title: Major depressive disorder among older African Americans, Caribbean blacks, and non-Hispanic whites: secondary analysis of the National Survey of American Life.
abstract: BACKGROUND
  Previous epidemiological and clinical research on mental disorders has treated Blacks as a homogenous group and yet Blacks of Caribbean descent and African Americans differ with respect to ethnicity, national heritage, living circumstances, and immigration status. The purpose of this article is to examine the prevalence of major depressive disorder (MDD) among African Americans, Caribbean Blacks, and non-Hispanic whites aged 50 and older with data on psychiatric and physical comorbidity, mental illness severity, and service use.
  
  
  METHODS
  Secondary analysis of data from the National Survey of American Life, a national household probability sample of African Americans, Caribbean Blacks, and non-Hispanic Whites in the United States, were used (n = 1,950). The response rate was 72.3%.
  
  
  RESULTS
  Controlling for age, the lifetime prevalence rate of MDD was 12.1% and the 12-month rate was 5.2%. Older Whites and Caribbean Blacks had significantly higher lifetime prevalence than African Americans but 12-month rates were similar across the three groups. Rates of co-occurring psychiatric disorders and physical conditions were high and were similar for African Americans, Caribbean Blacks, and Whites. Most older adults had either moderate or severe 12-month MDD and most talked to at least one professional, most frequently a family doctor, psychiatrist, or other mental health professional.
  
  
  CONCLUSIONS
  MDD among older adults is highly prevalent, often associated with other psychiatric disorders or chronic physical conditions, and is associated with high overall mental illness severity. Differences among older Blacks highlight the need for further research on this population to ensure appropriate treatment is being provided to these groups.
authors: School of Social Work, Michigan State University, Lansing, Michigan 48824, USA. awoodwar@msu.edu
authors: Amanda T
authors: AT
authors: Woodward
authors: Robert J
authors: RJ
authors: Taylor
authors: Jamie M
authors: JM
authors: Abelson
authors: Niki
authors: N
authors: Matusko
mesh_terms: D001741:Black or African American / Q000145:classification / Q000208:ethnology*; D000368:Aged; D000369:Aged, 80 and over; D017691:Caribbean Region / Q000208:ethnology; D002908:Chronic Disease / Q000208:ethnology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000208:ethnology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index; D014481:United States / Q000208:ethnology; D044465:White People / Q000208:ethnology