Underdiagnosed and Undertreated Depression Among Racially/Ethnically Diverse Patients With Type 2 Diabetes

OBJECTIVE: To examine racial/ethnic differences in the prevalence of depressive symptoms and in provider recognition of depression among Latino, Asian, and non-Hispanic white patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: Patients (n = 1,209) with type 2 diabetes were recruited from five university-affiliated primary care clinics for an observational study. RESULTS: Vietnamese American (133, 59.4%) and Mexican American (351, 50.2%) patients were more likely to report symptoms consistent with clinical depression (Center for Epidemiological Studies Depression CES-D scale score ≥ 22) than non-Hispanic whites (119, 41.6%; F 2, 1206 = 8.05, P < 0.001). Despite comparable diabetes care, Vietnamese and Mexican patients with high depressive symptoms were less likely to be diagnosed and treated than non-Hispanic whites (all P values < 0.001). Minority patients who reported low levels of trust in their provider were less likely to have been diagnosed or treated for depression (adjusted odds ratio 0.65, 95% CI 0.44-0.98, P < 0.05). CONCLUSIONS: Innovative strategies are needed to improve recognition of depressive symptoms in minority patients.