Depression: Poor, Ethnic Minorities Less Likely to Receive Treatment - Essay Sample

Introduction

Major depression refers to a disorder that has an early onset and frequently chronic course, which compels a high individual burden of suffering, pain, and disability. Poor and ethnic minority individuals are less probable to receive treatment, especially guideline-informed care, for primary depressive disorder as compared to middle-class and White individuals. It may be linked to the fact that the majority of depression treatment studies comprise primarily middle-class and White populations. It hence means that little information is known concerning the usefulness of established treatment for the disadvantaged people. Identifying the depression care effectiveness in this population is especially significant because rates of depression are high in younger age cohorts, women, and individuals living in poverty. It is because, in most scenarios, low-income women who are suffering from depression possess few resources and numerous challenges to overcome to start and continue with their treatment. It is significant to make thoughtful and personalized decisions concerning the most effective mediation for a given patient. In case a first treatment strategy is ineffective, patients may not have extra resources or the wish to pursue another treatment course (Siddique, Chung, Brown & Miranda, 2012). In this study, they described an investigative analysis to examine whether there exist latent trajectory classes in reply to treatment and whether these dormant classes moderate the antidepressant effects versus cognitive-behavioral therapy (CBT) within a sample of poor young minority women.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Save 25%

Hypothesis

There exists a latent trajectory class in response to treatment, and latent classes moderate the effects of medication versus psychotherapy (Siddique et al., 2012).

Methods

The data come from a randomized controlled experiment of 267 low-income, young, minority women with present major depression. The depression is randomized to antidepressants, CBT, or referrals to services of community mental health. The data applied in this analysis was from WECare clinical trial. Briefly, the researchers used the Mental Disorders Primary Care Evaluation as a depression screen within women going to social service agencies as well as safety-net health clinics. The clinics are located within Prince George's and Montgomery nations, Maryland, and in Arlington and Virginia (Siddique et al., 2012). The women who screened positive for severe depression were invited to take part in assenting psychiatric diagnostic telephone interviews.

The subjects were eliminated if they failed to attain a Composite International Diagnostic Interview (CIDI). Identification of severe depression, was suicidal, were bereaved, had symptoms of psychosis, mania, present alcohol or any other substance abuse, were currently breastfeeding, were presently receiving mental healthcare, or were pregnant or planning to be one. Women with verified severe depressive disorder diagnoses with the willingness to take part in the research were randomized to get pharmacotherapy, community referral, or Cognitive Behavioral Therapy. The raters were blinded to the assignment of treatment. Also, the study recruited a different ethnic women sample, including African American, White, and Latinas born in Latin America. Ethnicity was self-reported founded on options that are defined by the investigators of the study. The pertinent institutional review boards commended the present research, plus all patients offered with written informed consent. The primary research outcome is measured using the Hamilton Depression Rating Scale (Siddique et al., 2012). WECare partakers completed a version of structures HDRS through telephone at baseline.

Study Results

They identified two depression possible trajectories outcomes over the twelve months of the WECare research. Most significantly, the effects of antidepressant medication plus CBT over a single year period differed founded on trajectory class. In a severe trajectory, Cognitive Behavior Therapy appears to have more lifelong effects. As partakers receiving CBT within this class to enhance over the study course while medication partakers get worse after six months. The average treatment length for the medication partakers within the WECare study was exactly 4.8 months. Even though not all the participants started medication treatment at the study beginning, by eight months, nearly all of them had complemented treatment. There was continued improvement of Cognitive Behavior participants within the severe class. In the modest trajectory class, it has been identified that the medication intervention led to considerably better outcomes at six months though this difference had disappeared by twelve months (Siddique et al., 2012). When they calculated remission rates through trajectory class and established that remission rates were much elevated in the Moderate level Vs. Severe level.

In the GMM component predicting latent trajectory as a baseline covariates function, only baseline Hamilton anxiety that was an essential potential class predictor. For every additional point upon the anxiety scale, the chances of being within the severe trajectory amplified by 31%. Age and Ethnicity were not significant. A test of dissimilarity between the CBT and medication curves within the critical class was remarkable. The results indicated that there is no difference in the effects of treatment between the CBT and medication groups within the severe class at month six. At one year, the outcomes are notably better for participants of CBT due to the continued enhancement by CBT partakers after six months. The results indicate that outcomes are considerably better for medication partakers at six months, though the difference disappears by 12 months (Siddique et al., 2012). It is as a result of symptoms worsening by participants of medication after six months. Also, the Remission rates within the severe trajectory class remained low.

Conclusion

The study concluded that among the depressed women who have moderate baseline anxiety and depression, medication was supercilious to CBT at 6-months. However, the difference was not continued in one year. Also, among the depressed women who had severe depression, there existed no noteworthy treatment group differences, especially at six months. However, it tends out that CBT became superior at one year over medication. The conclusion was in support of the original hypothesis. The implications of further research include stratifying participants through baseline anxiety and depression and investigate the treatment effects in these strata prospectively (Siddique et al., 2012). The study also suggests further research in the long-term follow-up of women who are disadvantaged who frequently persist to experience stress to establish the impact of short-term results. It should include the outcomes of the mental health of their children.

My Perception

My thoughts after reading this study felt satisfied because I never found the information to know at all. Since it only confirmed the things and believed I already possessed regarding therapy and medication on mental illness, like depression. The study was very educative and informative in terms of their argument and presentation of ideas. On my side, I believe it was well structured, and the authors need no significant changes. Though there should be a slight improvement on the structuring of the study. For instance, there should be a clear division of the paper in terms of introduction, body, and conclusion.

Reference

Siddique, J., Chung, J. Y., Brown, C. H., & Miranda, J. (2012). Comparative Effectiveness of Medication Versus Cgnitive-Behavioral Therapy in a Randomized Controlled Trial of Low-Income Young Minority Women with Depression. Journal of Consulting and Clinical Psychology , 80(6), 995. Retrieved from https://psycnet.apa.org/buy/2012-28386-001.