USC Researchers Find High Rate of Depression Among Ill, Older Latinos

Latinos over 60, particularly those who said they had health problems, are more likely to suffer from depression than the general population, according to a newly released USC study of 704 Latinos in Los Angeles County.

In addition, the study found that none of the Latinos who showed symptoms of depression ever visited a mental health specialist or had been treated with anti-depressant medication.

At the same time, a high percentage of the Latinos interviewed said they had been treated by a doctor for physical ailments.

According to the study, 26% of the elderly Latinos interviewed showed symptoms of depression, compared to estimates ranging from 2% to 20% in the general population found in other studies. The vast majority of those showing symptoms of depression either complained of health problems or had seen a physician for some physical ailment in the last year.

Confirmed Suspicion

The 2-year study of Latinos over age 60, conducted by Drs. Bryan Kemp and Kenneth Brummel-Smith of USC, is believed the first to gauge what social scientists and many Latinos have suspected for years: an inordinately high rate of depression exists among Latinos.

“A lot of people have suspected this for a long time,” said Brummel-Smith, an associate professor of clinical family medicine at the USC School of Medicine. “Now that we have the knowledge, we need to develop treatments and services that would get to the problem.”

The study broke down the depression symptoms into categories under “major depression,” which is characterized by weight loss, sleep disturbances, concentration problems and suicidal tendencies, and “dysphoria,” in which a person feels discouraged, “down” or “blue.”

Those suffering from dysphoria with some medical disability were the largest group. Of the 704 interviewed, 7.5% were in this category.

There is no hard data to explain the high rate of depression among elderly Latinos, the researchers said. But the study hints at several underlying factors, including poor health, low income, an inability to speak English and an apparent deference to machismo among Latinos. The machismo manifests itself as an unwillingness to admit that he requires mental health counseling.

70% Spoke Only Spanish

Of the respondents acknowledging symptoms of depression, for example, 70% spoke only Spanish, a factor that would discourage them from seeking help. The inability to speak English makes such people feel isolated, adding to their depression, the researchers said.

About one-third of the “depressed” group also reported that they were unable to pay for essential services, such as food, rent, transportation and clothing.

But the most prevalent factor dealt with ill health. Brummel-Smith said the study showed that depressed Latino senior citizens felt their health was not as good as others in the general population.

“They were ill in bed more than a non-depressed person and they also saw a physician more often,” he said. About 85% of those who acknowledged depression symptoms said they saw a physician at least once a year compared to 73% of the “non-depressed” Latinos in the study.

The USC researchers said they had no conclusive information about whether the unusually high instances of depression would come up during medical visits.

“On the one hand, there has been a lot of evidence that doctors don’t recognize depression,” Brummel-Smith said, “because depression in the elderly may be in terms more physical--feeling tired, having pain all over.

“The other side of the coin is that Hispanics may withhold information . . . that they may not want to admit to any problems.”

The 704 people interviewed for the study were in four age groups--60-64, 65-69, 70-74 and 75 and older (20%). They were asked 500 questions during 2-hour sessions about psychiatric, medical, functional, nutritional and economic problems.

Seventy-eight percent of the study participants were not born in the United States, a group that ignores public agencies for problems that they believe are best dealt with privately, experts say.

Macho Problem

“The big problem is a cultural ‘macho’ thing among these older people,” said Claude Martinez, executive director of El Centro Human Services Corp., a nonprofit mental health clinic in East Los Angeles.

These people, he said, “just don’t go to mental health clinics. With younger Latinos, we’ve made a lot of strides, but we’ve got to regroove these taboos with the older folks.”

The reluctance was so great that the USC researchers were surprised to learn that none of the interviewees had ever sought help from a mental health specialist.

That differs greatly from this country’s general population, of which 12% said they had either visited a public mental health clinic or sought professional help from a psychiatrist in private practice, according to data compiled in 1987 from the American Psychological Assn.

The USC study also said there are few places where elderly Latinos could go for help even if they wanted to. Recent cutbacks in county health services have trimmed mental health services in Los Angeles County, health officials said.

El Centro is the only facility of its kind in the county that is specifically geared to serve Latinos. But at El Centro, which helps about 30,000 patients a year on a $5-million budget, delays for some counseling can take up to five weeks.