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White patients are more likely than minority patients to receive appropriate care for depression. However, evidence-based care for depression is equally effective in reducing depressive disorders for minority and white patients. Following a quality improvement initiative to provide evidence-based depression care at six managed primary care practices, minority patients who received appropriate care, compared with those who did not, had lower rates of probable depressive disorder at 6 months (20.5 vs. 70.5 percent). The findings were similar for white patients (24.3 percent vs. 71.2 percent).
On the other hand, functional outcomes of appropriate care, such as continued employment, may be more limited for minority than for white patients. For example, white patients who received appropriate depression care had higher rates of employment than those who did not receive appropriate care (71.4 vs. 52.4 percent). For minority patients, the effect was smaller (68.2 vs. 56.5 percent) and not statistically significant. The reasons for this difference are unclear. One possible explanation is that minority individuals may be less likely to capitalize on improvements in functioning by obtaining jobs because of educational and occupational preparedness differences, note the researchers.
The study findings suggest that efforts to develop ethnic-specific treatments for depression may be unnecessary, at least for Hispanics and blacks. However, that does not mean that treatment strategies do not need to be modified for minorities, caution the researchers. They examined depression and work status after an initiative to follow evidence-based guidelines for depression care at six managed primary care practices over 6 months. Their work was supported in part by the Agency for Healthcare Research and Quality (HS10858).
For more details, see "Effects of primary care depression treatment on minority patients' clinical status and employment," by Jeanne Miranda, Ph.D., Michael Schoenbaum, Ph.D., Cathy Sherbourne, Ph.D., and others, in the August 2004 Archives of General Psychiatry 61, pp. 827-834.
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