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Patients Face Undiagnosed Depression

by Elaine Lapriore

Kathleen Ell, professor of social work at the University of Southern California and lead author of the study.

Nearly one-fourth of low-income minority women with cancer suffer from depression, but few are diagnosed or treated for it, according to a study published in the May issue of the Journal of Clinical Oncology.

Twenty-four percent of women met standard criteria for major depressive disorder, said Kathleen Ell, professor of social work at the University of Southern California and lead author of the study. That figure doubles the percentage found in existing research of middle- and upper-class, predominantly white women.

“Most striking, we saw that only 12 percent of poor minority women were receiving antidepressant medications and only five percent met with a counselor or support group,” Ell said. “This is in stark contrast to a recent study in which 80 percent of middle- and upper-class white female cancer patients were receiving antidepressants.”

The study tracked 472 women receiving care for breast or gynecologic cancer in a large urban public medical center. Nearly 80 percent of women in the study were Latina; the majority were Spanish speaking, foreign born and were insured under Medi-Cal or limited state or local short-term assistance for specific cancer treatments.

Untreated depression proved to be associated with economic and health literacy barriers, Ell said.

“Depressed women were significantly more likely to report fears about receiving treatment and side effects, lack of understanding about the treatment being recommended, inability to get all prescribed medications and concerns about lost wages due to illness or medical appointments,” she explained.

And, Ell said, “Women receiving antidepressants were less likely to report high levels of pain.”

Ell said she hopes that the study encourages routine screening for depression to uncover low-income women who need treatment. “When identified, we assume they will be more likely to receive care,” she said.

Led by Ell, the study’s team included researchers from the Keck School of Medicine of USC, the University of Maryland and the University of Washington.

Patients Face Undiagnosed Depression

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