Doctors are just as likely to diagnose
depression in an older adult regardless of whether
the person is white or black, male or female, the
results of a study indicate.
"We were somewhat surprised, " Dr. Helen C. Kales
from the Veterans Affairs Ann Arbor Healthcare System,
Michigan, stated, because much recent attention "focuses
on physicians' bias as a potentially large contributor
to health disparities."
Kales and her associates explain in the Journal of
the American Geriatrics Society that lower rates of
diagnosed depression have been reported in African
Americans, and this might be due to physicians' attitudes.
The team used standardized video vignettes, in which
the patient-actor's race or sex was varied, to see
how that did or did not affect primary care physicians'
diagnosis of late-life depression.
Of the 178 physicians who participated in the study,
151 (85 percent) correctly diagnosed major depression
in the elderly patient(s), the investigators report.
The diagnosis rate was similar for African American
men and women and white men and women portraying a
depressed patient. In fact, the physicians were most
confident in their diagnosis of African American women.
The doctors did not differ in their treatment recommendations,
follow-up choices, or potential psychiatric referral
for the different races and sexes, the report indicates.
Moreover, the physicians did not judge different patient
groups as more or less likely to adhere to or benefit
from treatment, the researchers note.
"Our findings suggest that physician bias based simply
on apparent race is not a likely explanation" for
lower rates of diagnosed depression in African Americans,
Kales said.
There may be "a multitude of other explanations,"
she continued -- including a number on the patient
side: "lower use of formal health care settings for
depression, different presentations of symptoms, and
patient treatment preferences."
The team is planning a study to look into "adherence
to depression medication by race," Kales added. "We
plan to examine factors such as spirituality and religiosity
that may underlie racial differences in the willingness
to take medications for depression."
SOURCE: Journal of the American Geriatrics Society,
May 2005.