Minorities Prefer Counseling to Drugs for Treating Depression

Some ethnic minorities could be twice as likely as white and Native American people to prefer counseling and prayer to medication for treating depression, according to a national Internet survey.

African-Americans, Hispanics and Asians who took the survey were skeptical about the biological basis of depression and wary of becoming addicted to antidepressants, according to Jane Givens, M.D., of Boston University Medical Center and colleagues.

The survey results appear in the latest issue of the journal General Hospital Psychiatry.

“This study documents that, overall, ethnic minorities hold attitudes toward depression and depression treatment that are distinct from those of white participants,” Givens said.

The findings are important because studies show that while minority and white populations suffer from similar rates of depression, diagnosis and treatment are less likely for members of minority populations.

Junling Wang, Ph.D., a researcher at the University of Tennessee, College of Pharmacy, recently published a study showing that African-American and Hispanic patients use SSRI antidepressants, which include commonly prescribed medications such as Prozac and Zoloft, less often than white patients do.

Although Wang and her fellow researchers thought SSRI use might signal improved access to health care, “we did not study whether the lower use of SSRIs is indicative of fewer health care visits or a lower change of being diagnosed with depression among minorities,” she said.

For their study, Givens and colleagues surveyed people with the help of an anonymous Internet depression-screening test offered free on the health information Web site InteliHealth, owned by Aetna US Healthcare. The researchers collected information from 78,753 people who had taken the test between January 1999 and April 2002.

“To our knowledge, there are no prior studies examining ethnic variations in treatment preferences for depression or other illnesses among Internet users,” said the study’s senior author, Lisa Cooper, M.D., of Johns Hopkins University.

Nearly 65 percent of those surveyed said they would be most worried about their employers finding out about their depression diagnoses, although many said they would be concerned about the reaction of friends and family as well.

The survey also uncovered other surprising treatment preferences among the groups. For instance, African-American and Hispanic participants were more likely to prefer a doctor of the same sex to treat their depression than white participants. African-Americans surveyed had a strong preference for a doctor of the same ethnicity, while Asians, Hispanics and Native Americans were less likely than white participants to want a doctor from their own ethnic background.

The Aetna Foundation Quality Care Research Fund supported the study.