Psychosocial mediators of the relationship between race/ethnicity and depressive symptoms in Latino and white patients with coronary artery disease

SES and race-ethnic differences in the stress-buffering effects of coping resources among young adults

OBJECTIVES

This study assesses socioeconomic status (SES) and race-ethnic differences in the extent to which coping resources (social support and self-esteem) buffer the negative impact of chronic stress on depressive symptoms.

DESIGN

We analyze data from a large community-based sample of young adults (ages 18-23) living in Miami-Dade County, Florida, USA (N = 1411).

RESULTS

Study findings indicate that the stress-buffering effects of social support or self-esteem do not vary by SES. However, independent of SES and other study controls, non-Hispanic whites experience greater stress-buffering effects from social support than African-Americans and African-Americans experience greater stress-buffering effects from self-esteem than Cubans and Nicaraguans.

CONCLUSION

In light of these results, we conclude that a greater understanding of racial and ethnic differences in mental health requires close attention to cultural transmissions of coping strategies within groups, which may be partly responsible for these differences in buffering effects.

Cardiovascular and disease-related predictors of depression in systemic lupus erythematosus

OBJECTIVE

Depression and cardiovascular disease are common and debilitating comorbidities associated with systemic lupus erythematosus (SLE). In this study, history of cardiovascular events, cardiovascular risk factors, and SLE disease-related factors were evaluated as longitudinal predictors of depression in a large cohort of patients with SLE.

METHODS

Data were derived from 663 adult participants in the 2004-2008 Lupus Outcomes Study, who were followed for up to 5 annual interviews. Multivariate logistic regression analyses using generalized estimating equations were used to determine predictors of the development of increased depressive symptom severity over a 12-month period (Center for Epidemiologic Studies Depression Scale [CES-D] score of 23 or greater), yielding 2,224 paired observations. Predictors included sociodemographics, traditional cardiovascular risk factors (reported presence of heart disease, history of stroke or myocardial infarction, hypertension, hypercholesterolemia, diabetes mellitus, obesity, smoking status, and family history), and SLE-specific risk factors (glucocorticoid use, renal involvement, disease duration, and disease activity).

RESULTS

The annual incidence of depression was 12% in this cohort. Multivariate predictors of new-onset depression included younger age (ages 20-39 years: odds ratio [OR] 2.3, 95% confidence interval [95% CI] 1.3-3.9; ages 40-59 years: OR 1.8, 95% CI 1.1-2.7), Hispanic/Latino ethnicity (OR 1.8, 95% CI 1.2-2.8), having some college education (OR 1.8, 95% CI 1.1-3.0), baseline CES-D score (OR per point 1.1, 95% CI 1.1-1.2), presence of diabetes mellitus (OR 1.8, 95% CI 1.1-2.8), and baseline SLE disease activity (OR 1.2, 95% CI 1.1-1.4).

CONCLUSION

These results suggest that, in addition to known sociodemographic factors, the presence of diabetes mellitus and SLE disease activity may play a role in the development of depression in SLE.

Health-related conditions and depression in elderly mexican american and non-Hispanic white residents of a United States-Mexico border county: moderating effects of educational attainment

We investigated the prevalence of "high" levels of depressive symptomatology and 13 health-related medical conditions in elderly Mexican American (MA) and non-Hispanic white (NHW) residents of El Paso County, Texas. We analyzed the extent to which depressive symptoms in this population are associated with these conditions. Elderly MA residents possessed a higher prevalence of current depression, a relatively unique health-related condition profile, and were more likely to experience a set of conditions that impede participation in daily life-conditions that we found to be strongly associated with high depressive symptomatology in the elderly. After adjusting for educational attainment, using multiple regression analyses, depression was not associated with ethnicity and only six of the health related conditions showed significant differences between MA and NHW subjects. We believe these results provide an important insight into the mechanism of health-related conditions and depressive symptomatology in a large sample of elderly MAs; and how conditions typically attributed to MA ethnicity may in actuality be an artifact of socioeconomic status variables such as educational-attainment.