Ethnicity and preferences for depression treatment

• Published in: General hospital psychiatry 2007-05, Vol.29 (3), p.182-191
• Main Authors: Givens, Jane L., M.D., M.S.C.E, Houston, Thomas K., M.D., M.P.H, Van Voorhees, Benjamin W., M.D., M.P.H, Ford, Daniel E., M.D., M.P.H, Cooper, Lisa A., M.D., M.P.H
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Attitude towards mental illness; Biological and medical sciences; Counseling; Cross-Sectional Studies; Depression; Depression - diagnosis; Depression - ethnology; Depression - therapy; Ethnic Groups - psychology; Ethnicity; Female; Health Knowledge, Attitudes, Practice; Humans; Internet; Male; Medical sciences; Middle Aged; Patient Acceptance of Health Care - ethnology; Patient preferences; Psychiatric Status Rating Scales; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Regression Analysis; Social psychiatry. Ethnopsychiatry; Stigma
• ISSN: 0163-8343; 1873-7714
• DOI: 10.1016/j.genhosppsych.2006.11.002

Abstract Objective The objective of this work was to describe ethnic differences in attitudes toward depression, depression treatment, stigma and preferences for depression treatment (counseling vs. medication). Method This study used a cross-sectional Internet survey measuring treatment preference, stigma and attitudes toward depression. Depressive symptoms were measured with the Center for Epidemiological Studies Depression (CES-D) scale. Multivariable regression models adjusting for treatment attitudes and demographics estimated the independent effect of ethnicity on treatment preference. Results A total of 78,753 persons with significant depressive symptoms (CES-D>22), including 3596 African Americans, 2794 Asians/Pacific Islanders and 3203 Hispanics, participated. Compared to whites, African Americans, Asians/Pacific Islanders and Hispanics were more likely to prefer counseling to medications [odds ratio (OR)=2.6, 95% confidence interval (95% CI)=2.4–2.8; OR=2.5, 95% CI=2.2–2.7; and OR=1.8, 95% CI=1.7–2.0, respectively]. Ethnic minorities were less likely to believe that medications were effective and that depression was biologically based, but were more likely to believe that antidepressants were addictive and that counseling and prayer were effective in treating depression. Attitudes and beliefs somewhat attenuated the association between ethnicity and treatment preference in adjusted analyses. Conclusion Racial and ethnic minorities prefer counseling for depression treatment more than whites. Beliefs about the effects of antidepressants, prayer and counseling partially mediate preferences for depression treatment.