Study: Whites more likely to get antidepressant prescription than African-Americans, Hispanics

iStockphoto

(CBS News) If you're Caucasian, you're more likely to get a prescription for antidepressants than your Hispanic and African-American counterparts, new research shows.

A study published in last month's International Journal of Psychiatry in Medicine said that Caucasians were 1.52 times more likely to receive antidepressant medication over Hispanic and African-American patients also being treated for major depressive disorders.

"This study confirmed previous findings that sociological factors, such as race and ethnicity, and patient health insurance status, influence physician prescribing behaviors," lead researcher Dr. Rajesh Balkrishnan, associate professor in University of Michigan School of Public Health, said in the press release. "This is true in particular for major depressive disorder treatment."

Researchers also found out that while race didn't play a role in what type of antidepressant was prescribed, Medicare and Medicaid patients were 31 and 38 percent less likely to receive a prescription. And, if they did get one, more than half of the time it was for an older generation antidepressant.

The newer generation of medications, like such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), are considered the first-line treatment for major depression. Oder antidepressants, which include monoamine oxidase inhibitors (MAOIs), carry more side effects.

"We want the policy to motivate physicians to adhere to clinical practice guidelines better," study co-author Dr. Hsien-Chang Lin told The Atlantic. "Health disparities, especially with ethnic groups, can be helped with better access to healthcare and by having more insured people."

But, race may play more a factor than just the physician's prescribing choice. Loretta Jones, founder and executive director of Healthy African American Families, who has spent 30 years studying minority health policy, said to The Atlantic that African-Americans are less likely to take antidepressants because they are less likely to ask for them and don't want to be considered "crazy."

Brenda Wesley, a trained mental health educator and facilitator with the advocacy organization, National Alliance on Mental Illness in Milwaukee, also pointed to cultural disparities, telling the Milwaukee-Wisconsin Journal Sentinel that many minorities don't seek help for depression-related issues until they are in a "crisis mode." When they do seek help, Wesley said, doctors might see the elevated symptoms and misdiagnose patients with bipolar disorder or schizophrenia.

Jones also pointed out that African-Americans are more likely to be seen in clinics and centers where doctors don't have time to spend with their patients, which coincided with study's findings that physicians who had seen the patients before were 1.4 times more likely to prescribe antidepressants.

Said Jones, "Until the National Institute of Mental Health puts down a policy, and says treat all patients this [one] way the [healthcare discrepancies] will continue."

[ericbakker]

Modern researches identified that there is not only skin color difference, but there are some genomic differences. There was identified a single nucleotide polymorphism in the drug metabolizing enzyme, that highly significantly predicted antidepressants clearance in the Clinical Antipsychotic Trials. And increased clearance from its side reduces drug therapeutic concentration in the blood.

[amerilatino]

What the article does not point out is the fact that for most Hispanics and Blacks who wish to get ahead, approaching life's challenges from a percieved position of weakness is not a savory option at all, thus the strategy of attempting to cope with certain handicaps or depression internally or by "bucking up" rather that admitting the need for treatment and/or counseling. This probably comes from the fact that this kind of help was not usually financially available to minorities in the past, and therefore considered an unfortunate and expensive last resort for minority families which carried a stigma for those affected.

[lillyhorton]

My doctor is on a 5 minute a patient rule and gets flustered if I ask questions about his diagnosis. I am a middle class white with insurance. To make the statement that minorities get less attention from their doctors is bold. White people just don't talk about it. We don't turn everything into a racial issue. We internalize it. "The doctor hates me" type thought.

[amerilatino]

Lilly, if you're not perspicacious enough to demand proper medical attention from your doctor or change doctors having health insurance, that's your problem. Just don't presume that we Hispanics all subscribe to that mindset (or lack thereof) like sheep.