title: Recognizing and engaging depressed Chinese Americans in treatment in a primary care setting.
abstract: OBJECTIVE
  To examine the effectiveness of depression screening and the Engagement Interview Protocol (EIP) in identifying and engaging in treatment depressed Chinese Americans in a primary care setting.
  
  
  METHODS
  Chinese American patients who attended a primary care clinic between 15 September, 2004 and 14 September, 2005 were screened for depression using the Chinese Bilingual version of the Patient Health Questionnaire (CB-PHQ-9). Patients who screened positive (CB-PHQ-9>or=15) were evaluated using the EIP to establish psychiatric diagnosis and to engage patients in treatment.
  
  
  RESULTS
  Three thousand eight hundred and twelve patients completed the CB-PHQ-9, of which 113 (3.2%) screened positive for MDD. Among those screening positive, six (5.3%) had been receiving psychiatric treatment for depression, 57 (50%) declined to receive a psychiatric interview or were unable to be contacted, and 50 (44%) agreed to be interviewed with the EIP. Out of the 50 patients interviewed, 44 (88%) had their MDD diagnosis confirmed; among them, 41 (93%) agreed to receive treatment for depression and three (7%) declined intervention.
  
  
  CONCLUSIONS
  Under-recognition and under-treatment of depressed Chinese Americans in primary care settings continue to be prevalent. Recognition of depression can be enhanced by using the brief CB-PHQ-9 to screen for depression. Half of the Chinese Americans who screened positive for MDD declined evaluation by a mental health professional. Most of the depressed Chinese Americans who were evaluated agreed to receive treatment. Enhanced cultural sensitivity with the use of the EIP in psychiatric assessment may have contributed to the success in engaging depressed Chinese Americans in treatment.
authors.affiliation: Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA 02114, USA. ayeung@partners.org
authors.forename: Albert
authors.initials: A
authors.lastname: Yeung
authors.forename: Shu-Ching
authors.initials: SC
authors.lastname: Yu
authors.forename: Freddy
authors.initials: F
authors.lastname: Fung
authors.forename: Sienna
authors.initials: S
authors.lastname: Vorono
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fava
mesh_terms: D000328:Adult; D000368:Aged; D001213:Asian / Q000523:psychology*; D003466:Cultural Characteristics; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000208:ethnology* / Q000523:psychology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000523:psychology; D008404:Massachusetts; D008875:Middle Aged; D009042:Motivation; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology; D011320:Primary Health Care / Q000379:methods*; D011569:Psychiatric Status Rating Scales