title: Underdiagnosed and undertreated depression among racially/ethnically diverse patients with type 2 diabetes.
abstract: OBJECTIVE
  To examine racial/ethnic differences in the prevalence of depressive symptoms and in provider recognition of depression among Latino, Asian, and non-Hispanic white patients with type 2 diabetes.
  
  
  METHODS
  Patients (n = 1,209) with type 2 diabetes were recruited from five university-affiliated primary care clinics for an observational study.
  
  
  RESULTS
  Vietnamese American (133, 59.4%) and Mexican American (351, 50.2%) patients were more likely to report symptoms consistent with clinical depression (Center for Epidemiological Studies Depression [CES-D] scale score ≥ 22) than non-Hispanic whites (119, 41.6%; F [2, 1206] = 8.05, P < 0.001). Despite comparable diabetes care, Vietnamese and Mexican patients with high depressive symptoms were less likely to be diagnosed and treated than non-Hispanic whites (all P values < 0.001). Minority patients who reported low levels of trust in their provider were less likely to have been diagnosed or treated for depression (adjusted odds ratio 0.65, 95% CI 0.44-0.98, P < 0.05).
  
  
  CONCLUSIONS
  Innovative strategies are needed to improve recognition of depressive symptoms in minority patients.
authors.affiliation: Division of General Internal Medicine and Primary Care and Health Policy Research Institute, University of California, Irvine, California, USA. dsorkin@uci.edu
authors.forename: Dara H
authors.initials: DH
authors.lastname: Sorkin
authors.forename: Quyen
authors.initials: Q
authors.lastname: Ngo-Metzger
authors.forename: John
authors.initials: J
authors.lastname: Billimek
authors.forename: Kristin J
authors.initials: KJ
authors.lastname: August
authors.forename: Sheldon
authors.initials: S
authors.lastname: Greenfield
authors.forename: Sherrie H
authors.initials: SH
authors.lastname: Kaplan
mesh_terms: D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology* / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged