Symptoms of depression and psychological distress among Hispanics with rheumatoid arthritis

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Abstract

Objective. To explore the roles played by Hispanic ethnic background and acculturation to the mainstream English language culture of the United States in the depressive symptoms and mental health of rheumatoid arthritis (RA) patients. Methods. Members of a consecutive cohort of patients with RA were studied cross-sectionally. All underwent a comprehensive clinical and psychosocial evaluation. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D), and psychological distress was measured with the Medical Outcomes Study Short Form 36 (SF-36) mental health scale. Results. Two hundred thirty-six patients were studied. Women had significantly higher median CES-D scores than men (19 versus 14, P = 0.0004), Hispanics scored higher than non-Hispanics (14 versus 8, P = 0.0002), and foreign-born scored higher than US-born patients (14 versus 10, P = 0.009). Compared with those who were fully acculturated, patients who were partially acculturated were more likely to have a score ≥ 16 on the RA-adjusted CES-D (odds ratio [OR] = 1.79, 95% confidence interval [95% CI] 1.37 to 2.35, P ≤ 0.001). Among unacculturated patients, the likelihood of a score ≥ 16 increased 6-fold (OR = 6.68; 95% CI 3.50 to 12.72; P ≤ 0.001). A similar, inverse pattern was observed for the SF-36 mental health scale. In multivariate models accounting for age, sex, education, income, articular pain, deformity, and the level of disability, low acculturation was independently associated with high depressive symptoms, and a Hispanic background was independently associated with lower SF-36 mental health. Conclusions. In this consecutive series of RA patients, Hispanics, particularly those who are not fully acculturated to the mainstream Anglo society, had more depressive symptoms and psychological distress than did non-Hispanics.

Original languageEnglish (US)
Pages (from-to)156-167
Number of pages12
JournalArthritis Care and Research
Volume13
Issue number3
StatePublished - 2000

Fingerprint

Hispanic Americans
Rheumatoid Arthritis
Depression
Psychology
Mental Health
Epidemiologic Studies
Acculturation
Odds Ratio
Confidence Intervals
Sex Education
Language
Joints
Outcome Assessment (Health Care)
Pain

Keywords

  • Acculturation
  • Depression
  • Hispanic Americans
  • Immigrant populations
  • Mental health
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Rheumatology

Cite this

Symptoms of depression and psychological distress among Hispanics with rheumatoid arthritis. / Escalante, Agustin; Del Rincon, Inmaculada; Mulrow, Cynthia D.

In: Arthritis Care and Research, Vol. 13, No. 3, 2000, p. 156-167.

Research output: Contribution to journalArticle

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title = "Symptoms of depression and psychological distress among Hispanics with rheumatoid arthritis",
abstract = "Objective. To explore the roles played by Hispanic ethnic background and acculturation to the mainstream English language culture of the United States in the depressive symptoms and mental health of rheumatoid arthritis (RA) patients. Methods. Members of a consecutive cohort of patients with RA were studied cross-sectionally. All underwent a comprehensive clinical and psychosocial evaluation. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D), and psychological distress was measured with the Medical Outcomes Study Short Form 36 (SF-36) mental health scale. Results. Two hundred thirty-six patients were studied. Women had significantly higher median CES-D scores than men (19 versus 14, P = 0.0004), Hispanics scored higher than non-Hispanics (14 versus 8, P = 0.0002), and foreign-born scored higher than US-born patients (14 versus 10, P = 0.009). Compared with those who were fully acculturated, patients who were partially acculturated were more likely to have a score ≥ 16 on the RA-adjusted CES-D (odds ratio [OR] = 1.79, 95{\%} confidence interval [95{\%} CI] 1.37 to 2.35, P ≤ 0.001). Among unacculturated patients, the likelihood of a score ≥ 16 increased 6-fold (OR = 6.68; 95{\%} CI 3.50 to 12.72; P ≤ 0.001). A similar, inverse pattern was observed for the SF-36 mental health scale. In multivariate models accounting for age, sex, education, income, articular pain, deformity, and the level of disability, low acculturation was independently associated with high depressive symptoms, and a Hispanic background was independently associated with lower SF-36 mental health. Conclusions. In this consecutive series of RA patients, Hispanics, particularly those who are not fully acculturated to the mainstream Anglo society, had more depressive symptoms and psychological distress than did non-Hispanics.",
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AU - Escalante, Agustin

AU - Del Rincon, Inmaculada

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N2 - Objective. To explore the roles played by Hispanic ethnic background and acculturation to the mainstream English language culture of the United States in the depressive symptoms and mental health of rheumatoid arthritis (RA) patients. Methods. Members of a consecutive cohort of patients with RA were studied cross-sectionally. All underwent a comprehensive clinical and psychosocial evaluation. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D), and psychological distress was measured with the Medical Outcomes Study Short Form 36 (SF-36) mental health scale. Results. Two hundred thirty-six patients were studied. Women had significantly higher median CES-D scores than men (19 versus 14, P = 0.0004), Hispanics scored higher than non-Hispanics (14 versus 8, P = 0.0002), and foreign-born scored higher than US-born patients (14 versus 10, P = 0.009). Compared with those who were fully acculturated, patients who were partially acculturated were more likely to have a score ≥ 16 on the RA-adjusted CES-D (odds ratio [OR] = 1.79, 95% confidence interval [95% CI] 1.37 to 2.35, P ≤ 0.001). Among unacculturated patients, the likelihood of a score ≥ 16 increased 6-fold (OR = 6.68; 95% CI 3.50 to 12.72; P ≤ 0.001). A similar, inverse pattern was observed for the SF-36 mental health scale. In multivariate models accounting for age, sex, education, income, articular pain, deformity, and the level of disability, low acculturation was independently associated with high depressive symptoms, and a Hispanic background was independently associated with lower SF-36 mental health. Conclusions. In this consecutive series of RA patients, Hispanics, particularly those who are not fully acculturated to the mainstream Anglo society, had more depressive symptoms and psychological distress than did non-Hispanics.

AB - Objective. To explore the roles played by Hispanic ethnic background and acculturation to the mainstream English language culture of the United States in the depressive symptoms and mental health of rheumatoid arthritis (RA) patients. Methods. Members of a consecutive cohort of patients with RA were studied cross-sectionally. All underwent a comprehensive clinical and psychosocial evaluation. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D), and psychological distress was measured with the Medical Outcomes Study Short Form 36 (SF-36) mental health scale. Results. Two hundred thirty-six patients were studied. Women had significantly higher median CES-D scores than men (19 versus 14, P = 0.0004), Hispanics scored higher than non-Hispanics (14 versus 8, P = 0.0002), and foreign-born scored higher than US-born patients (14 versus 10, P = 0.009). Compared with those who were fully acculturated, patients who were partially acculturated were more likely to have a score ≥ 16 on the RA-adjusted CES-D (odds ratio [OR] = 1.79, 95% confidence interval [95% CI] 1.37 to 2.35, P ≤ 0.001). Among unacculturated patients, the likelihood of a score ≥ 16 increased 6-fold (OR = 6.68; 95% CI 3.50 to 12.72; P ≤ 0.001). A similar, inverse pattern was observed for the SF-36 mental health scale. In multivariate models accounting for age, sex, education, income, articular pain, deformity, and the level of disability, low acculturation was independently associated with high depressive symptoms, and a Hispanic background was independently associated with lower SF-36 mental health. Conclusions. In this consecutive series of RA patients, Hispanics, particularly those who are not fully acculturated to the mainstream Anglo society, had more depressive symptoms and psychological distress than did non-Hispanics.

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KW - Immigrant populations

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