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Screening for Depression in Latino Immigrants: A Systematic Review of Depression Screening Instruments Translated into Spanish

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Abstract

The research on the diagnostic accuracy of Spanish language depression-screening instruments continues to be scarce in the US. Under-detection of depression by Primary Care Providers is approximately 50 % in the general population and this rate may be even higher for Latino immigrants for whom the depression rate tends to be higher than for non-Hispanic Whites. This systematic review shows that there is still limited evidence that guides primary care-based depression screening for Spanish speakers. The economic, social, and human costs of depression are high and complex; yet improvements in the effectiveness of treatment cannot be made available to sufferers of the disorder if they go undetected.

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References

  1. Kessler RC, Berglund P, Demler O, et al. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). J Am Med Assoc. 2003;289(23):3095–105.

    Article  Google Scholar 

  2. Substance Abuse and Mental Health Services Administration. United States 2012 (DHHS Pub. No. [SMA] 13-4805). Rockville, MD: Substance Abuse and Mental Health Services; 2013.

  3. Soni A. Trends in use and expenditures for depression among US adults age 18 and older, civilian non-institutionalized population, 1999 and 2009. STATISTICAL BRIEF# 377. Rockville, MD: Agency for Healthcare Research and Quality; 2012.

  4. Alegria M, Canino G, Stinson FS, et al. Nativity and DSM-IV psychiatric disorders among Puerto Ricans, Cuban Americans, and non-Latino Whites in the United States: results from the National Epidemiologic Survey on alcohol and related conditions. J Clin Psychiatry. 2006;67(1):56–65.

    Article  PubMed  Google Scholar 

  5. Olfson M, Shea S, Feder A, et al. Prevalence of anxiety, depression, and substance use disorders in an urban general medicine practice. Arch Fam Med. 2000;9(9):876.

    Article  CAS  PubMed  Google Scholar 

  6. Lewis-Fernandez R, Das AK, Alfonso C, et al. Depression in US Hispanics: diagnostic and management considerations in family practice. J Am Board Fam Pract. 2005;18(4):282–96.

    Article  PubMed  Google Scholar 

  7. Escobar JI. Cross cultural aspects of the somatization trait. Hosp Commun Psychiatry. 1987;38(2):175.

    Google Scholar 

  8. Vega WA, Karno M, Alegria M, et al. Research issues for improving treatment of US Hispanics with persistent mental disorders. Psychiatr Serv. 2007;58(3):385–94.

    Article  PubMed  Google Scholar 

  9. Schmaling KB, Hernandez DV. Detection of depression among low-income Mexican Americans in primary care. J Health Care Poor Underserved. 2005;16(4):780–90.

    Article  PubMed  Google Scholar 

  10. Pignone MP, Gaynes BN, Rushton JL, et al. Screening for depression in adults: a summary of the evidence for the US preventive services task force. Ann Intern Med. 2002;136(10):765–76.

    Article  PubMed  Google Scholar 

  11. Interian A, Ang A, Gara MA, et al. The long-term trajectory of depression among Latinos in primary care and its relationship to depression care disparities. Gen Hosp Psychiatry. 2011;33(2):94–101.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Mitchell AJ, Coyne JC. Do ultra-short screening instruments accurately detect depression in primary care? A pooled analysis and meta-analysis of 22 studies. Br J Gen Pract. 2007;57(535):144–51.

    PubMed  PubMed Central  Google Scholar 

  13. Haug TT, Mykletun A, Dahl AA. The association between anxiety, depression, and somatic symptoms in a large population: the HUNT-II study. Psychosom Med. 2004;66(6):845–51.

    Article  PubMed  Google Scholar 

  14. Kirmayer LJ. Cultural variations in the clinical presentation of depression and anxiety: implications for diagnosis and treatment. J Clin Psychiatry. 2001;1(62):22–30.

    Google Scholar 

  15. Leng JC, Changrani J, Tseng CH, et al. Detection of depression with different interpreting methods among Chinese and Latino primary care patients: a randomized controlled trial. J Immigr Minor Health. 2009;12(2):234–41.

    Article  Google Scholar 

  16. Bauer AM, Chen CN, Alegría M. Associations of physical symptoms with perceived need for and use of mental health services among Latino and Asian Americans. Soc Sci Med. 2012;75(6):1128–33.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Nadeem E, Lange JM, Miranda J. Perceived need for care among low-income immigrant and US-born black and Latina women with depression. J Women’s Health. 2009;18(3):369–75.

    Article  Google Scholar 

  18. Carroll DJ, Samardick R, Bernard S, et al. Findings from the National Agricultural Workers Survey (NAWS) 2001–2002: a demographic and employment profile of United States farm workers. Washington, DC: US Dep. Labor, Office of the Assistant Secretary of Policy; 2005.

    Google Scholar 

  19. Pinkay IEM, Guarnaccia PJ. “It’s like going through an earthquake”: anthropological perspectives on depression among Latino immigrants. J Immigr Minor Health. 2007;9(1):17–28.

    Google Scholar 

  20. Del Castillo JC. The influence of language upon symptomatology in foreign-born patients. Am J Psychiatry. 1970;27(2):242–4.

    Article  Google Scholar 

  21. Beck AT, Steer RA, Brown G. Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation; 1996.

    Google Scholar 

  22. Radloff LS. The CES-D scale a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401.

    Article  Google Scholar 

  23. Kroenke K, Spitzer RL, Williams JB. The Phq-9. J Gen Intern Med. 2001;16(9):606–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1983;17(1):37–49. doi:10.1016/0022-3956(82)90033-4.

