King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
Second Department of Psychiatry, University General Hospital 'ATTIKON', School of Medicine, Athens, Greece.
J Affect Disord. 2020 Mar 1;264:340-347. doi: 10.1016/j.jad.2019.12.031. Epub 2019 Dec 23.
An elevated risk of late-life depression has been suggested in older adults from minority ethnic groups, but little is known about ethnic group differences in symptom and treatment profiles. The current study aimed to compare symptoms and types of treatment between ethnic groups in patients with late-life depression.
Data were extracted from the Clinical Record Interactive Search (CRIS) system , which provides access to the anonymised electronic health records of a large mental health care provider in South London. In total, 5,546 individuals aged 65 years and older, and diagnosed with late-life depression between 2006 and 2017, were included. Patients from ethnic minority backgrounds were compared to White British individuals on the following features recorded at depression diagnosis: mental and physical wellbeing,functional scales, individual depressive symptoms recorded, and treatments administered.
Black Africans and Black Caribbeans more frequently presented with psychotic problems and were significantly less likely to have antidepressant treatment prescribed post diagnosis compared to White British. White Irish had higher rates of substance use and sleep disturbance. Depressive symptoms of hopelessness, guilt feelings, and suicidal thoughts were less common in Black Caribbeans, Black Africans, and South Asians compared to White British.
Only patients with depression under a specialist mental health care provider were included in the study.
Ethnic minority elders have significantly different presentations and undertake different types of treatment both across groups and relative to their White British counterparts. These differences need to be taken into consideration to optimise pathways into care and to personalise treatment.
少数民族老年人晚年患抑郁症的风险较高，但对于不同族裔群体在症状和治疗方式方面的差异知之甚少。本研究旨在比较晚年抑郁症患者的不同族裔群体之间的症状和治疗类型。
从 Clinical Record Interactive Search (CRIS) 系统中提取数据，该系统可访问伦敦南部一家大型精神卫生服务提供商的匿名电子健康记录。共有 5546 名年龄在 65 岁及以上、2006 年至 2017 年间被诊断为晚年抑郁症的患者被纳入研究。与英国白人相比，来自少数民族背景的患者在以下方面的抑郁诊断时记录的特征方面存在差异：心理健康和身体健康、功能量表、个体抑郁症状以及治疗方法。
与英国白人相比，非洲裔黑人患者和加勒比裔黑人患者更常出现精神病问题，并且在诊断后接受抗抑郁药物治疗的可能性显著降低。爱尔兰裔白人患者更常出现物质使用和睡眠障碍。与英国白人相比，绝望感、内疚感和自杀念头等抑郁症状在加勒比裔黑人、非洲裔黑人和南亚人中不太常见。
本研究仅纳入了在专科精神卫生服务机构就诊的抑郁症患者。
少数民族老年人的表现存在显著差异，并且在不同群体以及与英国白人相比，他们接受的治疗类型也不同。这些差异需要考虑在内，以优化进入护理的途径并个性化治疗。
