Examining differential treatment effects for depression in racial and ethnic minority women: a qualitative systematic review.
OBJECTIVE
To examine effectiveness of depression treatment in racial and ethnic minority women.


METHODS



METHODS
1) the study examined treatment of depression among racial and ethnic minority women age > 17, 2) data analysis was separated by race and ethnicity, and 3) the study was conducted in the United States. Interventions considered were: psychotropic medications, psychotherapy (including cognitive-behavioral, interpersonal therapy and any type of psychotherapy adapted for minority populations) and any type of psychotherapy combined with case management or a religious focus. Individual and group psychotherapy were eligible. Each study was critically reviewed to identify treatment effectiveness specific to racial and ethnic minority women.


RESULTS
Ten published studies met the inclusion criteria (racial and ethnic minority participants n = 2,136). Seven of these were randomized clinical trials, one was a retrospective cohort study, one was a case series, and the remaining one had an indeterminate study design. Participants' age ranged from 18-74 years, with a higher proportion > 40 years. Most were low income. Differences in treatment responses between African-American, Latino and white women were found. Adapted models of care, including quality improvement and collaborative care, were found to be more effective than usual care and community referral in treating depression. Although medication and psychotherapy were both effective in treating depression, low-income women generally needed case management to address other social issues.


CONCLUSIONS
Adapted models that allow patients to select the treatment of their choice (medication or psychotherapy or a combination) while providing outreach and other supportive services (case management, childcare and transportation) appear to result in optimal clinical benefits.
Ward
Earlise C
EC
University of Wisconsin-Madison, School of Medicine and Public Health, Center for Women's Health Research, 600 Highland Ave., Madison, WI 53792, USA. ecward@wisc.edu
D000928:Antidepressive Agents / Q000627:therapeutic use; D019090:Case Management; D003866:Depressive Disorder / Q000208:ethnology / Q000628:therapy*; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D006801:Humans; D008913:Minority Groups / Q000523:psychology*; D010327:Pastoral Care; D011613:Psychotherapy; D016032:Randomized Controlled Trials as Topic; D014481:United States; D016387:Women's Health / Q000208:ethnology*
D000928:Antidepressive Agents