Cummings Janet R, Case Brady G, Ji Xu, Chae David H, Druss Benjamin G
Rollins School of Public Health, Emory University.
Health Services Research Program, Bradley Hospital, Alpert Medical School of Brown University, and Brown Public Health Program.
J Am Acad Child Adolesc Psychiatry. 2014 Sep;53(9):980-90. doi: 10.1016/j.jaac.2014.05.016. Epub 2014 Jul 3.
Racial/ethnic differences in the course of treatment for a major depressive episode (MDE) among adolescents may arise, in part, from variation in the perceived rationale for treatment. We examined racial/ethnic differences in the perceived reasons for receiving mental health (MH) treatment among adolescents with an MDE.
A total of 2,789 adolescent participants who experienced an MDE and received MH treatment in the past year were drawn from the 2005 to 2008 National Survey on Drug Use and Health. Adolescents reported the settings in which they received care and reasons for their most recent visit to each setting. Distributions of specific depressive symptoms were compared across racial/ethnic groups. Racial/ethnic differences in endorsing each of 11 possible reasons for receiving treatment were examined using weighted probit regressions adjusted for sociodemographic characteristics, health and mental health status, treatment setting, and survey year.
Despite similar depressive symptom profiles, Hispanic adolescents were more likely than whites to endorse "breaking rules" or getting into physical fights as reasons for MH treatment. Black adolescents were more likely than white adolescents to endorse "problems at school" but less likely to endorse "felt very afraid or tense" or "eating problems" as reasons for treatment. Asian adolescents were more likely to endorse "problems with people other than friends or family" but less likely than whites to endorse "suicidal thoughts/attempt" and "felt depressed" as reasons for treatment.
Racial/ethnic minority participants were more likely than white participants to endorse externalizing or interpersonal problems and less likely to endorse internalizing problems as reasons for MH treatment. Understanding racial/ethnic differences in the patient's perceived treatment rationale can offer opportunities to enhance outcomes for depression among diverse populations.
青少年重度抑郁发作(MDE)治疗过程中的种族/民族差异可能部分源于对治疗理由的认知差异。我们研究了患有MDE的青少年在接受心理健康(MH)治疗的认知原因方面的种族/民族差异。
从2005年至2008年全国药物使用和健康调查中选取了2789名在过去一年中经历过MDE并接受过MH治疗的青少年参与者。青少年报告了他们接受治疗的场所以及最近一次去每个场所就诊的原因。比较了不同种族/民族群体中特定抑郁症状的分布情况。使用针对社会人口学特征、健康和心理健康状况、治疗场所及调查年份进行调整的加权概率回归,研究了认可11种可能的治疗原因中的每一种的种族/民族差异。
尽管抑郁症状特征相似,但西班牙裔青少年比白人更有可能认可“违反规则”或打架作为接受MH治疗的原因。黑人青少年比白人青少年更有可能认可“学校问题”,但认可“感到非常害怕或紧张”或“饮食问题”作为治疗原因的可能性较小。亚洲青少年更有可能认可“与朋友或家人以外的人有问题”,但认可“自杀念头/企图”和“感到抑郁”作为治疗原因的可能性比白人小。
种族/民族少数群体参与者比白人参与者更有可能认可外化或人际问题,而认可内化问题作为接受MH治疗原因的可能性较小。了解患者对治疗理由的种族/民族差异可为改善不同人群的抑郁症治疗效果提供机会。