Racial and ethnic disparities in post-stroke depression detection

Huanguang Jia, Neale R. Chumbler, Xinping Wang, Ho Chih Chuang, Teresa M. Damush, Randi Cameon, Linda S. Williams

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Objectives: Post-stroke depression (PSD) is common among stroke survivors and is associated with increased morbidity and mortality. Little is understood about racial/ethnic differences in PSD detection. This study assessed the racial/ethnic disparities in PSD detection in a national cohort of Department of Veterans Affairs (VA) acute stroke patients. Methods: The study included VA patients who: received inpatient care for acute stroke within 2001; survived >60 days post-index hospitalization; had an index stay <365 days; and were confirmed VA healthcare enrollees. PSD was established if a patient had a depression diagnosis in VA or Medicare inpatient or outpatient files, or was dispensed an antidepressant with guideline recommended minimum daily dosage during the 12 months post stroke. A multivariate logistic regression model was fitted to estimate the effects of race/ethnicity on PSD detection, adjusting for sociodemographic and clinical factors. Results: The study cohort (N = 5825) was comprised of 66% white, 22% black, 7% Hispanic, and 6% for all other racial/ethnic categories. Among these stroke patients, 39% had PSD. Black and 'all other' racial/ethnic categories were significantly less likely to be diagnosed with PSD than non-Hispanic whites, even adjusting for potential risk factors. Conclusion: White, non-Hispanic VA acute stroke patients were more likely to be diagnosed with PSD, even controlling for sociodemographic and clinical characteristics. Whether these findings suggest racial/ethnic differences in symptom endorsement by patients or in symptom recognition by providers is not clear.

Original languageEnglish (US)
Pages (from-to)298-304
Number of pages7
JournalInternational Journal of Geriatric Psychiatry
Volume25
Issue number3
DOIs
StatePublished - Mar 1 2010

Keywords

  • Ethnicity
  • Post-stroke depression
  • Race
  • Stroke
  • Veterans

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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