title: Undiagnosed depression and its correlates in a predominantly immigrant Hispanic neurology clinic.
abstract: OBJECTIVE
  Previous studies have reported a high incidence of depression in neurology clinics, however areas where there are predominantly underserved immigrants have not been studied.
  
  
  METHODS
  Retrospective cohort study in an academic outpatient neurology clinic in Los Angeles, California. Newly referred patients (N=318) were assessed consecutively for depression using a PHQ-9 questionnaire, accompanied by review of the assessment of the depressive disorder.
  
  
  RESULTS
  The patient cohort consisted of 190 females (59%) and 130 males (41%), primarily of Hispanic descent (72%), with 8% Asian 11% white, and 5% African-American. Sixty-eight percent (68%) had depression, with 40% exhibiting moderate to severe depression. Patients who had moderate to severe depression (based on PHQ-9) were more likely to be unemployed (75.2% vs. 60.7%, p=0.008), dependent on government income (29.5% vs. 20.4%, p=0.06), and have headache or pain as the reason for referral (42.4% vs. 28.5%, p=0.03). Severity of depression also significantly correlated with current treatment by psychiatrist, current antidepressant use, and less independent living. Patients with moderate to severe depression were more likely to have made ER visits in the last 12 months (0.9 vs. 0.7, p=0.01) and were taking more medications (3.3 vs. 2.5, p=0.03), compared to patient with mild or no depression.
  
  
  CONCLUSIONS
  The presence of moderate to severe depression significantly correlated with socioeconomic status, use of emergency room, and presence of headache/pain. Neurology clinics with predominantly underserved immigrant patients have a disproportionate amount of depression, which may be related to socioeconomic factors resulting in overutilization of scarce healthcare resources.
authors.affiliation: Department of Neurology, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA. sahai@usc.edu
authors.forename: Soma
authors.initials: S
authors.lastname: Sahai-Srivastava
authors.forename: Ling
authors.initials: L
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009462:Neurology; D010044:Outpatient Clinics, Hospital; D012189:Retrospective Studies; D012959:Socioeconomic Factors
chemical_list: D000928:Antidepressive Agents