TY - JOUR
KW - Adult
KW - African Americans
KW - Depressive Disorder, Major/diagnosis/therapy
KW - Family Practice
KW - Female
KW - Humans
KW - Male
KW - Mental Health Services/organization & administration
KW - Middle Aged
KW - Physician-Patient Relations
KW - Primary Health Care
AU - A. K. Das
AU - M. Olfson
AU - H. L. McCurtis
AU - M. M. Weissman
A1 - 
AB - OBJECTIVE: Recent studies in primary care settings indicate that African Americans face health disparities in the treatment of major depression. We reviewed the literature to find evidence of specific patient, physician, and practice-setting factors related to such barriers. DATA SOURCES: We searched for and retrieved articles in Medline (1966-2004) and hand-checked bibliographies to find additional articles that were relevant to the evaluation and treatment of African Americans with depression. STUDY SELECTION AND DATA EXTRACTION: Two investigators (AKD, MO) independently examined the abstracts retrieved from the literature search, and excluded articles that did not match a predefined search strategy. Two other investigators (HLC, MMW) identified potential articles through bibliographic review. In the extracted set articles, we examined cited barriers to diagnosis and effective management. RESULTS: We found 24 articles that fulfilled our criteria. These studies indicate that African Americans face a number of barriers in the recognition and treatment of major depression including clinical presentation with somatization, stigma about diagnosis, competing clinical demands of comorbid general medical problems, problems with the physician-patient relationship, and lack of comprehensive primary care services. CONCLUSIONS: Research indicates that African Americans who have depression may be frequently under diagnosed and inadequately managed in primary care as a result of patient, physician, and treatment-setting factors. Our systematic review can assist family physicians in understanding how to overcome such barriers to the diagnosis and treatment of depressive disorders in African American patients.
BT - The Journal of family practice
C5 - Healthcare Disparities; Medically Unexplained Symptoms
CP - 1
CY - United States
IS - 1
JF - The Journal of family practice
N2 - OBJECTIVE: Recent studies in primary care settings indicate that African Americans face health disparities in the treatment of major depression. We reviewed the literature to find evidence of specific patient, physician, and practice-setting factors related to such barriers. DATA SOURCES: We searched for and retrieved articles in Medline (1966-2004) and hand-checked bibliographies to find additional articles that were relevant to the evaluation and treatment of African Americans with depression. STUDY SELECTION AND DATA EXTRACTION: Two investigators (AKD, MO) independently examined the abstracts retrieved from the literature search, and excluded articles that did not match a predefined search strategy. Two other investigators (HLC, MMW) identified potential articles through bibliographic review. In the extracted set articles, we examined cited barriers to diagnosis and effective management. RESULTS: We found 24 articles that fulfilled our criteria. These studies indicate that African Americans face a number of barriers in the recognition and treatment of major depression including clinical presentation with somatization, stigma about diagnosis, competing clinical demands of comorbid general medical problems, problems with the physician-patient relationship, and lack of comprehensive primary care services. CONCLUSIONS: Research indicates that African Americans who have depression may be frequently under diagnosed and inadequately managed in primary care as a result of patient, physician, and treatment-setting factors. Our systematic review can assist family physicians in understanding how to overcome such barriers to the diagnosis and treatment of depressive disorders in African American patients.
PP - United States
PY - 2006
SN - 0094-3509; 0094-3509
SP - 30
EP - 39
EP - 
T1 - Depression in African Americans: Breaking barriers to detection and treatment
T2 - The Journal of family practice
TI - Depression in African Americans: Breaking barriers to detection and treatment
U1 - Healthcare Disparities; Medically Unexplained Symptoms
U2 - 16388764
VL - 55
VO - 0094-3509; 0094-3509
Y1 - 2006
ER -