Depression in Latinos: Assessment, Treatment, and Prevention PDF
Preview Depression in Latinos: Assessment, Treatment, and Prevention
Depression in Latinos For other titles published in this series, go to http://www.springer.com/series/6110 Sergio A. Aguilar-Gaxiola l Thomas P. Gullotta Editors Depression in Latinos Assessment, Treatment, and Prevention Editorial Research and Assistance Jessica M. Ramos Child and Family Agency of Southeastern Connecticut, New London, USA Cristina G. Magan˜ a Center for Reducing Health Disparities (CRHD) University of California, Davis, School of Medicine CTSC Building, Sacramento Foreword by Pedro Ruiz 1 3 Editors Sergio A. Aguilar-Gaxiola Thomas P. Gullotta Center for Reducing Health Disparities Child and Family Agency of Southeastern University of California, Davis Connecticut School of Medicine, New London, CT, USA Sacramento, CA 95817, USA 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 most far-advanced conceptualization of and knowledge about ‘‘depression’’ in the Latino population that resides in the United States. Depression is more than a mental illness that requires prompt and effective clinical treatment; it is a major public health problem for the U.S. Latino as well as the Latin American 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, reduced productivity, etc.), and suicide-related costs were 5.45 billion (Mun˜ oz, 2003). The worldwide burden of depression is so great that the World Health Organization has predicted that by 2020major depression will be second only to ischemic heart disease as a cause of disability worldwide (Ballenger et al., 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 deficient among Latinos (Delgado et al., 2006). Latinos who suffer from depres- sion are subjected to a high level of ethnic disparity regarding their diagnosis and treatment (Simpson, Krishnan, Kunik, & Ruiz, 2007). There are quite a few differences in the clinical manifestations of depression among Latinos residing in the United States, as well as in their conceptualiza- tion and way of seeking mental health care for depression (Lopez & Carrillo, 2001; Ruiz, 1985). At times, these special characteristics of depression are well 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 depressive disorders (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 factors strongly associated with level of acculturation and acculturative stress; 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). It is within this previously alluded context and background that the editors decided to address ‘‘depression’’ among U.S. Latinos. Needless-to-say, the cadre of scholars, clinicians, educators and investigators that they chose to join them for this formidable task could not be a better one. All of the authors selected to address the topics included in this book are well-known researchers and/or clinicians in the mental health and psychiatric field, and all are currently working in the mental health field. They also are highly respected for their past and current contributions, as well as for their capacities to make important contributions in the mental health field for years to come. This book offers an excellent set of topics divided into four parts. Part I addresses the socioeconomic, epidemiological, linguistic, and cultural factors in depression among Latinos. In this part, five chapters address these very impor- 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 the application of the right treatments in this ethnic minority population. Part III discusses the treatment of depression among U.S. Latinos. Three chapters are included in this section, and each covers key relevant areas in the therapeutic armamentarium related to the treatment of depression in this population. Part IV focuses on gender and life-cycle issues pertaining to depression among U.S. Latinos. The three chapters in this section cover these two critical areas related to the care of depression in U.S. Latino populations. 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 the largest ethnic-minority group. Given the trends observed in the globa- 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, the number of ethnic-minority populations are expected to increase in this country. Migrants come to the United States, as well as emigrate to other countries all over the world, expecting to improve their socioeconomic condi- 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 health professionals become experts in cross-cultural psychiatry. It is essential because we owe these multiethnic patients the quality of mental health care that they deserve as human beings. Much attention is currently given in this respect Foreword xi (Gonzalez, Griffith, &Ruiz, 2001;Munoz, Primm, Ananth, &Ruiz, 2007; Ruiz, 1998, 2004). Depression in Latinos: Epidemiology, Treatment, and Preventionis an excel- lent contribution to the prevention and treatment of depression in Latino populations both in the United States and abroad. This is timely and impor- 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 Pedro Ruiz References Ballenger, J. C., Davidson, J. R. T., Lecubrier, Y., Nutt, D. J., Kirmayer, L. J., Lepine, J. P., et al. (2001). Consensus statement on transcultural issues in depression and anxiety from the International Consensus Group on Depression and Anxiety. Journal of Clinical Psychiatry, 62(Suppl 13), 47–55. Delgado, P. L., Alegria, M., Canive, J. M., Diaz, E., Escobar, J. I., Kopelowicz, A., et al. (2006). Depression and access to treatment amongU.S. Hispanics: Review of the literature and recommendations for policy and research. FOCUS, 14(1), 38–47. Fernandez, F., & Ruiz, P. (eds.) (2006). Psychiatric aspects of HIV/AIDS. Philadelphia, PA: Lippincott Williams & Wilkins. Gomez, R., Ruiz, P., &Rumbaut, R.D. (1985). Hispanic patients: A linguo-cultural minority. Hispanic Journal of Behavioral Sciences, 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: American Psychiatric Publishing. Kirmayer, L. J. (2001). Cultural variations in the clinical presentation of depression and anxiety: 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: American Psychiatric Publishing. Marcos, L.R., Urcuyo, L., Kesselman, M., & Alpert, M. (1973). The language barrier in evaluating Spanish-American patients. Archives of General Psychiatry, 29, 655–659. Munoz, R., Primm, A., Ananth, J., & Ruiz, P. (2007). Life in color: Culture in American psychiatry.Chicago, IL: Hilton Publishing Co. 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. Annual Review of Medicine, 36, 63–71. Ruiz, P. (1998). New clinical perspective in cultural psychiatry. Journal of Practical Psychiatry and Behavioral Health, 4, 150–156. Ruiz, P. (ed.). (2000). Ethnicity and psychopharmacology. Washington, DC: American Psychiatric Press. 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 Cultura Latinoamericana, S.A. de C.V.: JGH Editores, 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.
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