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Depressive symptoms, MDD risk may differ between blacks, whites

Recent findings indicated the association between baseline depressive symptoms and subsequent major depressive disorder risk differed between blacks and whites, though they may be due to certain assessment scale structures.

“Some studies imply that [Center for Epidemiologic Studies Depression Scale (CES-D)] score may differently represent true depression in whites and blacks. In addition, there have been inconsistent results comparing the reliability of CES-D scale across ethnic groups,” the researchers wrote. “Although some studies have found slightly a lower reliability for CES-D in blacks, there are other studies reporting a higher reliability for negative affect and interpersonal problem domains of CES-D in blacks compared with those of whites. This is particularly important given the role of ethnicity, culture, social class, and education on survey response style.”

To assess differences in psychosocial and medical correlates of depressive symptoms and major depressive disorder (MDD), researchers analyzed data from the Americans’ Changing Lives study for 3,361 individuals from 1986 to 2001. The study cohort included 2,205 whites and 1,156 blacks. Baseline depressive symptoms were assessed via an 11-item CES-D in 1986. Outcome of 12-month MDD was assessed via the Composite International Diagnostic Interview (CIDI) in 2001 and covariates such as baseline socio-demographics, financial difficulty, chronic medical conditions and self-rated health were assessed in 1986.

Researchers found an interaction between race and baseline depressive symptoms that suggested baseline depressive symptoms significantly affected subsequent MDD risk for whites compared with blacks.

Baseline CES-D scores were predictive of subsequent MDD risk after 15 years among whites, but not blacks, regardless of baseline socio-demographics and health.

Differences between blacks and whites regarding the predictive role of CES-D for MDD risk could not be attributed to ethnic differences in the reliability of the CES-D, which was higher for blacks compared with whites, according to researchers.

“Our findings may explain some of the racial and ethnic differences in psychosocial and medical correlates of depressive symptoms and MDD. Future research is needed to compare factor structure of the CES-D scale between blacks and whites,” the researchers concluded. – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.