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Published in: Journal of Clinical Psychology in Medical Settings 3/2021

01-09-2021 | Mood Disorders

Depression Screening in a Primary Care Setting: Examining Perceptions and Experiences of English- and Spanish-Speaking Patients

Authors: Nataliya Pilipenko, Christian Vivar-Ramon

Published in: Journal of Clinical Psychology in Medical Settings | Issue 3/2021

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Abstract

Depression is highly prevalent in primary care settings, but screening rates remain sub-optimal and patients’ screening perspectives are poorly understood. This study examined depression screening experiences and beliefs among primary care patients (N = 100, Mage = 51.9, SD = 17.03, 49% Spanish speakers). Participants completed a survey regarding screening experiences, stigma concerns, and perceptions of screening-related importance, barriers, and concerns. While 83% of participants were screened for depression, only 44.6% had screening results explained. Levels of depression treatment-related stigma concerns were low, with English speakers endorsing higher levels of such concerns. Importance and barriers of screening scores were significantly, negatively correlated rs = − .52, p < .001. Patients’ self-identification as ‘long-standing’ to the clinic was associated with greater endorsed screening concerns t(98) =  − 2.08, p < .05. Results suggest that improved understanding of patients’ screening-related perceptions and experiences is critical to ensuring delivery of quality care. Communication practices around screening should be studied, reviewed, and revised to ensure the success of screening efforts.
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Literature
go back to reference American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Washington (D.C.): American Psychiatric Association.CrossRef American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Washington (D.C.): American Psychiatric Association.CrossRef
go back to reference Betancourt, J. R. (2006). Cultural competency: Providing quality care to diverse populations. The Consultant Pharmacist: The Journal of the American Society of Consultant Pharmacists, 21, 988–995.CrossRef Betancourt, J. R. (2006). Cultural competency: Providing quality care to diverse populations. The Consultant Pharmacist: The Journal of the American Society of Consultant Pharmacists, 21, 988–995.CrossRef
go back to reference Betancourt, J. R., Carrillo, J. E., & Green, A. R. (1999). Hypertension in multicultural and minority populations: Linking communication to compliance. Current Hypertension Reports, 1, 482–488.CrossRef Betancourt, J. R., Carrillo, J. E., & Green, A. R. (1999). Hypertension in multicultural and minority populations: Linking communication to compliance. Current Hypertension Reports, 1, 482–488.CrossRef
go back to reference Bridges, A. J., Andrews, A. R., 3rd, & Deen, T. L. (2012). Mental health needs and service utilization by hispanic immigrants residing in mid-southern United States. Journal of Transcultural Nursing : Official Journal of the Transcultural Nursing Society, 23, 359–368.CrossRef Bridges, A. J., Andrews, A. R., 3rd, & Deen, T. L. (2012). Mental health needs and service utilization by hispanic immigrants residing in mid-southern United States. Journal of Transcultural Nursing : Official Journal of the Transcultural Nursing Society, 23, 359–368.CrossRef
go back to reference Cabassas, L. J. (2016). Depression Fotonovela: Integrating cultural factors and entertainment-education to improve depression literacy in the Latino community. In S. J. Schwartz & J. Unger (Eds.), The Oxford book of acculturation and health (pp. 1–23). Oxford: Oxford University Press. Cabassas, L. J. (2016). Depression Fotonovela: Integrating cultural factors and entertainment-education to improve depression literacy in the Latino community. In S. J. Schwartz & J. Unger (Eds.), The Oxford book of acculturation and health (pp. 1–23). Oxford: Oxford University Press.
