Monday, April 21, 2008

Psychiatric Times: Cultural Aspects of the Pharmacological Treatment of Depression: Factors Affecting Minority and Youth

Eugenio M. Rothe, MD, Andres J. Pumariega, MD, and Kenneth M. Rogers, MD
Dr Rothe is associate professor at the Robert Stempel School of Public Health, department of health promotion and disease prevention, Florida International University; he is also in private practice in Miami. Dr Pumariega is chair of the department of psychiatry at Reading Hospital in Pennsylvania; he is also professor of psychiatry at Temple University School of Medicine in Philadelphia. Dr Rogers is assistant professor and director of child and adolescent psychiatry residency at the University of Maryland in Baltimore. The authors report that they have no conflicts of interest concerning the subject matter of this article.

The most recent studies reveal that minority children and adolescents are at a higher risk for depression than white youth. This is particularly true for Hispanic, non-Hispanic black, and American Indian youths.

Suicide rates, which have been traditionally lower among minority youth, are now equal to or surpass those of white youth. Hispanic, non-Hispanic black, and American Indian youth have a higher suicide risk than youth from the mainstream culture.

The stresses of living in poverty are frequently accompanied by variables such as discrimination, gender role pressures, losses related to immigration, and ongoing frustration and deficient support systems, which abound in this population.

Conflict also plays an important role in depression and often evolves into a vicious cycle in which irritability—a common feature of child and adolescent depression—increases interpersonal tensions and may cause parents, teachers, and friends to distance themselves from the depressed person. This, in turn, increases feelings of abandonment and lack of support.

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