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. 1997 Nov;89(11):731–736.

A review of racial differences in geriatric depression: implications for care and clinical research.

D C Steffens 1, D L Artigues 1, K A Ornstein 1, K R Krishnan 1
PMCID: PMC2608282  PMID: 9375477

Abstract

How racial differences influence depressed elders' seeking and obtaining treatment for depression is poorly understood. Studies in other medical illnesses show older African Americans use fewer health-care services for heart disease, stroke, and renal dialysis. This article reviews the racial composition of Duke University's Clinical Research Center (CRC) for the Study of Depression in the Elderly. Possible explanations for low participation of African Americans in such programs also are discussed. During most of the first year of the CRC project, minority enrollment varied from 5% to 10%, at least one third the African-American population of the area. Active efforts to improve minority recruitment increased this percentage to 15% by the end of the project's second year. Likely explanations for low minority participation rates include 1) elders may recognize depressive symptoms, but do not seek or cannot obtain medical treatment, and 2) depressive symptoms may be attributed to a crisis of the spirit (so help is sought through prayer and the church), the "slowing down" process of aging, or part of life's burden to be endured. Future attempts at both treatment and clinical research recruitment efforts are needed to address these possibilities.

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Selected References

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  1. Barbee E. L. Healing time: the blues and African-American women. Health Care Women Int. 1994 Jan-Feb;15(1):53–60. doi: 10.1080/07399339409516094. [DOI] [PubMed] [Google Scholar]
  2. Bazargan M., Hamm-Baugh V. P. The relationship between chronic illness and depression in a community of urban black elderly persons. J Gerontol B Psychol Sci Soc Sci. 1995 Mar;50(2):S119–S127. doi: 10.1093/geronb/50b.2.s119. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Blazer D., Hughes D. C., George L. K. The epidemiology of depression in an elderly community population. Gerontologist. 1987 Jun;27(3):281–287. doi: 10.1093/geront/27.3.281. [DOI] [PubMed] [Google Scholar]
  4. Cornoni-Huntley J., LaCroix A. Z., Havlik R. J. Race and sex differentials in the impact of hypertension in the United States. The National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. Arch Intern Med. 1989 Apr;149(4):780–788. [PubMed] [Google Scholar]
  5. Ellison C. G. Race, religious involvement and depressive symptomatology in a southeastern U.S. community. Soc Sci Med. 1995 Jun;40(11):1561–1572. doi: 10.1016/0277-9536(94)00273-v. [DOI] [PubMed] [Google Scholar]
  6. George L. K., Blazer D. G., Hughes D. C., Fowler N. Social support and the outcome of major depression. Br J Psychiatry. 1989 Apr;154:478–485. doi: 10.1192/bjp.154.4.478. [DOI] [PubMed] [Google Scholar]
  7. Greenwald B. S., Kramer-Ginsberg E., Krishnan R. R., Ashtari M., Aupperle P. M., Patel M. MRI signal hyperintensities in geriatric depression. Am J Psychiatry. 1996 Sep;153(9):1212–1215. doi: 10.1176/ajp.153.9.1212. [DOI] [PubMed] [Google Scholar]
  8. Held P. J., Pauly M. V., Bovbjerg R. R., Newmann J., Salvatierra O., Jr Access to kidney transplantation. Has the United States eliminated income and racial differences? Arch Intern Med. 1988 Dec;148(12):2594–2600. doi: 10.1001/archinte.148.12.2594. [DOI] [PubMed] [Google Scholar]
