title: Race by sex differences in depression symptoms and psychosocial service use among non-Hispanic black and white patients with lung cancer.
abstract: OBJECTIVE
  This study examined race by sex differences in depression symptoms and psychosocial service use (pastors, social workers, mental health workers, support groups) among patients with lung cancer.
  
  
  METHODS
  The multiregional Cancer Care Outcomes Research and Surveillance study surveyed black and white adults with stages I to III lung cancer (n = 1,043) about depression symptoms, interest in help for mood, and psychosocial service use. Multivariable logistic regression was used to evaluate race/sex differences in depression symptoms (modified Center for Epidemiologic Studies Depression Scale ≥ 6) and psychosocial service use, independent of demographic, clinical, psychosocial, and behavioral covariates.
  
  
  RESULTS
  A total of 18.2% screened positive for depression symptoms. This proportion was highest among black men (24.7%), followed by white women (20.6%), black women (15.8%), and white men (15.0%). In adjusted analyses, white women showed greater risk for depression symptoms relative to black women (P = .01) and white men (P = .002), with no other differences among groups. Black patients were less likely than white patients to receive desired help for mood from their doctors (P = .02), regardless of sex. Among all patients, black women were most likely to have contact with pastoral care and social work.
  
  
  CONCLUSIONS
  Race and sex interacted to predict risk of depression symptoms. Covariates accounted for elevated risk among black men. White women showed greater risk than black women and white men, independent of covariates. Black patients may experience greater barriers to receiving help for mood from their doctors. Race by sex differences in contact with psychosocial services highlight potential differences in the extent to which services are available, acceptable, and/or sought by patients.
authors: Lara Traeger, William F. Pirl, and Elyse R. Park, Massachusetts General Hospital; Lara Traeger, Nancy L. Keating, William F. Pirl, Yulei He, and Elyse R. Park, Harvard Medical School; Sheila Cannon, University of Massachusetts Boston; Nancy L. Keating, Brigham and Women's Hospital; Christopher Lathan, Dana-Farber Cancer Institute, Boston, MA; and Michelle Y. Martin, University of Alabama at Birmingham, AL.
authors: Lara
authors: L
authors: Traeger
authors: Sheila
authors: S
authors: Cannon
authors: Nancy L
authors: NL
authors: Keating
authors: William F
authors: WF
authors: Pirl
authors: Christopher
authors: C
authors: Lathan
authors: Michelle Y
authors: MY
authors: Martin
authors: Yulei
authors: Y
authors: He
authors: Elyse R
authors: ER
authors: Park
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D015331:Cohort Studies; D003863:Depression / Q000150:complications / Q000208:ethnology / Q000628:therapy*; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000150:complications* / Q000208:ethnology / Q000473:pathology; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D011159:Population Surveillance / Q000379:methods; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*