go back to reference Caplan, S., Alvidrez, J., Paris, M., Escobar, J. I., Dixon, J. K., Desai, M. M., ..., & Scahill, L. D. (2010). Subjective versus objective: An exploratory analysis of Latino primary care patients with self-perceived depression who do not fulfill primary care evaluation of mental disorders patient health questionnaire criteria for depression. Primary Care Companion to the Journal of Clinical Psychiatry. https://doi.org/10.4088/PCC.09m00899blu.CrossRefPubMedPubMedCentral Caplan, S., Alvidrez, J., Paris, M., Escobar, J. I., Dixon, J. K., Desai, M. M., ..., & Scahill, L. D. (2010). Subjective versus objective: An exploratory analysis of Latino primary care patients with self-perceived depression who do not fulfill primary care evaluation of mental disorders patient health questionnaire criteria for depression. Primary Care Companion to the Journal of Clinical Psychiatry. https://​doi.​org/​10.​4088/​PCC.​09m00899blu.CrossRefPubMedPubMedCentral
go back to reference Craven, M., & Bland, R. (2013). Depression in primary care: Current and future challenges. The Canadian Journal of Psychiatry, 58, 442–448.CrossRef Craven, M., & Bland, R. (2013). Depression in primary care: Current and future challenges. The Canadian Journal of Psychiatry, 58, 442–448.CrossRef
go back to reference Deneke, D., Schultz, H., & Fluent, T. (2015). Screening for depression in primary care populations. Psychatric Clinics of North America, 38, 23–43.CrossRef Deneke, D., Schultz, H., & Fluent, T. (2015). Screening for depression in primary care populations. Psychatric Clinics of North America, 38, 23–43.CrossRef
go back to reference Davis, K., Schoenbaum, S. C., & Audet, A. M. (2005). A 2020 vision of patient-centered primary care. Journal of General Internal Medicine, 20, 953–957.CrossRef Davis, K., Schoenbaum, S. C., & Audet, A. M. (2005). A 2020 vision of patient-centered primary care. Journal of General Internal Medicine, 20, 953–957.CrossRef
go back to reference Dow, H. D. (2011). Migrants’ mental health and barriers to receiving mental health services. Home Health Care Management & Practice, 23, 176–185.CrossRef Dow, H. D. (2011). Migrants’ mental health and barriers to receiving mental health services. Home Health Care Management & Practice, 23, 176–185.CrossRef
go back to reference Gilbody, S., Richards, D., Brealey, S., & Hewitt, C. (2007). Screening for depression in medical settings with the Patient Health Questionnaire (PHQ): A diagnostic meta-analysis. Journal of General Internal Medicine, 22, 1596–1602.CrossRef Gilbody, S., Richards, D., Brealey, S., & Hewitt, C. (2007). Screening for depression in medical settings with the Patient Health Questionnaire (PHQ): A diagnostic meta-analysis. Journal of General Internal Medicine, 22, 1596–1602.CrossRef
go back to reference Hinterland, K., Naidoo, M., King, L., Lewin, V., Myerson, G., Noumbissi, B., ..., & Bassett, M. T. (2018). Community health profiles 2018, Manhattan Community District 12: Washington Heights and Inwood. New York City Community Health Profiles, 12, 1–20. Hinterland, K., Naidoo, M., King, L., Lewin, V., Myerson, G., Noumbissi, B., ..., & Bassett, M. T. (2018). Community health profiles 2018, Manhattan Community District 12: Washington Heights and Inwood. New York City Community Health Profiles, 12, 1–20.
go back to reference IBM Corp. (2016). IBM SPSS statistics for windows, version 24.0. Armonk, NY: IBM Corp. IBM Corp. (2016). IBM SPSS statistics for windows, version 24.0. Armonk, NY: IBM Corp.
