title: Depression among Asian-American Adults in the Community: Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  In this systematic review, we provide an overview of the literature on depression among Asian-Americans and explore the possible variations in depression prevalence estimates by methodological and demographic factors.
  
  
  METHODS
  Six databases were used to identify studies reporting a prevalence estimate for depression in Asian-American adults in non-clinical settings. Meta-analysis was used to calculate pooled estimates of rates of depression by assessment type. Statistical heterogeneity was assessed for subgroup analyses by gender, age, ethnicity, and other participant characteristics.
  
  
  RESULTS
  A total of 58 studies met the review criteria (n = 21.731 Asian-American adults). Heterogeneity across the studies was considerably high. The prevalence of major depression assessed via standardized clinical interviews ranged between 4.5% and 11.3%. Meta-analyses revealed comparable estimated prevalence rates of depression as measured by the Center for Epidemiologic Studies Depression Scale (35.6%, 95% CI 27.6%-43.7%) and the Geriatric Depression Scale (33.1%, 95% CI 14.9%-51.3%). Estimates varied by Asian racial/ethnic group and other participant characteristics. Estimates of depression among special populations, which included maternity, caregivers, and homosexuals, were significantly higher than estimates obtained from other samples (58.8% vs 29.3%, p = .003). Estimates of depression among Korean and Filipino-Americans were similar (33.3%-34.4%); however, the estimates were twice as high as those for Chinese-Americans (15.7%; p = .012 for Korean, p = .049 for Filipino).
  
  
  CONCLUSIONS
  There appears to be wide variability in the prevalence rates of depression among Asian-Americans in the US. Practitioners and researchers who serve Asian-American adults need to be sensitive to the potential diversity of the expression of depression and treatment-seeking across Asian-American subgroups. Public health policies to increase Asian-American access to mental health care, including increased screening, are necessary. Further work is needed to determine whether strategies to reduce depression among specific Asian racial/ethnic groups is warranted.
authors.affiliation: School of Nursing, University of Maryland, Baltimore, Maryland, United States of America.
authors.forename: Hee Jun
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: EunMi
authors.initials: E
authors.lastname: Park
authors.affiliation: Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, Maryland, United States of America.
authors.forename: Carla L
authors.initials: CL
authors.lastname: Storr
authors.affiliation: Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Katherine
authors.initials: K
authors.lastname: Tran
authors.affiliation: Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States of America.
authors.forename: Hee-Soon
authors.initials: HS
authors.lastname: Juon
mesh_terms: D000328:Adult; D001213:Asian / Q000706:statistics & numerical data*; D003863:Depression / Q000453:epidemiology*; D006801:Humans; D015995:Prevalence; D012111:Residence Characteristics; D014481:United States / Q000453:epidemiology