title: Discord of biological and psychological measures in a group of depressed african american and white cancer patients.
abstract: OBJECTIVE
  This study examined racial differences in the self-report of depressive symptoms by reference to biological states.
  
  
  METHODS
  The study used a convenience sample of 20 depressed cancer patients (CES-D ≥16) (15 African Americans and 5 Whites). Subjects completed depression assessment on a battery of psychological measures and provided blood and saliva samples. Laboratory tests were performed on biomarkers (serotonin, cortisol and IL-6). T-test was computed to examine racial differences on biological and psychological measures.
  
  
  RESULTS
  Depressed Whites had a significantly higher cortisol level than depressed African Americans, but no significant group difference was found on any self-reported psychological measures of depression. There was a trend that African Americans reported fewer depressive symptoms on psychological measures but exceeded Whites on the domain of somatization; however, such group differences did not approach statistic significance in this small sample.
  
  
  CONCLUSIONS
  African Americans did not appear to underreport depression in consideration of their biological states, but had a tendency to report more somatic symptoms than Whites; this may be attributable to non-depression diseases or reporting behavior rather than somatic sensitivity. African Americans exhibited more mistrust in the health care system, which could affect the self-report of depression. There is a discord between biological and psychological measures of depression. Biomarkers prove to be useful for evaluating racial difference in the self-report of depression.  IMPLICATION FOR NURSING:  Nurses should be cautious of somatic complaints when assessing African American cancer patient's depression. Establishing trust is essential for an accurate assessment of depression in African American cancer patients.
authors.affiliation: Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4904, USA.
authors.forename: Amy Y
authors.initials: AY
authors.lastname: Zhang