A Hidden Disease: In Older Blacks, Depression Often Goes Untreated

Whites Are Far More Likely to Be Prescribed Antidepressant Drugs

Although depression is a common and troubling problem among the elderly, a July 2000 study suggests that its symptoms are being overlooked in many older black people. Elderly white people, the study found, are more than three times as likely to be prescribed anti-depressant drugs as elderly blacks.

In the July 2000 issue of the American Journal of Psychiatry, study author Dan Blazer, MD, PhD and colleagues from Duke University Medical Center in Durham, N.C., report the results of a 10 year survey of more than 4,000 people age 65 and older.

• One researcher says that part of the problem may be a reluctance on the part of black people to take antidepressants, to understand depressive symptoms, or to admit to having depression.
• Another expert says depression is often overlooked by patients and their doctors, and the symptoms are instead attributed to age-related medical conditions.

"Misconceptions of clinical depression as a weakness of character or a normal [part] of aging, rather than a treatable illness, are common," says George S. Zubenko, MD, PhD. Zubenko is a professor of psychiatry and biological sciences at the University of Pittsburgh School of Medicine.

A study that Zubenko conducted a few years ago suggested that older, depressed blacks responded better to antidepressants than whites. But further investigation found that, unlike whites with depression, the majority of blacks were never even treated for their depression until they required hospitalization.

Zubenko says that both patients and doctors may attribute signs of depression -- such as decreases in mood, interest, energy, sleep, and concentration -- to age-related medical conditions. "This contributes to the underdiagnosis of depression," he says.

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