Racial and ethnic differences in the persistence of Depression and Dysthymia: Results from the Collaborative Psychiatric Epidemiology Surveys

Background: Some studies have indicated that the course of mood disorders is more persistent for racial and ethnic minorities. However previous studies have not investigated some of the hypothesized mechanisms that may explain these racial disparities.

Objective: To examine if age of onset, psychiatric comorbidity, chronic medical conditions, or access to mental healthcare explain racial differences in the persistence of Depression and Dysthymia.

Methods: Data were obtained from the Collaborative Psychiatric Epidemiology Surveys. The sample was restricted to 2,745 Black, Latino, Asian, and Non-Hispanic White participants that met the WHO-CIDI criteria for Major Depressive Disorder or Dysthymia at least two years prior to the interview. Persistence was indicated if the disorder was present within the last twelve months. Logistic regression models were used to examine racial and ethnic differences in the odds of a persistent disorder.

Results: There were racial disparities in persistence. All of the minority groups were more likely to meet the criteria for persistent Depression or Dysthymia compared to the Non-Hispanic White participants. Age of onset was not associated with a persistent course after adjusting for the other predictors. However chronic medical conditions, the use of professional mental health services, and a history of Anxiety or Substance Use Disorders were all associated with persistent Depression or Dysthymia. Racial and ethnic differences in persistence remained after controlling for these other factors. There was no evidence that racial differences in comorbidity or access to mental health care explained the racial disparities.