Patient ethnicity and perceptions of families and friends regarding depression treatment.
OBJECTIVE
Black Americans are less likely than white Americans to seek professional treatment for depression. Whether treatment recommendations are sought and implemented by patients will be influenced by the role families and friends play in diagnostic acceptance and treatment decisions. We investigated the association of ethnicity with the perceived need for treatment of depression by family and friends of older primary care patients.


METHODS
Cross-sectional survey of 355 older adults with and without significant depressive symptoms was conducted. At the baseline visit, family and friends' ratings of apathy and need for depression treatment were obtained on 314 of the 355 patients (88% response rate) and examined according to ethnicity. Participants were interviewed using standardized measures of chronic medical conditions, functional status, and psychological status.


RESULTS
Older black patients compared to older white patients were less likely to be rated as needing depression treatment by their family and friends (odds ratio (OR) = 0.34; 95% confidence interval (CI) = [0.18, 0.64]) adjusting for depressive symptoms, cognition, functional status, and other potentially influential characteristics.


CONCLUSIONS
Our study suggests that patient ethnicity may play a role in a family member's or friend's perceived need for depression treatment of older adults who present in the primary care setting. Further study of attitudes, expectations, and values of patients and family members or friends in primary care settings may help elucidate the interplay of physician, patient, and family member or friend.
Bogner
Hillary
H
Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, USA. Hillary.Bogner@uphs.upenn.edu
Dobransky
Larissa N
LN
Wittink
Marsha N
MN
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003863:Depression / Q000188:drug therapy* / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy; D005006:Ethnicity; D005190:Family / Q000523:psychology*; D005260:Female; D033062:Friends / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D011287:Prejudice; D011320:Primary Health Care; D011581:Psychological Tests; D011594:Psychometrics; D012938:Social Perception; D012944:Social Support; D014481:United States / Q000453:epidemiology