Abstract
Purpose: Asian and Latinx individuals have a high burden of untreated depression. Under-recognition of depressive symptoms may contribute to existing disparities in depression treatment. The objective of this cross-sectional study was to determine whether physicians recognize and treat depressive symptoms for Chinese and Latinx patients during routine primary care visits.Methods: We analyzed data from 1171 Chinese and Latinx patients who were interviewed within 1 week after a primary care visit in a large academic practice, which had not yet implemented universal depression screening. We included participants with depressive symptoms (defined as a Patient Health Questionaire-2 score ≥3) and no prior history of depression (N=118). We investigated whether patients perceived having a mental health need in the prior year and conducted chart reviews to assess provider recognition of depressive symptoms, defined as documentation of symptoms, antidepressant initiation, or mental health referral within 30 days of the visit. We further examined differences by race/ethnicity and language preference.Results: Among the 118 patients with depressive symptoms and no prior depression diagnosis (mean age 68), 71 (61%) reported a mental health need in the prior 12 months; however, providers recognized depressive symptoms in only 8/118 patients (7%). The number of patients with recognized symptoms was small across race/ethnicity and language preference groups and we found no significant differences.Conclusion: Physicians recognized and documented depressive symptoms for 1 in 10 Chinese and Latinx patients during routine primary care visits. Targeted efforts are needed to address under-recognition of symptoms and improve depression care for these populations.
Highlights
The primary aim of this study was to investigate the proportion of Chinese and Latinx patients with current depressive symptoms, whose symptoms were recognized during a routine primary care visit in the absence of universal depression screening
The majority of Language Access System Improvement (LASI) participants were seen by primary care physicians, with a smaller number seen by primary care nurse practitioners or medicine residents between January 2016 and July 2017
Sample characteristics and prevalence of current depressive symptoms The 118 participants with current depressive symptoms and no history of depression tended to be older than 65 years, included majority women (70%), most had LEP (63%), had adequate health literacy (58%), were seen by their Primary Care Physician (PCP) during the index visit (72%), and were seen in languageconcordant visits in English or a non-English language (57%; Table 1)
Summary
Prior studies have found that racial/ethnic minority patients who are clinically depressed are less likely to be diagnosed and treated for their depression compared to non-Hispanic whites.[15,18,19,20,21,22,23,24,25,26,27,28] Asian and Latinx individuals are more likely to have untreated depression.[18,19,29,30] Yet it is unknown to what extent physicians recognize depressive symptoms among Chinese and Latinx patients without a prior diagnosis of depression and how this may contribute to mental health treatment disparities. Physicians cannot begin to address depressive symptoms, representing a missed opportunity for diagnosis and leading to a potential gap in treatment for patients with depressive symptoms. Primary care physicians are uniquely poised to detect, refer, and/or treat patients with depressive symptoms
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
