Too Sad to Care: Relationship between depressive symptoms and delays in seeking medical care

Objective: 1. To determine whether five symptoms of depression are correlated to delayed medical care among an at-risk, majority African American population in Houston, TX; 2. To assess gender differences regarding the influence of symptoms of depression on delayed medical care among an at-risk predominately African American, community population.

Methods: Questionnaires administered to 215 Houston residents. Participants were recruited from clinics and club/bars locally. A chi-square analysis revealed symptoms of depression were associated with delayed medical care. Logistic regression models calculated odds ratios and 95% confidence intervals for five symptoms of depression, individually and collectively, among the study population. Obvious differences were revealed by a gender stratification of the logistic regression. Findings were stratified by 1) individual or collective entry into the regression model, 2) gender, and 3) a total analysis of cases and places, cases only, and/or places only.

Results: Women who reported feelings of worthlessness (OR=1.59, 1.18-2.14), feelings of hopelessness (OR = 1.33, 1.02-1.74), a change in appetite (OR=1.33, 1.01-1.76) and a loss of pleasure and interest in enjoyable activities (OR = 1.41, 1.06-1.87) revealed a significantly stronger correlation to delayed medical care than men. Conversely, trouble sleeping was significantly correlated with delayed medical care among men (OR=1.70, 1.02-2.82).

Conclusion: This assessment of symptoms of depression in association with delayed medical care revealed a gender difference in the relationship between symptoms of depression and willingness to sustain physical health among an at-risk, African American population. Findings such as this have not been published to date. Future research should explore this correlation among similar populations for the purpose of generalizing the findings and designing interventions purposed to improve medical care access at the onset of depression symptoms.