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Depression in Later-Life Puerto Rican Primary Care Patients: The Role of Illness, Stress, Social Integration, and Religiosity

Published online by Cambridge University Press:  10 January 2005

Julie Robison ,
Leslie Curry ,
Cynthia Gruman ,
Theresa Covington ,
Sonia Gaztambide  and
Karen Blank
Julie Robison
Affiliation:
Braceland Center for Mental Health and Aging, Institute of Living, Hartford Hospital's Mental Health Network, Hartford, Connecticut, US University of Connecticut School of Medicine, Farmington, Connecticut, US
Leslie Curry
Affiliation:
Braceland Center for Mental Health and Aging, Institute of Living, Hartford Hospital's Mental Health Network, Hartford, Connecticut, US University of Connecticut School of Medicine, Farmington, Connecticut, US
Cynthia Gruman
Affiliation:
Braceland Center for Mental Health and Aging, Institute of Living, Hartford Hospital's Mental Health Network, Hartford, Connecticut, US University of Connecticut School of Medicine, Farmington, Connecticut, US
Theresa Covington
Affiliation:
Braceland Center for Mental Health and Aging, Institute of Living, Hartford Hospital's Mental Health Network, Hartford, Connecticut, US
Sonia Gaztambide
Affiliation:
Braceland Center for Mental Health and Aging, Institute of Living, Hartford Hospital's Mental Health Network, Hartford, Connecticut, US
Karen Blank
Affiliation:
Braceland Center for Mental Health and Aging, Institute of Living, Hartford Hospital's Mental Health Network, Hartford, Connecticut, US University of Connecticut School of Medicine, Farmington, Connecticut, US
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Abstract

Background: Older Puerto Ricans belong to two rapidly growing demographic groups known to have high rates of depression: the aging and Hispanic populations. Studies of depression in Puerto Ricans have primarily focused on the impact of demographic factors and health. This study expands previous research, examining the relationships between depression and social stressors, social support, and religiosity, for Puerto Rican primary care patients aged 50 and older. Patients: Participants included 303 Puerto Ricans from six primary care clinics in a northeastern city. Methods: Patients completed in-person interview in Spanish. The Composite International Diagnostic Interview indicated depressive disorders meeting DSM-IV criteria. Bivariate and multivariate relationships between depression and demographics, health, social stress and support, and religiosity were explored. Results: One fifth of participants met DSM-IV criteria for major depression or dysthymia. Participants with the lowest income, more recent migration, and poor subjective health were significantly more likely to be depressed. In addition, rates of depression increased steeply for patients caring for grandchildren and those with personal or family legal problems. Seeing few relatives each month and needing more instrumental, emotional, or financial support were also related to higher rates of depression. Unexpectedly, low objective illness severity correlated with increased depression, whereas religiosity and religious participation had no relationship to depression. Conclusions: The findings presented here indicate the potential for social stressors and inadequate supports to substantially increase the risk of depression in older Puerto Ricans in primary care settings. Further studies should explore incorporating these social risk factors into improved prevention, clinical detection, and culturally sensitive treatment of older depressed Puerto Ricans.

Keywords

DepressionPuerto RicanHispanicprimary careagingsocial support
Type
Articles
Information
International Psychogeriatrics , Volume 15 , Issue 3 , September 2003 , pp. 239 - 251
Copyright
© 2003 International Psychogeriatric Association

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