go back to reference Jimenez, D. E., Bartels, S. J., Cardenas, V., & Alegría, M. (2013). Stigmatizing attitudes toward mental illness among racial/ethnic older adults in primary care. International Journal of Geriatric Psychiatry, 28, 1061–1068.CrossRef Jimenez, D. E., Bartels, S. J., Cardenas, V., & Alegría, M. (2013). Stigmatizing attitudes toward mental illness among racial/ethnic older adults in primary care. International Journal of Geriatric Psychiatry, 28, 1061–1068.CrossRef
go back to reference Interian, A., Martinez, I. E., Guarnaccia, P. J., Vega, W. A., & Escobar, J. I. (2007). A qualitative analysis of the perception of stigma among Latinos receiving antidepressants. Psychiatric Services (Washington, D.C.), 58, 1591–1594.CrossRef Interian, A., Martinez, I. E., Guarnaccia, P. J., Vega, W. A., & Escobar, J. I. (2007). A qualitative analysis of the perception of stigma among Latinos receiving antidepressants. Psychiatric Services (Washington, D.C.), 58, 1591–1594.CrossRef
go back to reference Interian, A., Ang, A., Gara, M. A., Link, B. G., Rodriguez, M. A., & Vega, W. A. (2010). Stigma and depression treatment utilization among Latinos: Utility of four stigma measures. Psychiatric Services, 61, 373–379.CrossRef Interian, A., Ang, A., Gara, M. A., Link, B. G., Rodriguez, M. A., & Vega, W. A. (2010). Stigma and depression treatment utilization among Latinos: Utility of four stigma measures. Psychiatric Services, 61, 373–379.CrossRef
go back to reference Interian, A., Ang, A., Gara, M. A., Rodriguez, M. A., & Vega, W. A. (2011). The long-term trajectory of depression among Latinos in primary care and its relationship to depression care disparities. General Hospital Psychiatry, 33, 94–101.CrossRef Interian, A., Ang, A., Gara, M. A., Rodriguez, M. A., & Vega, W. A. (2011). The long-term trajectory of depression among Latinos in primary care and its relationship to depression care disparities. General Hospital Psychiatry, 33, 94–101.CrossRef
go back to reference Kirmayer, L. J. (2001). Cultural variations in the clinical presentation of depression and anxiety: Implications for diagnosis and treatment. Journal of Clinical Psychiatry, 62, 22–30. Kirmayer, L. J. (2001). Cultural variations in the clinical presentation of depression and anxiety: Implications for diagnosis and treatment. Journal of Clinical Psychiatry, 62, 22–30.
go back to reference Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613.CrossRef Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613.CrossRef
go back to reference Kroenke, K. (2018). Depression screening and management in primary care. Family Practice, 35, 1–3.CrossRef Kroenke, K. (2018). Depression screening and management in primary care. Family Practice, 35, 1–3.CrossRef
go back to reference Kessler, R., & Stafford, D. (2008). Primary care is the de facto mental health system. In R. Kessler & D. Stafford (Eds.), Collaborative medicine case studies: Evidence in practice (pp. 9–21). New York: Springer.CrossRef Kessler, R., & Stafford, D. (2008). Primary care is the de facto mental health system. In R. Kessler & D. Stafford (Eds.), Collaborative medicine case studies: Evidence in practice (pp. 9–21). New York: Springer.CrossRef
go back to reference Lakkis, N., & Mahmassani, D. (2015). Screening instruments for depression in primary care: A concise review for clinicians. Postgraduate Medicine, 127, 99–106.CrossRef Lakkis, N., & Mahmassani, D. (2015). Screening instruments for depression in primary care: A concise review for clinicians. Postgraduate Medicine, 127, 99–106.CrossRef
go back to reference Lewis-Fernandez, R., Das, A. K., Alfonso, C., Weissman, M. M., & Olfson, M. (2005). Depression in US hispanics: Diagnostic and management considerations in family practice. The Journal of the American Board of Family Medicine, 18, 282–296.CrossRef Lewis-Fernandez, R., Das, A. K., Alfonso, C., Weissman, M. M., & Olfson, M. (2005). Depression in US hispanics: Diagnostic and management considerations in family practice. The Journal of the American Board of Family Medicine, 18, 282–296.CrossRef
go back to reference Limon, F. J., Lamson, A. L., Hodgson, J., Bowler, B., & Saeed, S. (2016). Screening for depression in latino immigrants: A systematic review of depression screening instruments translated into Spanish. J Immigrant Minority Health, 18, 787–798.CrossRef Limon, F. J., Lamson, A. L., Hodgson, J., Bowler, B., & Saeed, S. (2016). Screening for depression in latino immigrants: A systematic review of depression screening instruments translated into Spanish. J Immigrant Minority Health, 18, 787–798.CrossRef
go back to reference Lopez, V., Sanchez, K., Killian, M. O., & Eghaneyan, B. H. (2018). Depression screening and education: An examination of mental health literacy and stigma in a sample of Hispanic women. BMC Public Health, 18, 646.CrossRef Lopez, V., Sanchez, K., Killian, M. O., & Eghaneyan, B. H. (2018). Depression screening and education: An examination of mental health literacy and stigma in a sample of Hispanic women. BMC Public Health, 18, 646.CrossRef
go back to reference Martinez Pincay, I. E., & Guarnaccia, P. J. (2007). “It’s like going through an earthquake”: Anthropological perspectives on depression among Latino immigrants. Journal of Immigrant and Minority Health, 9, 17–28.CrossRef Martinez Pincay, I. E., & Guarnaccia, P. J. (2007). “It’s like going through an earthquake”: Anthropological perspectives on depression among Latino immigrants. Journal of Immigrant and Minority Health, 9, 17–28.CrossRef
go back to reference Maurer, D. (2012). Screening for depression. American Academy of Family Physicians, 85, 139–144. Maurer, D. (2012). Screening for depression. American Academy of Family Physicians, 85, 139–144.
