Depression in Latinos - Assessment, Treatment, and Prevention

Depression in Latinos

Foreword

Contents

Contributors

Introduction

Part 1: Sociodemographic, Epidemiological, Linguistic, and Cultural Factors in Depression in Latinos

The Context of Depression in Latinos in the United States

Personal Journey: Sergio Aguilar-Gaxiola

Introduction

The Latino Population in the United States

Mexicans

Puerto Ricans

Cubans

Dominicans

Central and South Americans

Cultural Issues, Values, and Constructs

The Importance of Culture in Mental Illness

Idioms of Distress

Cultural Constructs

Culture Bound Syndromes

General Characteristics of the Latino Population

Religion

Depression in Latinos

Prevalence

Risk and Protective Factors for Depression

Risk Factors

Protective Factors

Comorbid Conditions

Disability, Morbidity, and Mortality in the Elderly

Health Care Beliefs and Behaviors, and Health Services Utilization

Beliefs and Behaviors

Health Service Utilization

Conclusions

References

Latino Population Demographics, Risk Factors, and Depression: A Case Study of the Mexican American Prevalence and Services Survey

Personal Journey: William A. Vega

Personal Journey: William M. Sribney

Introduction

Population Structure of U.S. Latinos

Major Depression in Different Latino Populations

Description of the MAPSS Methodology

Characteristics of the MAPSS Study Population

Lifetime Major Depressive Episodes Compared to Anxiety and Substance Disorders

Immigrant Age at Arrival and Major Depression

Assimilation and Depression

The Impact of Disrupted Marital Status

Parental Risk Factors, Social Assimilation, and Depression

Conclusions

References

Descriptive Epidemiology of Depression in Latin America and Hispanics in the United States

Personal Journey: Guilherme Borges

Introduction

Methods

Samples

Measures

Diagnostic

Prevalence

Disorder Severity

Role Impairment

Treatment Sectors

Analyses

Results

Discussion

Conclusion

References

Comorbidity: Depression and Substance Abuse

Personal Journey: María Elena Medina-Mora

Introduction

Definitions and Theory

Tobacco Smoking and Depression

Cocaine Abuse and Depression

Alcohol and Depression

Substance Abuse and Depression: The Context

Sociocultural Issues

Extent of Substance Abuse and Mental Health Disorders

Alcohol Abuse

Abuse of Other Substances

Mental Disorders

Comorbidity

Treatment of Comorbid Disorders

Conclusion

References

Cultural Considerations in the Diagnosis and Classification of Depression: The Hispanic Perspective

Personal Journey: Renato D. Alarcón

Introduction

Sociocultural Characteristics of Hispanic Populations

Cultural Dimensions in the Diagnosis of Depression among Hispanics

DSM-IV-TR Cultural Formulation and the Hispanic Depressed Patient

Suggestions for Diagnosis and Classification of Depression among Hispanics

General

Specific

A Research Agenda

Conclusions

References

Part 2: Prevention, Screening, Assessment, and Diagnosis of Depression

Prevention of Depression in Latinos

Personal Journey: John Pérez

Personal Journey: Ricardo Muñoz

Introduction

Levels of Prevention

Randomized, Controlled Prevention Trials Focusing on Depressive Symptoms

Randomized, Controlled Trials Designed to Prevent Major Depressive Episodes

Enhancing Cultural Competency in Depression Prevention Interventions

Risk Factors for Depression

Socioeconomic Status

Residence in the United States

Enhancing Protective Factors

Social Support/Family Network

Religion and Spirituality

Multilevel, Multidisciplinary Approach

Use of Innovative Delivery Methods

Conclusions

References

Assessment of Depression Symptoms: Self-report Paper-and-Pencil and Computerized Questionnaires

Personal Journey: Gerardo M. González

Detection of Depression

Obstacles to Depression Assessment and Services for Latinos

Conventional Methods of Depression Screening

The Beck Depression Inventory-II (BDI-II )

The Center for Epidemiological Studies-Depression Scale (CES-D)

The Children’s Depression Inventory (CDI)

Reynolds Child and Adolescent Depression Scales

Geriatric Depression Scale (GDS)

Limitations of Conventional Screening

Computerized Assessment of Depression

Telephone-Assisted Computerized Screening

The Voice-Interactive Depression Assessment System (VIDAS)

