Depression in Latinos: Assessment, Treatment, and Prevention

337 Pages·2008·2.59 MB·English

by  Sergio A. Aguilar-Gaxiola

Depression in Latinos
Forothertitlespublishedinthisseries,goto
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Sergio A. Aguilar-Gaxiola Thomas P. Gullotta
l
Editors
Depression in Latinos
Assessment, Treatment, and Prevention
EditorialResearchandAssistance
Jessica M. Ramos
ChildandFamilyAgencyofSoutheasternConnecticut,
NewLondon,USA
Cristina G. Magan˜ a
CenterforReducingHealthDisparities(CRHD)UniversityofCalifornia,
Davis,SchoolofMedicineCTSCBuilding,Sacramento
Foreword by Pedro Ruiz
1 3
Editors
SergioA.Aguilar-Gaxiola ThomasP.Gullotta
CenterforReducingHealthDisparities ChildandFamilyAgencyofSoutheastern
UniversityofCalifornia,Davis Connecticut
SchoolofMedicine, NewLondon,CT,USA
Sacramento,CA95817,USA [email protected]
sergio.aguilar-gaxiola@
ucdmc.ucdavis.edu
ISSN:1572-1981 e-ISSN:1572-1981
ISBN:978-0-387-78511-0 e-ISBN:978-0-387-78512-7
DOI:10.1007/978-0-387-78512-7
LibraryofCongressControlNumber:2008932563
#2008SpringerScienceþBusinessMedia,LLC
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For my wife, Diana, for your unwavering
love, support and confidence
Foreword
This book, Depression in Latinos: Epidemiology, Treatment, and Prevention,
edited by Sergio A. Aguilar-Gaxiola and Thomas P. Gullotta, represents the
mostfar-advancedconceptualizationofandknowledgeabout‘‘depression’’in
theLatinopopulationthatresidesintheUnitedStates.Depressionismorethan
a mental illness that requires prompt and effective clinical treatment; it is a
majorpublichealthproblemfortheU.S.LatinoaswellastheLatinAmerican
population. The economic burden of depression is a serious mental health
problem. In 2000, the total cost of depression was 83.08 billion dollars. Of
this amount, treatment costs were 26.09 billion, workplace costs were 51.54
billion(absenteeism,reducedproductivity,etc.),andsuicide-relatedcostswere
5.45billion(Mun˜oz,2003).Theworldwideburdenofdepressionissogreatthat
the World Health Organization has predicted that by 2020major depression
willbesecondonlytoischemicheartdiseaseasacauseofdisabilityworldwide
(Ballengeretal.,2001).
The cultural variations in the clinical manifestations of depression have
major implications from a diagnostic and treatment point of view, especially
for Latinos (Delgado et al., 2006; Kirmayer, 2001). Furthermore, even in the
best of circumstances, access and adherence to depression treatment is rather
deficientamongLatinos(Delgadoetal.,2006).Latinoswhosufferfromdepres-
sion are subjected to a high level of ethnic disparity regarding their diagnosis
andtreatment(Simpson,Krishnan,Kunik,&Ruiz,2007).
Therearequiteafewdifferencesintheclinicalmanifestationsofdepression
amongLatinosresidingintheUnitedStates,aswellasintheirconceptualiza-
tion and way of seeking mental health care for depression (Lopez & Carrillo,
2001;Ruiz,1985).Attimes,thesespecialcharacteristicsofdepressionarewell
manifested when Latinos suffer from different comorbidities to their depres-
sion, especially pain syndromes and HIV/AIDS (Fernandez & Ruiz, 2006;
Ruiz, Maldonado, & Fernandez, 1999). It also is very important to realize
that Latino patients have been found to respond differently to the various
psychopharmacological treatment approaches employed in the care of
depressivedisorders(Ruiz,2000).
Latinos living in the United States also have a special characteristic that
needs to be taken into consideration when attempting to diagnose and treat
ix
x Foreword
them, specifically their language. Some U.S. Latinos are fully bilingual in
English and Spanish but others are not. In addition, language is one of the
factorsstronglyassociatedwithlevelofacculturationandacculturativestress;
thus, the issue of language requires attention, knowledge, and study when
clinically addressing U.S. Latinos who suffer from depression. This issue has
already been addressed quite well in the medical literature (Gomez, Ruiz, &
Rumbaut,1985;Marcos,Urcuyo,Kesselman,&Alpert,1973).
Itiswithinthispreviouslyalludedcontextandbackgroundthattheeditors
decided to address ‘‘depression’’ among U.S. Latinos. Needless-to-say, the
cadre of scholars, clinicians, educators and investigators that they chose to
jointhemforthisformidabletaskcouldnotbeabetterone.Alloftheauthors
selectedtoaddressthetopicsincludedinthisbookarewell-knownresearchers
and/orcliniciansinthementalhealthandpsychiatricfield,andallarecurrently
workinginthementalhealthfield.Theyalsoarehighlyrespectedfortheirpast
and current contributions, as well as for their capacities to make important
contributionsinthementalhealthfieldforyearstocome.
This book offers an excellent set of topics divided into four parts. Part I
addressesthesocioeconomic,epidemiological,linguistic,andculturalfactorsin
depressionamongLatinos.Inthispart,fivechaptersaddresstheseveryimpor-
tant basic topics; the study of which is essential for the understanding of
