Depression among Asian-American Adults in the Community: Systematic Review and Meta-Analysis

• Published in: PloS one 2015-06, Vol.10 (6), p.e0127760-e0127760
• Main Authors: Kim, Hee Jun, Park, EunMi, Storr, Carla L, Tran, Katherine, Juon, Hee-Soon
• Format: Article
• Language: English
• Subjects: Adult; Adults; Anxiety; Asian Americans; Asian Americans - statistics & numerical data; Demographics; Depression - epidemiology; Epidemiology; Estimates; Ethnic factors; Health care; Health policy; Heterogeneity; Humans; Identification methods; Mathematical analysis; Mental depression; Mental disorders; Mental health; Meta-analysis; Minority & ethnic groups; Prevalence; Public health; Residence Characteristics; Reviews; Statistical analysis; Statistical methods; Studies; Subgroups; Systematic review; United States - epidemiology
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0127760

In this systematic review, we provide an overview of the literature on depression among Asian-Americans and explore the possible variations in depression prevalence estimates by methodological and demographic factors. Six databases were used to identify studies reporting a prevalence estimate for depression in Asian-American adults in non-clinical settings. Meta-analysis was used to calculate pooled estimates of rates of depression by assessment type. Statistical heterogeneity was assessed for subgroup analyses by gender, age, ethnicity, and other participant characteristics. A total of 58 studies met the review criteria (n = 21.731 Asian-American adults). Heterogeneity across the studies was considerably high. The prevalence of major depression assessed via standardized clinical interviews ranged between 4.5% and 11.3%. Meta-analyses revealed comparable estimated prevalence rates of depression as measured by the Center for Epidemiologic Studies Depression Scale (35.6%, 95% CI 27.6%-43.7%) and the Geriatric Depression Scale (33.1%, 95% CI 14.9%-51.3%). Estimates varied by Asian racial/ethnic group and other participant characteristics. Estimates of depression among special populations, which included maternity, caregivers, and homosexuals, were significantly higher than estimates obtained from other samples (58.8% vs 29.3%, p = .003). Estimates of depression among Korean and Filipino-Americans were similar (33.3%-34.4%); however, the estimates were twice as high as those for Chinese-Americans (15.7%; p = .012 for Korean, p = .049 for Filipino). There appears to be wide variability in the prevalence rates of depression among Asian-Americans in the US. Practitioners and researchers who serve Asian-American adults need to be sensitive to the potential diversity of the expression of depression and treatment-seeking across Asian-American subgroups. Public health policies to increase Asian-American access to mental health care, including increased screening, are necessary. Further work is needed to determine whether strategies to reduce depression among specific Asian racial/ethnic groups is warranted.