Psychiatric services : a journal of the American Psychiatric Association
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Randomized Controlled Trial
A randomized controlled trial of culturally relevant, brief interpersonal psychotherapy for perinatal depression.
Depression during pregnancy is one of the strongest predictors of postpartum depression, which, in turn, has deleterious, lasting effects on infant and child well-being and on the mother's and father's mental health. The primary question guiding this randomized controlled trial was, Does culturally relevant, enhanced brief interpersonal psychotherapy (IPT-B) confer greater advantages to low-income, pregnant women than those that accrue from enhanced usual care in treating depression in this population? Enhanced IPT-B is a multicomponent model of care designed to treat antenatal depression and consists of an engagement session, followed by eight acute IPT-B sessions before the birth and maintenance IPT up to six months postpartum. IPT-B was specifically enhanced to make it culturally relevant to socioeconomically disadvantaged women. ⋯ Findings suggest that enhanced IPT-B ameliorates depression during pregnancy and prevents depressive relapse and improves social functioning up to six months postpartum.
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This study examined the association of maternal depression with the emotional and behavioral problems and adaptive skills of four- to ten-year-old children as rated by their mothers, fathers, and teachers. ⋯ This study contributes to the scientific literature by demonstrating the effects of raters and testing mediators of maternal depression in low-income African-American and Latino families. It demonstrated that mothers, fathers, and teachers observed worse functioning among children of mothers with depression than without depression, although reporters' perspectives varied somewhat. The impact of maternal depression over and above that of poverty suggests the importance of developing and funding services to address the needs of affected families.
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This secondary data analysis from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study compared clinical characteristics and outcome after citalopram treatment for Hispanic outpatients whose language preference was English (N=121) or Spanish (N=74). ⋯ Compared with English-speaking Hispanic patients, Spanish-speaking Hispanic patients may have a less robust response to antidepressants. The reasons for this are not clear but may include more disadvantaged social status. The degree to which these results can be generalized to other Hispanic populations or to other non-English-speaking groups remains to be seen.
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Disparity in depression treatment among racial and ethnic minority populations in the United States.
Prior research on racial and ethnic disparities in depression treatment has been limited by the scarcity of national samples that include an array of diagnostic and quality indicators and substantial numbers of non-English-speaking individuals from minority groups. Using nationally representative data for 8,762 persons, the authors evaluated differences in access to and quality of depression treatments between patients in racial-ethnic minority groups and non-Latino white patients. ⋯ Simply relying on present health care systems without consideration of the unique barriers to quality care that ethnic and racial minority populations face is unlikely to affect the pattern of disparities observed. Populations reluctant to visit a clinic for depression care may have correctly anticipated the limited quality of usual care.