latinos: Utility of Four Stigma Measures

Interian¹,

Ang²,

Gara³

et al. 2010

Psychiatric Services

View full text Add to dashboard Cite

Objectives Stigma associated with mental illness is an important yet understudied issue among Latinos. This study examined the psychometric properties of four stigma measures with a sample of Spanish-speaking Latino primary care patients. The study evaluated the scale for Perceived Discrimination Devaluation (PDD), Stigma Concerns About Mental Health Care (SCMHC), the Latino Scale for Antidepressant Stigma (LSAS), and the Social Distance (SD) scale. Methods Participants (N=200) were low-income Latinos who were screened for depression with the Patient Health Questionnaire (PHQ-2) and asked about their depression treatment history, and they completed the four stigma measures at two time points. The four stigma measures were examined for internal consistency, convergent validity, construct validity, and criterion-related validity. Results The factor-analytic results generally provided support for the construct validity of the measures. The four stigma measures also demonstrated internal consistency between two time points. Patients who reported greater social distance from individuals with depression were more likely to have been receiving treatment for emotional care in the past three months (OR=.70, p<.05). Also, Latinos who scored high on the SCMHC (OR=.64, p<.05) and LSAS (OR=.77, p<.05) were less likely to have been taking antidepressant medications. Conclusions The SCMHC, LSAS, and SD scales received support for their reliability and construct validity. Results also showed some support for their criterion-related validity. A more mixed picture emerged for the PDD. Stigma ratings were associated with depression treatment utilization. Stigma ratings changed over time and were associated with treatment experiences.

show abstract

“…In addition, the increased antidepressant adherence among Latinos having 8 or more visits to a non-medical therapist (45) is consistent with findings from predominantly Euro-American samples (57, 84), and a position paper (39) calling for culturally appropriate practice-initiated quality improvement interventions, including psychoeducational and psychotherapeutic components. The finding that Latinos were more likely than Euro-Americans to want counseling and less likely to want antidepressants (85) suggests therapy may be an especially important adherence enhancer for Latinos.…”

Section: Discussionmentioning

confidence: 99%

Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review

Lanouette¹,

Folsom²,

Sciolla³

et al. 2009

Psychiatric Services

View full text Add to dashboard Cite

Objective Psychotropic medication nonadherence is a major public health problem, but few studies have focused on Latinos. We systematically reviewed the literature on rates of and factors influencing antipsychotic, antidepressant, or mood stabilizer nonadherence among United States (US) Latinos. Methods Data Sources: MEDLINE and PsycINFO were searched using keywords adherence, compliance, Latino, Hispanic, psychotropic, and related terms, as well as bibliographies from relevant reviews and studies. Study Selection: 21 studies met inclusion criteria: published since 1980 in English or Spanish; measured psychotropic medication nonadherence rates among US Latino adults. Data Abstraction: We examined articles for study design and objective, location, population, medication type, participant demographics, adherence measure, adherence rates, and factors related to adherence. Results and Conclusions In studies including Latinos and other ethnic groups, mean nonadherence rates were 41%, 31%, and 43% among Latinos, Euro-Americans, and African Americans respectively, with an overall effect size of 0.64 between Latinos and Euro-Americans. In studies including only Latinos, the mean nonadherence rate was 44%. Ten of 16 studies found Latinos had significantly lower adherence rates than Euro-Americans. Risk factors for nonadherence included being monolingual Spanish speaking, lacking health insurance, experiencing barriers to quality care, and having lower socioeconomic status. Protective factors included family support and psychotherapy. Rates of nonadherence to psychotropic medications were higher for Latinos than for Euro-Americans. Further investigation is needed into the potentially modifiable individual and societal level mechanisms of this discrepancy. Clinical and research interventions to improve adherence should be culturally appropriate and incorporate identified factors.

show abstract

The Acceptability of Treatment for Depression Among African-American, Hispanic, and White Primary Care Patients

Cited by 507 publications

References 38 publications

Predicting 6‐week treatment response to escitalopram pharmacotherapy in late‐life major depressive disorder

Predicting 6‐week treatment response to escitalopram pharmacotherapy in late‐life major depressive disorder

Stigma and Depression Treatment Utilization Among Latinos: Utility of Four Stigma Measures

Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review

Contact Info

Product

Resources

About