Depression in US Hispanics: diagnostic and management considerations in family practice.
US Hispanics, currently the largest minority group in the country, face disparities in the recognition and treatment of major depression. This article provides an evidence-based review of the prevalence, presentation, and management of major depression in primary care in this heterogeneous ethnic group. Under-recognition of depression in adult Hispanic Americans may be related to language differences, health literacy barriers, somatic presentations, and use of cultural idioms of distress. Hispanic patients are often agreeable to treatment but as a group may tend to prefer psychotherapy or combined counseling and medication to pharmacotherapy alone. Recent studies have found both psychological and pharmacologic treatment options are efficacious in this minority group. Treatment adherence should be actively monitored to help ensure its effectiveness. To help reduce the number of depressed Hispanic patients who pass through primary care undetected or inadequately treated, family physicians should make a concerted effort to increase their awareness of the presentation of major depression in this population and actively promote adherence to effective treatments.
Department of Psychiatry, Columbia University, New York, USA. rlewis@nyspi.cpmc.columbia.edu
Roberto
R
Lewis-Fernández
Amar K
AK
Das
César
C
Alfonso
Myrna M
MM
Weissman
Mark
M
Olfson
D000069:Acculturation; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy*; D005194:Family Practice; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D015995:Prevalence; D014481:United States / Q000453:epidemiology