go back to reference Mitchell, A., & Coyne, J. (2008). Screening for postnatal depression: Barriers to success. BJOG, 116, 11–14.CrossRef Mitchell, A., & Coyne, J. (2008). Screening for postnatal depression: Barriers to success. BJOG, 116, 11–14.CrossRef
go back to reference Montero, L. G., Galilea, C. N., Conde, R. L., Villalba, C. P., & Vítores, D. F. (2019). El español: Una lengua viva informe. Madid: Instituto Cervantes. Montero, L. G., Galilea, C. N., Conde, R. L., Villalba, C. P., & Vítores, D. F. (2019). El español: Una lengua viva informe. Madid: Instituto Cervantes.
go back to reference Morelli, D. L., Pati, S., Butler, A., Blum, N. J., Gerdes, M., Pinto-Martin, J., & Guevara, J. P. (2014). Challenges to implementation of developmental screening in urban primary care: A mixed methods study. BMC Pediatrics, 14, 16.CrossRef Morelli, D. L., Pati, S., Butler, A., Blum, N. J., Gerdes, M., Pinto-Martin, J., & Guevara, J. P. (2014). Challenges to implementation of developmental screening in urban primary care: A mixed methods study. BMC Pediatrics, 14, 16.CrossRef
go back to reference Nadeem, E., Lange, J. M., Edge, D., Fongwa, M., Belin, T., & Miranda, J. (2007). Does stigma keep poor young Immigrant and U.S.-born black and Latina women from seeking mental health care? Psychiatric Services, 58, 1547–1554.CrossRef Nadeem, E., Lange, J. M., Edge, D., Fongwa, M., Belin, T., & Miranda, J. (2007). Does stigma keep poor young Immigrant and U.S.-born black and Latina women from seeking mental health care? Psychiatric Services, 58, 1547–1554.CrossRef
go back to reference Oakley, L., Kanter, J., Taylor, J., & Duguid, M. (2011). The self-stigma of depression for women. International Journal of Social Psychiatry, 58, 512–520.CrossRef Oakley, L., Kanter, J., Taylor, J., & Duguid, M. (2011). The self-stigma of depression for women. International Journal of Social Psychiatry, 58, 512–520.CrossRef
go back to reference Pignone, M. P., Gaynes, B. N., Rushton, J. L., Burchell, C. M., Orleans, C. T., ..., & Lohr, K. N. (2002). Screening for depression in adults: A summary of the evidence for the U.S. Preventive Services Task Force. Annals of Internal Medicine, 36, 765–776.CrossRef Pignone, M. P., Gaynes, B. N., Rushton, J. L., Burchell, C. M., Orleans, C. T., ..., & Lohr, K. N. (2002). Screening for depression in adults: A summary of the evidence for the U.S. Preventive Services Task Force. Annals of Internal Medicine, 36, 765–776.CrossRef
go back to reference Rucci, P., Gherardi, S., Tansella, M., Piccinelli, M., Berardi, D., Bisoffi, G., … Pini, S. (2003). Subthreshold psychiatric disorders in primary care: Prevalence and associated characteristics. Journal of Affective Disorders, 76, 171–181.CrossRef Rucci, P., Gherardi, S., Tansella, M., Piccinelli, M., Berardi, D., Bisoffi, G., … Pini, S. (2003). Subthreshold psychiatric disorders in primary care: Prevalence and associated characteristics. Journal of Affective Disorders, 76, 171–181.CrossRef
go back to reference Sanchez, K., Eghaneyan, B. H., & Trivedi, M. H. (2016). Depression screening and education: Options to reduce barriers to treatment (DESEO): Protocol for an educational intervention study. BMC Health Services Research, 16, 322.CrossRef Sanchez, K., Eghaneyan, B. H., & Trivedi, M. H. (2016). Depression screening and education: Options to reduce barriers to treatment (DESEO): Protocol for an educational intervention study. BMC Health Services Research, 16, 322.CrossRef