depression among U.S. Latino populations. Part II discusses the prevention,
screening, assessment, and diagnosis of depression among U.S. Latinos. This
section encompasses three chapters that address these relevant issues; the
appropriate expertise in diagnosing depression among Latinos is essential for
theapplicationoftherighttreatmentsinthisethnicminoritypopulation.Part
III discussesthe treatment ofdepression among U.S. Latinos.Three chapters
areincludedinthissection,andeachcoverskeyrelevantareasinthetherapeutic
armamentariumrelatedtothetreatmentofdepressioninthispopulation.Part
IVfocusesongenderandlife-cycleissuespertainingtodepressionamongU.S.
Latinos.Thethreechaptersinthissectioncoverthesetwocriticalareasrelated
tothecareofdepressioninU.S.Latinopopulations.
This book is both timely and relevant. Today, about 100million ethnic
minority persons reside in the United States. In this number, Latinos are by
far thelargestethnic-minoritygroup.Giventhetrends observed inthegloba-
lization process that is currently occurring in all regions of the world, but
especially in industrialized regions like the United States and the European
Union,thenumberofethnic-minoritypopulationsareexpectedtoincreasein
thiscountry.MigrantscometotheUnitedStates,aswellasemigratetoother
countries all overtheworld,expecting toimprovetheir socioeconomiccondi-
tions; however, they also bring with them their norms, heritage, languages,
religions, food, etc.; that is, their cultures. The United States has become a
pluralistic and multiethnic society. It therefore is imperative that we mental
healthprofessionalsbecomeexpertsincross-culturalpsychiatry.Itisessential
becauseweowethesemultiethnicpatientsthequalityofmentalhealthcarethat
theydeserveashumanbeings.Muchattentioniscurrentlygiveninthisrespect
Foreword xi
(Gonzalez,Griffith,&Ruiz,2001;Munoz,Primm,Ananth,&Ruiz,2007;Ruiz,
1998,2004).
DepressioninLatinos:Epidemiology,Treatment,andPreventionisanexcel-
lent contribution to the prevention and treatment of depression in Latino
populationsbothintheUnitedStatesandabroad.Thisistimelyandimpor-
tant, and it will serve as a model for other clinicians, educators, and inves-
tigators who follow suit in addressing mental health needs among the
rainbow of ethnic-minority groups who reside in the United States. I con-
gratulate the editors and contributors to this book, especially Dr. Sergio
Aguilar-Gaxiola.
Houston,Texas PedroRuiz
References
Ballenger,J.C.,Davidson,J.R.T.,Lecubrier,Y.,Nutt,D.J.,Kirmayer,L.J.,Lepine,J.P.,
etal.(2001).Consensusstatementontransculturalissuesindepressionandanxietyfrom
the International Consensus Group on Depression and Anxiety. Journal of Clinical
Psychiatry,62(Suppl13),47–55.
Delgado,P.L.,Alegria,M.,Canive,J.M.,Diaz,E.,Escobar,J.I.,Kopelowicz,A.,etal.
(2006).DepressionandaccesstotreatmentamongU.S.Hispanics:Reviewoftheliterature
andrecommendationsforpolicyandresearch.FOCUS,14(1),38–47.
Fernandez, F., & Ruiz, P. (eds.) (2006). Psychiatric aspects of HIV/AIDS. Philadelphia,
PA:LippincottWilliams&Wilkins.
Gomez,R.,Ruiz,P.,&Rumbaut,R.D.(1985).Hispanicpatients:Alinguo-culturalminority.
HispanicJournalofBehavioralSciences,7(2),177–186.
Gonzalez, C.A., Griffith, E.E.H., & Ruiz, P. (2001). Cross-cultural issues in psychiatric
treatment. In G.O. Gabbard (ed.), Treatments of psychiatric disorder (5th edn.,
pp.47–67).Washington,DC:AmericanPsychiatricPublishing.
Kirmayer,L.J.(2001).Culturalvariationsintheclinicalpresentationofdepressionandanxiety:
Implications for diagnosis and treatment. Journal of Clinical Psychiatry, 62(Suppl 13),
22–28.
Lopez, A. G., & Carrillo, E. (eds.). (2001). The Latino psychiatric patient: Assessment and
treatment.Washington,DC:AmericanPsychiatricPublishing.
Marcos, L.R., Urcuyo, L., Kesselman, M., & Alpert, M. (1973). The language barrier in
evaluatingSpanish-Americanpatients.ArchivesofGeneralPsychiatry,29,655–659.
Munoz, R., Primm, A., Ananth, J., & Ruiz, P. (2007). Life in color: Culture in American
psychiatry.Chicago,IL:HiltonPublishingCo.
Munoz, S. S. (2003, December 31). Cost to treat a depression case falls. The Wall Street
Journal,p.D2.
Ruiz, P. (1985). Cultural barriers to effective medical care among Hispanic–American
patients.AnnualReviewofMedicine,36,63–71.
Ruiz,P.(1998).Newclinicalperspectiveinculturalpsychiatry.JournalofPracticalPsychiatry
andBehavioralHealth,4,150–156.
Ruiz, P. (ed.). (2000). Ethnicity and psychopharmacology. Washington, DC: American
PsychiatricPress.
Ruiz, P. (2004). Addressing culture, race & ethnicity in psychiatric practice. Psychiatric
Annals,34(7),527–532.
xii Foreword
Ruiz, P., Maldonado, J. L., & Fernandez, F. (1999). Depresion en pacientes con dolor
cronico. In J.A. Aldrete (ed.), Tratado de Algiologia. Mexico City, Mexico, Ciencia y
CulturaLatinoamericana,S.A.deC.V.:JGHEditores,pp.629–640.
Simpson, S. M., Krishnan, L. L., Kunik, M. E., & Ruiz, P. (2007). Racial disparities
in diagnosis and treatment of depression: A literature review. Psychiatric Quarterly,
78,3–14.