Falling through the cracks

Gaps in depression treatment among older Mexican-origin and white men

W Ladson Hinton, Ester Carolina Apesoa-Varano, Hector M. González, Sergio Aguilar-Gaxiola, Megan Dwight-Johnson, Judith C. Barker, Cindy Tran, Ramiro Zuniga, Jürgen Unützer

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1283-1290
Number of pages8
JournalInternational Journal of Geriatric Psychiatry
Volume27
Issue number12
DOIs
StatePublished - Dec 2012

Fingerprint

Depression
Therapeutics
Ethnic Groups
Diagnostic and Statistical Manual of Mental Disorders
Primary Health Care
Ambulatory Care Facilities
Psychotherapy
Observational Studies
Mental Health
Language
Referral and Consultation
Cross-Sectional Studies
Interviews

Keywords

  • access and quality of care
  • depression
  • elderly
  • men
  • minorities
  • primary care

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

Falling through the cracks : Gaps in depression treatment among older Mexican-origin and white men. / Hinton, W Ladson; Apesoa-Varano, Ester Carolina; González, Hector M.; Aguilar-Gaxiola, Sergio; Dwight-Johnson, Megan; Barker, Judith C.; Tran, Cindy; Zuniga, Ramiro; Unützer, Jürgen.

In: International Journal of Geriatric Psychiatry, Vol. 27, No. 12, 12.2012, p. 1283-1290.

Research output: Contribution to journalArticle

Hinton, W Ladson ; Apesoa-Varano, Ester Carolina ; González, Hector M. ; Aguilar-Gaxiola, Sergio ; Dwight-Johnson, Megan ; Barker, Judith C. ; Tran, Cindy ; Zuniga, Ramiro ; Unützer, Jürgen. / Falling through the cracks : Gaps in depression treatment among older Mexican-origin and white men. In: International Journal of Geriatric Psychiatry. 2012 ; Vol. 27, No. 12. pp. 1283-1290.
@article{f932cea5c6134d18a91306ec77f57d26,
title = "Falling through the cracks: Gaps in depression treatment among older Mexican-origin and white men",
abstract = "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.",
keywords = "access and quality of care, depression, elderly, men, minorities, primary care",
author = "Hinton, {W Ladson} and Apesoa-Varano, {Ester Carolina} and Gonz{\'a}lez, {Hector M.} and Sergio Aguilar-Gaxiola and Megan Dwight-Johnson and Barker, {Judith C.} and Cindy Tran and Ramiro Zuniga and J{\"u}rgen Un{\"u}tzer",
year = "2012",
month = "12",
doi = "10.1002/gps.3779",
language = "English (US)",
volume = "27",
pages = "1283--1290",
journal = "International Journal of Geriatric Psychiatry",
issn = "0885-6230",
publisher = "John Wiley and Sons Ltd",
number = "12",

}

TY - JOUR

T1 - Falling through the cracks

T2 - Gaps in depression treatment among older Mexican-origin and white men

AU - Hinton, W Ladson

AU - Apesoa-Varano, Ester Carolina

AU - González, Hector M.

AU - Aguilar-Gaxiola, Sergio

AU - Dwight-Johnson, Megan

AU - Barker, Judith C.

AU - Tran, Cindy

AU - Zuniga, Ramiro

AU - Unützer, Jürgen

PY - 2012/12

Y1 - 2012/12

N2 - 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.

AB - 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.

KW - access and quality of care

KW - depression

KW - elderly

KW - men

KW - minorities

KW - primary care

UR - http://www.scopus.com/inward/record.url?scp=84868529778&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84868529778&partnerID=8YFLogxK

U2 - 10.1002/gps.3779

DO - 10.1002/gps.3779

M3 - Article

VL - 27

SP - 1283

EP - 1290

JO - International Journal of Geriatric Psychiatry

JF - International Journal of Geriatric Psychiatry

SN - 0885-6230

IS - 12

ER -