Future Directions in Depression Screening Methods

Computerized Assessment with Latino Children

Comorbidity

The Internet

Practical Implications of Depression Screening for Latinos

Conclusion

References

Diagnosis of Depression Among Latino Children and Adults

Personal Journey: Antonio J. Polo

Personal Journey: Steven R. López

Introduction

Classification and Diagnostic Criteria for Depressive Disorders

Major Depressive Disorder

Criteria for Major Depressive Episode (DSM-IV-TR; APA, 2000)

Dysthymic Disorder

Criteria for Dysthymic Disorder (APA, 2000)

Diagnostic Instruments for Depressive Disorders

Diagnostic Instruments for Adults

Diagnostic Instruments for Children and Adolescents

Psychometric Properties of Depression Diagnostic Instruments

Test-Retest Reliability Findings

Concurrent Validity Findings

Translation and ‘‘Real World’’ Considerations

Summary

References

Part 3: Treatment of Depression

Psychosocial Treatments for Depression with Adult Latinos

Personal Journey: Guillermo Bernal

Introduction

Historical Conceptualization of Depression

Ethnic Differences in the Concept of Depression

Epidemiology

Psychosocial Treatment for Depression

Cognitive Behavior Therapy

Treatment of Depression

Working with Cognitions

Pleasant Activities

Contact with People

Cultural Adaptations of CBT

Effectiveness of CBT with Latinos

Interpersonal Psychotherapy

Interpersonal Problem Areas

Grief

Interpersonal Disputes

Role Transitions

Interpersonal Deficits

Effectiveness of IPT with Latinos

Visions for the Future and Recommendations

References

Pharmacological Treatment of Depression in Hispanic Americans

Personal Journey: Alex J. Kopelowicz

Introduction

Efficacy of Antidepressant Treatment in Hispanic Americans

Efficacy of Pharmacologic Versus Psychotherapy Treatment for Depressed Hispanics

Preference and Acceptability of Antidepressant Treatment Among Hispanics

Pharmacogenetics of Drug Metabolizing Enzymes

Drug Metabolizing Enzymes

CYP2D6

CYP2C19

CYP1A2

CYP3A4

Environmental Factors

Traditional and Alternative Healing Methods

Dietary Effects

Placebo Effects

Compliance

Coexisting Conditions

Discussion and Recommendations

References

Community-Based Interventions for Depression

Personal Journey: Jeanne Miranda

Introduction

Treatment of Depression in Latinos

Treatment of Depression in Medical Settings

Community-Based Interventions to Improve Access to Appropriate Care

Vision of the Future and Recommendations

References

Part 4: Gender and Life-Cycle Issues

Women and Depression: The Influence of Gender in Major Depressive Disorder

Personal Journey: María Asunción Lara

Gender Differences in Depression

Experience of Depression in Latinas

Explaining Gender Differences in Depression Rates

Biological Explanations

Genetic Factors

Reproductive Hormones

Pregnancy and the Postpartum Period

Psychosocial Explanations

Risk Factors for Depression in Women

Childhood and Adverse Conditions

Life Events and Social Support

Domestic Violence

Women’s Status in Societies and Gender Roles

Marital Status and Childcare

The Cost of Caring for Others

Paid Work

Poverty

Migration and Nativity

Assessment, Treatment and Prevention of Depression in Women

Assessment

Treatment

Preventing Depression

Use of Mental Health Services by Latinas

Recommendations

References

Depression in Latino Children and Adolescents: Prevalence, Prevention, and Treatment

Personal Journey: Guillermo Bernal and Jeannette Rosselló

Introduction and Epidemiology of Depression

Prevention of Depression

Treatment of Depression in Latino Youth

Vision for the Future and Recommendations

References

Epidemiology, Assessment, and Treatment of Depression in Older Latinos

Personal Journey: Ladson Hinton

Personal Journey: Pat Areán

Demography of Aging in Latinos

Epidemiology: Prevalence, Correlates, and Consequences

Prevalence of Depression in Community Settings

Prevalence of Depression in Primary-Care Settings

Risk Factors Associated with Depression

Patterns of Treatment for Depression

Assessing Depression in Older Latinos

Validity of MDD Criteria in Elderly

Psychosocial Interventions

Pharmacological Treatment Approaches

Depression and Dementia

Depression and the Family

Depression and Substance Abuse

Adherence and Access to Care

Cultural and Linguistic Considerations

Depression and End-of-Life Care

Summary

References

Epilogue

About the Editors

About the Authors

Index