title: Depression screening in Black Americans with multiple sclerosis.
abstract: Depression is prevalent in Multiple Sclerosis (MS) and impacts treatment adherence. Depression screening may be a useful mechanism to identify Blacks at risk for depression in an MS setting, as they frequently experience more disabling MS disease and also may be less likely than Whites to be accurately diagnosed with depression, which can further impact MS disease and diminish quality of life. The purpose of this study was to compare the clinical presentation (e.g. psychiatric histories, current symptoms, and provider treatment recommendations) of Black and White MS patients identified as at risk for depression using a validated depression screening instrument. Secondary analysis of an archival chart data-set of 279 MS patients (90 Blacks) indicated that Black patients were less likely than Whites to have a past mental health diagnosis (X(2) = 12.794, p < .001), prior experience with psychotropics (X(2) = 11.394, p < .001), or be prescribed psychotropics at the time of screening (X(2) = 10.225, p < .001). No differences in depression scores were observed between Black and White patients. Approximately 44% of patients received provider treatment recommendations following a positive screening with no between group differences in the likelihood of receiving at least one recommendation. Consistent with the literature, our Black patient sample was less likely than Whites to have a history of mental health diagnosis or to have been treated with psychotropics. Although more research is needed, screening programs for depression in MS may facilitate access to services for all MS patients while reducing health disparities in Black American patients and removing barriers to early intervention and ongoing care.
authors.affiliation: a Department of Psychiatry and Health Behavior , Medical College of Georgia, Georgia Regents University , Augusta , GA , USA .
authors.forename: Lara M
authors.initials: LM
authors.lastname: Stepleman
authors.forename: Matthew
authors.initials: M
authors.lastname: Decker
authors.forename: Michael
authors.initials: M
authors.lastname: Rollock
authors.forename: Rhonda
authors.initials: R
authors.lastname: Casillas
authors.forename: Tricia
authors.initials: T
authors.lastname: Brands
mesh_terms: D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data*; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000523:psychology; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011619:Psychotropic Drugs / Q000627:therapeutic use; D011788:Quality of Life; D012017:Referral and Consultation / Q000706:statistics & numerical data; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data*
chemical_list: D011619:Psychotropic Drugs