Journal of Clinical Psychiatry
Volume 77, Issue 10, 2016, Pages e1287-e1292

Association between stigma and depression outcomes among Chinese immigrants in a primary care setting (Conference Paper)

Chen J.A.* , Shapero B.G. , Trinh N.-H.T. , Chang T.E. , Parkin S. , Alpert J.E. , Fava M. , Yeung A.S.
  • a Massachusetts General Hospital Depression Clinical and Research Program, 1 Bowdoin Sq, 6th Floor, Boston, MA 02114, United States, Harvard Medical School, Boston, MA, United States
  • b Massachusetts General Hospital Depression Clinical and Research Program, 1 Bowdoin Sq, 6th Floor, Boston, MA 02114, United States, Harvard Medical School, Boston, MA, United States
  • c Massachusetts General Hospital Depression Clinical and Research Program, 1 Bowdoin Sq, 6th Floor, Boston, MA 02114, United States, Harvard Medical School, Boston, MA, United States
  • d Massachusetts General Hospital Depression Clinical and Research Program, 1 Bowdoin Sq, 6th Floor, Boston, MA 02114, United States, Harvard Medical School, Boston, MA, United States
  • e Massachusetts General Hospital Depression Clinical and Research Program, 1 Bowdoin Sq, 6th Floor, Boston, MA 02114, United States
  • f Massachusetts General Hospital Depression Clinical and Research Program, 1 Bowdoin Sq, 6th Floor, Boston, MA 02114, United States, Harvard Medical School, Boston, MA, United States
  • g Massachusetts General Hospital Depression Clinical and Research Program, 1 Bowdoin Sq, 6th Floor, Boston, MA 02114, United States, Harvard Medical School, Boston, MA, United States
  • h Massachusetts General Hospital Depression Clinical and Research Program, 1 Bowdoin Sq, 6th Floor, Boston, MA 02114, United States, Harvard Medical School, Boston, MA, United States, South Cove Community Health Center, Boston, MA, United States

Abstract

Objective: Stigma has been proposed to be a major underlying factor contributing to lower rates of mental health service utilization among racial/ethnic minorities in the United States. Yet, surprisingly little research has specifically explored associations between stigma, race/ethnicity, and psychiatric morbidity. This study aims to assess the impact of stigmatizing attitudes on depression outcomes among a psychiatrically underserved, immigrant Chinese population. Methods: Between 2009 and 2012, 190 Chinese immigrants with major depressive disorder as diagnosed by the Mini International Neuropsychiatric Interview were enrolled in a trial of culturally sensitive collaborative care for depression. Participants? selfreported stigma regarding their symptoms was assessed at study entry using the Explanatory Model Interview Catalogue, and depressive symptoms were assessed with the Hamilton Depression Rating Scale (HDRS) at baseline and follow-up. Hierarchical linear regression was used to assess the association between baseline stigma score and change in HDRS score, adjusting for potential confounders. Results: Higher stigma scores at baseline were significantly associated with attenuated improvement in both HDRS score and quality of life at 6 months (P < .05 for both). Conclusions: Stigma has a directly harmful effect on depression outcomes, even after individuals have been accurately diagnosed within a culturally sensitive community health center and agreed to treatment. These results support further research into interventions targeting stigma to improve mental health outcomes among minority populations. Trial Registration: This study is a secondary analysis of prospectively collected data from the randomized controlled trial registered by ClinicalTrials.gov identifier: NCT00854542. © Copyright 2016 Physicians Postgraduate Press, Inc.

Author Keywords

[No Keywords available]

Index Keywords

secondary analysis China prospective study immigrant Chinese primary medical care mental health service randomized controlled trial (topic) minority group follow up human Prospective Studies Self Report middle aged statistics Interview, Psychological controlled study priority journal randomized controlled trial Aged Statistics as Topic Depressive Disorder telepsychiatry ethnology prognosis mini international neuropsychiatric interview cultural sensitivity Surveys and Questionnaires Young Adult quality of life Humans migrant psychology psychological interview male Emigrants and Immigrants Acculturation Aged, 80 and over female very elderly questionnaire Social Stigma Conference Paper linear regression analysis cultural factor Outcome Assessment (Health Care) major clinical study adult teleconference Hamilton Depression Rating Scale confounding variable outcome assessment Culturally Competent Care transcultural care major depression Telemedicine primary health care
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84992707532&doi=10.4088%2fJCP.15m10225&partnerID=40&md5=d9d432900a2ff33fecccfd02a135c971
DOI: 10.4088/JCP.15m10225
ISSN: 01606689
Cited by: 7
Original Language: English