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1. Depressionin African American Women Allesa English, M.D.
University of Tennessee Health Science Center
Department of Psychiatry Good Morning,
Thanks to Dr. Greene for inviting me to be your last Grand Rounds Speaker for this academic year. I’m excited to be visiting my future home, and feel honored to have the opportunity to share with you some of the literature as well as my thoughts regarding African American women with depression.
It’s a topic that has some personal resonance for me. Growing up, I knew very little about mental illness, and it seemed to be a foreign entitiy that happened to other people or or TV. Choosing psychiatry for a career was surprising to me, and to my family. However, once I began training, family members began to pull me aside and tell me about their experiences with the mental health system. Many women in my extended family had experienced “nervous breakdowns”. Some had even been hospitalized.
I’ve been fortunate to work in East Baltimore and Washington, D.C., areas that have large African American populations like Memphis. At Johns Hopkins, I was one of a few African American female residents, and tended to have some African American patients referred specficially to me. I also worked there in the community psychiatry clinic which served the surrounding East Baltimore population.
Then at Howard, I’ve had the unique experience of working at a Historically Black Medical School and serving a predominantly African American population. My interest in this topic has developed from those experiences, and I’ll share some of them with you today.Good Morning,
Thanks to Dr. Greene for inviting me to be your last Grand Rounds Speaker for this academic year. I’m excited to be visiting my future home, and feel honored to have the opportunity to share with you some of the literature as well as my thoughts regarding African American women with depression.
It’s a topic that has some personal resonance for me. Growing up, I knew very little about mental illness, and it seemed to be a foreign entitiy that happened to other people or or TV. Choosing psychiatry for a career was surprising to me, and to my family. However, once I began training, family members began to pull me aside and tell me about their experiences with the mental health system. Many women in my extended family had experienced “nervous breakdowns”. Some had even been hospitalized.
I’ve been fortunate to work in East Baltimore and Washington, D.C., areas that have large African American populations like Memphis. At Johns Hopkins, I was one of a few African American female residents, and tended to have some African American patients referred specficially to me. I also worked there in the community psychiatry clinic which served the surrounding East Baltimore population.
Then at Howard, I’ve had the unique experience of working at a Historically Black Medical School and serving a predominantly African American population. My interest in this topic has developed from those experiences, and I’ll share some of them with you today.
3. Depression in African American Women Are African American women depressed?
Why are African American women less likely to receive treatment?
Is treatment effective for African American Women?
How Can We Address the Problem?
4. Depression in African American Women:What is Known? Depression is significant in African-American Women
Data are discrepant on prevalence
Consider syndromal vs subsyndromal
The prevalence of schizophrenia and bipolar disorder is accepted to be equally prevalent across races, but the data for depression is less clear. In fact, the data are contradictory in comparing the rates of depressive illness in African American and Caucasian Americans. The prevalence of schizophrenia and bipolar disorder is accepted to be equally prevalent across races, but the data for depression is less clear. In fact, the data are contradictory in comparing the rates of depressive illness in African American and Caucasian Americans.
5. Depression is Significant
Discrepant Data
ECA (Zhang and Snowden,1999) compared the ethnic ratio of mental disorders among white, black, Hispanic and Asian Americans, and found African Americans:
Less likely to have MDD, MDE, and dysthymia
More likely to have somatization and phobias
NHANES III (Riolo, 2005) examined depression prevalence by race and ethnicity across a nationally representative sample, & African Americans were:
Less likely to have MDD
More likely to have dysthymia Depression in African American Women:What is Known?
6. Depression is Significant
Discrepant Data – other studies suggest equal or greater prevalence
A 2004 study of 1,197 young African American adults in Baltimore found:
Overall prevalence of lifetime MDD was 9.4%, women were 1.6 times more like to report MDD (Ialongo et al, 2004)
a 2004 study of “middle aged” African American found 21% had clinically relevant levels of depressive symptoms (Miller et al, 2004)
Depression in African American Women:What is Known?
7. Depression is Significant
Syndromal vs sub-syndromal
Depression in African American Women:What is Known?
8. Depression in African American Women:What is Known?