TY - JOUR
KW - Adolescent
KW - Adult
KW - Aged
KW - Antidepressive Agents/therapeutic use
KW - Depression/drug therapy/epidemiology/ethnology
KW - Female
KW - Healthcare Disparities
KW - Hispanic Americans/psychology
KW - Humans
KW - Los Angeles/epidemiology
KW - Male
KW - Middle Aged
KW - Primary Health Care
KW - Questionnaires
KW - Young Adult
AU - A. Interian
AU - A. Ang
AU - M. A. Gara
AU - M. A. Rodriguez
AU - W. A. Vega
A1 - 
AB - OBJECTIVE: Lower use of medication treatment, poorer doctor-patient communication (DPC) and depression stigma are key contributors to mental healthcare disparities among Latinos with depression. The current study investigated the relationship between these key variables and the long-term trajectory of depression in primary care among Latinos. METHOD: Participants (N=220) were Latinos presenting to primary care who screened positive for depression. A repeated measures design was used to assess participants at baseline and 6, 25 and 30 months. Repeated measures included depression (Patient Health Questionnaire-9), self-reported quality of DPC and stigma pertaining to antidepressants. Using growth curve modeling, participants' depressive symptom trajectories were examined for a 30-month period. Self-reported utilization of antidepressants, DPC and antidepressant stigma were examined as predictors of the depressive symptom trajectory. In addition, rates of depression improvement/remission and recurrence/relapse were examined. RESULTS: Improvement/remission was experienced by 69.4% of participants during a 30-month period. Among those who improved/remitted at 6 or 25 months, 63.4% maintained that improvement/remission by 30 months. The long-term trajectory of depressive symptoms demonstrated a significant positive association with antidepressant stigma and significant negative associations with use of antidepressant treatment and quality DPC. CONCLUSIONS: While relapse/recurrence is common, most Latinos in this study experienced improvement in depression over 30 months. For many, there is a considerable time to reach improvement/remission. Also, these findings confirm the significance of antidepressant underutilization, DPC and stigma in the long-term outcome of depression among Latinos in primary care.
BT - General hospital psychiatry
C5 - Healthcare Disparities
CP - 2
CY - United States
DO - 10.1016/j.genhosppsych.2010.12.001
IS - 2
JF - General hospital psychiatry
N2 - OBJECTIVE: Lower use of medication treatment, poorer doctor-patient communication (DPC) and depression stigma are key contributors to mental healthcare disparities among Latinos with depression. The current study investigated the relationship between these key variables and the long-term trajectory of depression in primary care among Latinos. METHOD: Participants (N=220) were Latinos presenting to primary care who screened positive for depression. A repeated measures design was used to assess participants at baseline and 6, 25 and 30 months. Repeated measures included depression (Patient Health Questionnaire-9), self-reported quality of DPC and stigma pertaining to antidepressants. Using growth curve modeling, participants' depressive symptom trajectories were examined for a 30-month period. Self-reported utilization of antidepressants, DPC and antidepressant stigma were examined as predictors of the depressive symptom trajectory. In addition, rates of depression improvement/remission and recurrence/relapse were examined. RESULTS: Improvement/remission was experienced by 69.4% of participants during a 30-month period. Among those who improved/remitted at 6 or 25 months, 63.4% maintained that improvement/remission by 30 months. The long-term trajectory of depressive symptoms demonstrated a significant positive association with antidepressant stigma and significant negative associations with use of antidepressant treatment and quality DPC. CONCLUSIONS: While relapse/recurrence is common, most Latinos in this study experienced improvement in depression over 30 months. For many, there is a considerable time to reach improvement/remission. Also, these findings confirm the significance of antidepressant underutilization, DPC and stigma in the long-term outcome of depression among Latinos in primary care.
PP - United States
PY - 2011
SN - 1873-7714; 0163-8343
SP - 94
EP - 101
EP - 
T1 - The long-term trajectory of depression among Latinos in primary care and its relationship to depression care disparities
T2 - General hospital psychiatry
TI - The long-term trajectory of depression among Latinos in primary care and its relationship to depression care disparities
U1 - Healthcare Disparities
U2 - 21596201
U3 - 10.1016/j.genhosppsych.2010.12.001
VL - 33
VO - 1873-7714; 0163-8343
Y1 - 2011
ER -