Racial differences in the discussion and treatment of depressive symptoms accompanying type 2 diabetes

Abstract

Objective To compare rates of discussion of and treatment for depression among African Americans and Whites with diabetes. Methods Measures of diabetes status, depressive symptoms, and history of discussing and being treated for depression were collected from 56 adults with elevated depressive symptoms accompanying diabetes who were drawn from a larger study of type 2 diabetes. Results Analyses adjusted for confounders and multiple tests indicated that relative to Whites, African Americans were 6–12 times less likely to have ever: discussed depression with anyone ( p = .007), discussed depression with their primary care physician ( p = .008), been prescribed an antidepressant ( p = .002), and they were 25 times less likely to have seen a psychiatrist ( p = .003). There were no significant differences in discussing depression with clergypersons, or family members/friends. Conclusions Compared to their White counterparts, African Americans with depressive symptoms accompanying diabetes are unlikely to discuss depression with healthcare professionals, be prescribed antidepressant medication, or be seen by a psychiatrist. Minority diabetes patients’ medical and psychiatric outcomes may improve if healthcare providers more actively initiate these discussions, provide culturally tailored education about the nature of depression and its management, incorporate patient preferences into treatment plans, and establish relationships with persons more likely to learn about African American patient symptoms.