González Hector M, Vega William A, Williams David R, Tarraf Wassim, West Brady T, Neighbors Harold W
Institute of Gerontology and Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI 48202, USA.
Arch Gen Psychiatry. 2010 Jan;67(1):37-46. doi: 10.1001/archgenpsychiatry.2009.168.
To determine the prevalence and adequacy of depression care among different ethnic and racial groups in the United States.
Collaborative Psychiatric Epidemiology Surveys (CPES) data were analyzed to calculate nationally representative estimates of depression care.
The 48 coterminous United States.
Household residents 18 years and older (N = 15 762) participated in the study.
Past-year depression pharmacotherapy and psychotherapy using American Psychiatric Association guideline-concordant therapies. Depression severity was assessed with the Quick Inventory of Depressive Symptomatology Self-Report. Primary predictors were major ethnic/racial groups (Mexican American, Puerto Rican, Caribbean black, African American, and non-Latino white) and World Mental Health Composite International Diagnostic Interview criteria for 12-month major depressive episode.
Mexican American and African American individuals meeting 12-month major depression criteria consistently and significantly had lower odds for any depression therapy and guideline-concordant therapies despite depression severity ratings not significantly differing between ethnic/racial groups. All groups reported higher use of any past-year psychotherapy and guideline-concordant psychotherapy compared with pharmacotherapy; however, Caribbean black and African American individuals reported the highest proportions of this use.
Few Americans with recent major depression have used depression therapies and guideline-concordant therapies; however, the lowest rates of use were found among Mexican American and African American individuals. Ethnic/racial differences were found despite comparable depression care need. More Americans with recent major depression used psychotherapy over pharmacotherapy, and these differences were most pronounced among Mexican American and African American individuals. This report underscores the importance of disaggregating ethnic/racial groups and depression therapies in understanding and directing efforts to improve depression care in the United States.
确定美国不同族裔和种族群体中抑郁症护理的患病率及充分性。
分析协作精神疾病流行病学调查（CPES）数据，以计算具有全国代表性的抑郁症护理估计值。
美国本土48个州。
18岁及以上的家庭居民（N = 15762）参与了该研究。
使用符合美国精神病学协会指南的疗法进行的上一年度抑郁症药物治疗和心理治疗。使用抑郁症状快速自评量表评估抑郁严重程度。主要预测因素为主要族裔/种族群体（墨西哥裔美国人、波多黎各人、加勒比黑人、非裔美国人以及非拉丁裔白人）以及12个月重度抑郁发作的世界心理健康综合国际诊断访谈标准。
符合12个月重度抑郁症标准的墨西哥裔美国人和非裔美国人，尽管不同族裔/种族群体之间的抑郁严重程度评分无显著差异，但接受任何抑郁症治疗及符合指南的治疗的几率始终显著较低。与药物治疗相比，所有群体报告的上一年度心理治疗及符合指南的心理治疗使用率均更高；然而，加勒比黑人和非裔美国人的这一使用率最高。
近期患有重度抑郁症的美国人中，很少有人使用抑郁症治疗及符合指南的治疗；然而，使用率最低的是墨西哥裔美国人和非裔美国人。尽管抑郁症护理需求相当，但仍发现了族裔/种族差异。更多近期患有重度抑郁症的美国人使用心理治疗而非药物治疗，且这些差异在墨西哥裔美国人和非裔美国人中最为明显。本报告强调了在理解和指导改善美国抑郁症护理的努力中，区分族裔/种族群体及抑郁症治疗方法的重要性。
