Depression among Asian Americans: Review and Recommendations

Michigan State University, East Lansing, MI, USA.
Depression research and treatment 09/2011; 2011(10):320902. DOI: 10.1155/2011/320902
Source: PubMed


This article presents a review of the prevalence and manifestation of depression among Asian Americans and discusses some of the existing issues in the assessment and diagnosis of depression among Asian Americans. The authors point out the diversity and increasing numbers of Asian Americans and the need to provide better mental health services for this population. While the prevalence of depression among Asian Americans is lower than that among other ethnic/racial groups, Asian Americans receive treatment for depression less often and its quality is less adequate. In addition, the previous belief that Asians somatize depression may become obsolete as more evidence appears to support that Westerners may "psychologize" depression. The cultural validity of the current DSM-IV conceptualization of depression is questioned. In the course of the review, the theme of complexity emerges: the heterogeneity of ethnic Asian American groups, the multidimensionality of depression, and the intersectionality of multiple factors among depressed Asian Americans.

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Available from: Frederick T.L. Leong, Feb 12, 2014
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    • "API groups differences in depression risk have been observed with Filipinos and Pacific Islanders at higher risk than other Asians [5] [6]. These findings highlight the importance of examining API sub-groups separately since they differ on a number of variables such as income, educational level, and immigration status [7] "

    01/2015; 2(1):16-21. DOI:10.15764/STP.2015.01003
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    • "One of the major problems with ethnocultural variations of depressive disorders is evident in the measurement of depressive experiences. The existing assessments of depressive symptoms may have limited cultural validity that may reduce their clinical utility in non-Western populations (Marsella et al. 1985; Kalibatseva & Leong, 2011). In particular, measurement variance may result in misclassification, such that minorities are less likely to meet DSM-IV criteria despite similar levels of an underlying disorder. "
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    ABSTRACT: Background: Theoretical and clinical publications suggest the existence of cultural differences in the expression and experience of depression. Measurement non-equivalence remains a potential methodological explanation for the lower prevalence of depression among Asian Americans compared to European Americans. Method: This study compared DSM-IV depressive symptoms among Asian Americans and European Americans using secondary data analysis of the Collaborative Psychiatric Epidemiology Surveys (CPES). The Composite International Diagnostic Interview (CIDI) was used for the assessment of depressive symptoms. Of the entire sample, 310 Asian Americans and 1974 European Americans reported depressive symptoms and were included in the analyses. Measurement variance was examined with an item response theory differential item functioning (IRT DIF) analysis. Results: χ2 analyses indicated that, compared to Asian Americans, European American participants more frequently endorsed affective symptoms such as 'feeling depressed', 'feeling discouraged' and 'cried more often'. The IRT analysis detected DIF for four out of the 15 depression symptom items. At equal levels of depression, Asian Americans endorsed feeling worthless and appetite changes more easily than European Americans, and European Americans endorsed feeling nervous and crying more often than Asian Americans. Conclusions: Asian Americans did not seem to over-report somatic symptoms; however, European Americans seemed to report more affective symptoms than Asian Americans. The results suggest that there was measurement variance in a few of the depression items.
    Psychological Medicine 09/2014; 44(12):2567-2578. DOI:10.1017/S0033291714000130 · 5.94 Impact Factor
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    • "First, research investigating depression treatment in immigrant populations is sparse and treatment recommendations are largely inferred on the basis of studies done on Caucasian populations [10]. Second, while there is evidence to suggest that culturally framed interventions are effective in treating mental disorders in culturally diverse patient groups [11], it is not clear which specific models and interventions are more (or less) effective in treating depression in immigrant populations [12]. Therefore, this review will systematically identify studies that investigate depression treatments in immigrant populations and evaluate the effectiveness of these treatment strategies/models. "
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    ABSTRACT: Background The unprecedented rates of global migration present unique challenges to mental health services in migrant receiving countries to provide efficacious and culturally salient treatment for mental health conditions including depression. This review aimed to identify and evaluate the effectiveness of depression interventions specifically directed towards first-generation immigrant populations. Methods We conducted a systematic review of original research published between 2000 and 2013 that investigated depression interventions in first generation immigrants. Results Fifteen studies were included; the majority focused on Latino immigrants living in the United States (US). Twelve studies investigated the use of psychotherapies; the remainder examined collaborative care models and physical exercise-based interventions. Cognitive Behavioral Therapy and Behavioral Activation tended to improve depressive symptoms, especially when culturally adapted to suit clients while Problem Solving Therapy improved depressive symptomology with and without adaptations. Collaborative care and exercise did not significantly improve depressive symptoms. Conclusion Depression may be effectively treated by means of psychotherapies, especially when treatments are culturally adapted. However the reviewed studies were limited due to methodological weaknesses and were predominantly undertaken in the US with Latino patients. To improve generalizability, future research should be undertaken in non-US settings, amongst diverse ethnic groups and utilize larger sample sizes in either randomized clinical trials or observational cohort studies.
    BMC Psychiatry 06/2014; 14(1):176. DOI:10.1186/1471-244X-14-176 · 2.21 Impact Factor
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