go back to reference Shah, A., Scogin, F., Pierpaoli, C., & Shah, A. (2018). Older adults' attitudes toward depression screening in primary care settings and exploring a brief educational pamphlet. International Journal of Geriatric Psychiatry, 33, e40–e48.CrossRef Shah, A., Scogin, F., Pierpaoli, C., & Shah, A. (2018). Older adults' attitudes toward depression screening in primary care settings and exploring a brief educational pamphlet. International Journal of Geriatric Psychiatry, 33, e40–e48.CrossRef
go back to reference Tyson, M., Arriola, N., & Corvin, J. (2016). Perceptions of depression and access to mental health care among Latino immigrants: Looking beyond one size fits all. Qualitative Health Research, 26, 1289–1302.CrossRef Tyson, M., Arriola, N., & Corvin, J. (2016). Perceptions of depression and access to mental health care among Latino immigrants: Looking beyond one size fits all. Qualitative Health Research, 26, 1289–1302.CrossRef
go back to reference Unützer, J., & Park, M. (2012). Strategies to improve the management of depression in primary care. Primary Care, 39, 415–431.CrossRef Unützer, J., & Park, M. (2012). Strategies to improve the management of depression in primary care. Primary Care, 39, 415–431.CrossRef
go back to reference US Office of the Surgeon General (US), Center for Mental Health Services (US), National Institute of Mental Health (US). (2001). Mental Health Care for Hispanic Americans. Mental health: Culture, race, and ethnicity: A supplement to mental health: A report of the surgeon general, pp. 127–156. Retrieved May 05, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK44245. US Office of the Surgeon General (US), Center for Mental Health Services (US), National Institute of Mental Health (US). (2001). Mental Health Care for Hispanic Americans. Mental health: Culture, race, and ethnicity: A supplement to mental health: A report of the surgeon general, pp. 127–156. Retrieved May 05, 2020, from https://​www.​ncbi.​nlm.​nih.​gov/​books/​NBK44245.
go back to reference Vargas, S., Cabassa, L., Nicasio, A., De La Cruz, A., Jackson, E., Rosario, M., ..., & Lewis-Fernandez, R. (2015). Towards a cultural adaptation of pharmacotherapy: Latino views of depression and antidepressant therapy. Transcultural Psychiatry, 52, 244–273.CrossRef Vargas, S., Cabassa, L., Nicasio, A., De La Cruz, A., Jackson, E., Rosario, M., ..., & Lewis-Fernandez, R. (2015). Towards a cultural adaptation of pharmacotherapy: Latino views of depression and antidepressant therapy. Transcultural Psychiatry, 52, 244–273.CrossRef
go back to reference Wittkampf, K., van Zwieten, M., Smits, F., Schene, A., Huyser, J., & van Weert, H. (2008). Patients' view on screening for depression in general practice. Family Practice, 25, 438–444.CrossRef Wittkampf, K., van Zwieten, M., Smits, F., Schene, A., Huyser, J., & van Weert, H. (2008). Patients' view on screening for depression in general practice. Family Practice, 25, 438–444.CrossRef
Metadata
Title
Depression Screening in a Primary Care Setting: Examining Perceptions and Experiences of English- and Spanish-Speaking Patients
Authors
Nataliya Pilipenko
Christian Vivar-Ramon
Publication date
01-09-2021
Publisher
Springer US
Published in
Journal of Clinical Psychology in Medical Settings / Issue 3/2021
Print ISSN: 1068-9583
Electronic ISSN: 1573-3572
DOI
https://doi.org/10.1007/s10880-020-09746-0

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