  9. Jones-Webb R. J., Snowden L. R. Symptoms of depression among blacks and whites. Am J Public Health. 1993 Feb;83(2):240–244. doi: 10.2105/ajph.83.2.240. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Jones B. E., Gray B. A. Problems in diagnosing schizophrenia and affective disorders among blacks. Hosp Community Psychiatry. 1986 Jan;37(1):61–65. doi: 10.1176/ps.37.1.61. [DOI] [PubMed] [Google Scholar]
  11. Judd L. L., Rapaport M. H., Paulus M. P., Brown J. L. Subsyndromal symptomatic depression: a new mood disorder? J Clin Psychiatry. 1994 Apr;55 (Suppl):18–28. [PubMed] [Google Scholar]
  12. Koenig H. G., Meador K. G., Cohen H. J., Blazer D. G. Depression in elderly hospitalized patients with medical illness. Arch Intern Med. 1988 Sep;148(9):1929–1936. [PubMed] [Google Scholar]
  13. Koenig H. G., Meador K. G., Goli V., Shelp F., Cohen H. J., Blazer D. G. Self-rated depressive symptoms in medical inpatients: age and racial differences. Int J Psychiatry Med. 1992;22(1):11–31. doi: 10.2190/29TE-NUBN-3RNT-CY0Y. [DOI] [PubMed] [Google Scholar]
  14. Krishnan K. R., Hays J. C., Tupler L. A., George L. K., Blazer D. G. Clinical and phenomenological comparisons of late-onset and early-onset depression. Am J Psychiatry. 1995 May;152(5):785–788. doi: 10.1176/ajp.152.5.785. [DOI] [PubMed] [Google Scholar]
  15. Levin J. S., Taylor R. J., Chatters L. M. Race and gender differences in religiosity among older adults: findings from four national surveys. J Gerontol. 1994 May;49(3):S137–S145. doi: 10.1093/geronj/49.3.s137. [DOI] [PubMed] [Google Scholar]
  16. Lichtenstein R. L., Alcser K. H., Corning A. D., Bachman J. G., Doukas D. J. Black/white differences in attitudes toward physician-assisted suicide. J Natl Med Assoc. 1997 Feb;89(2):125–133. [PMC free article] [PubMed] [Google Scholar]
  17. Moffic H. S., Paykel E. S. Depression in medical in-patients. Br J Psychiatry. 1975 Apr;126:346–353. doi: 10.1192/bjp.126.4.346. [DOI] [PubMed] [Google Scholar]
  18. Nations M. K., Camino L. A., Walker F. B. 'Nerves': folk idiom for anxiety and depression? Soc Sci Med. 1988;26(12):1245–1259. doi: 10.1016/0277-9536(88)90156-6. [DOI] [PubMed] [Google Scholar]
  19. Nelson P. B. Ethnic differences in intrinsic/extrinsic religious orientation and depression in the elderly. Arch Psychiatr Nurs. 1989 Aug;3(4):199–204. [PubMed] [Google Scholar]
  20. Olfson M., Klerman G. L. Depressive symptoms and mental health service utilization in a community sample. Soc Psychiatry Psychiatr Epidemiol. 1992 Aug;27(4):161–167. doi: 10.1007/BF00789000. [DOI] [PubMed] [Google Scholar]
  21. Rosenfield S. Race differences in involuntary hospitalization: psychiatric vs. labeling perspectives. J Health Soc Behav. 1984 Mar;25(1):14–23. [PubMed] [Google Scholar]
  22. Savage D. D., McGee D. L., Oster G. Reduction of hypertension-associated heart disease and stroke among black Americans: past experience and new perspectives on targeting resources. Milbank Q. 1987;65 (Suppl 2):297–321. [PubMed] [Google Scholar]
  23. Schwab J. J., Bialow M., Brown J. M., Holzer C. E. Diagnosing depression in medical inpatients. Ann Intern Med. 1967 Oct;67(4):695–707. doi: 10.7326/0003-4819-67-4-695. [DOI] [PubMed] [Google Scholar]
  24. Wenneker M. B., Epstein A. M. Racial inequalities in the use of procedures for patients with ischemic heart disease in Massachusetts. JAMA. 1989 Jan 13;261(2):253–257. [PubMed] [Google Scholar]

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