    Article  CAS  Google Scholar 

  25. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150(6):782–6.

    Article  CAS  PubMed  Google Scholar 

  26. Beck CT, Gable RK. Postpartum Depression Screening Scale: development and psychometric testing. Nurs Res. 2000;49(5):272–82.

    Article  CAS  PubMed  Google Scholar 

  27. Reuland DS, Cherrington A, Watkins GS, et al. Diagnostic accuracy of Spanish language depression-screening instruments. Ann Fam Med. 2009;7(5):455–62.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Snowden LR, Yamada AM. Cultural differences in access to care. Annu Rev Clin Psychol. 2005;1:143–66.

    Article  PubMed  Google Scholar 

  29. Willerton E, Dankoski ME, Martir JF. Medical family therapy: a model for addressing mental health disparities among Latinos. Fam Syst Health. 2008;26(2):196–206.

    Article  Google Scholar 

  30. Nylund D. Critical multiculturalism, whiteness, and social work: towards a more radical view of cultural competence. J Prog Hum Serv. 2006;17(2):27–42.

    Article  Google Scholar 

  31. McDowell T, Fang SRS. Feminist-informed critical multiculturalism considerations for family research. J Fam Issues. 2007;28(4):549–66.

    Article  Google Scholar 

  32. Cooper H. Research synthesis and meta-analysis: a step by step approach. Thousand Oaks, CA: Sage Publications; 2009.

    Book  Google Scholar 

  33. Crocker L, Algina J. Introduction to classical and modern test theory. Boston, MA: Cengage Learning; 2006.

    Google Scholar 

  34. First MB, Spitzer RL, Gibbon M, et al. Structured clinical interview for DSM-IV® Axis I Disorders (SCID-I), Clinician Version, Administration Booklet. Washington, DC: American Psychiatric Press; 2012.

    Google Scholar 

  35. Aranda MP, Knight BG. The influence of ethnicity and culture on the caregiver stress and coping process: a sociocultural review and analysis. Gerontologist. 1997;37(3):342–54.

    Article  CAS  PubMed  Google Scholar 

  36. Losada A, Villareal M, Nuevo R, et al. Cross-cultural confirmatory factor analysis of the CES-D in Spanish and Mexican dementia caregivers. Span J Psychol. 2012;15(02):783–92.

    Article  PubMed  Google Scholar 

  37. Gibson J, McKenzie-McHarg K, Shakespeare J, et al. A systematic review of studies validating the Edinburgh Postnatal Depression Scale in antepartum and postpartum women. Acta Psychiatr Scand. 2009;119(5):350–64.

    Article  CAS  PubMed  Google Scholar 

  38. Zweig MH, Campbell G. Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine. Clin Chem. 1993;39(4):561–77.

    CAS  PubMed  Google Scholar 

  39. Anastasi A. Psychological testing. New York, NY: Macmillan; 1988.

    Google Scholar 

  40. Rivera-Medina CL, Bernal G, Rosselló J, et al. A Study of the predictive validity of the Children’s Depression Inventory for major depression disorder in Puerto Rican adolescents. Hisp J Behav Sci. 2010;32(2):232–58.

    Article  Google Scholar 

  41. American Psychiatric Association. Diagnostic and statistical manual IV. Washington, DC: American Psychiatric Association; 1994.

    Google Scholar 

  42. Lara MA, Navarrete L, Navarro C, et al. Evaluation of the psychometric measures for the Postpartum Depression Screening Scale-Spanish version for Mexican women. J Transcult Nurs. 2013;24(4):378–86.

    Article  PubMed  Google Scholar 

  43. Vega-Dienstmaier JM, Stucchi-Portocarrero S, Valdez-Huarcaya N, et al. The Depressive Psychopathology Scale: presentation and initial validation in a sample of Peruvian psychiatric patients. Rev Panam Salud Pública. 2011;30(4):317–26.

    PubMed  Google Scholar 

  44. Ruiz-Grosso P, de Mola CL, Vega-Dienstmaier JM, et al. Validation of the spanish center for epidemiological studies depression and zung self-rating depression scales: a comparative validation study. PloS one. 2012;7(10):e45413.

  45. Pew Hispanic Research Center. Statistical portrait of Hispanics in the United States, 2010. Washington, DC: Pew Hispanic Center; 2010.

    Google Scholar 

  46. United States Census Bureau. US Census Bureau projections show a slower growing, older, more diverse nation a half century from now, 2012 (US Census Bureau Pub no. CB12-243). Washington, DC: News Room Archive; 2013.

  47. Centers of Disease Control and Prevention. Depression 2013. Atlanta, GA: Workplace Health Promotion; 2013.

    Google Scholar 

  48. Greenberg PE, Birnbaum HG. The economic burden of depression in the US: societal and patient perspectives. Expert Opin Pharmacother. 2005;6(3):369–76.

    Article  PubMed  Google Scholar 

  49. Thase ME. New approaches to managing difficult-to-treat depressions. J Clin Psychiatry. 2003;64(1):3–4.

    CAS  Google Scholar 

  50. Robison J, Gruman C, Gaztambide S, Blank K. Screening for depression in middle-aged and older Puerto Rican primary care patients. J Gerontol A Biol Sci Med Sci. 2002;57(5):M308–14.

    Article  PubMed  Google Scholar 

  51. Beck CT, Gable RK. Screening performance of the postpartum depression screening scale—Spanish version. J Transcult Nurs. 2005;16(4):331–8.

    Article  PubMed  Google Scholar 

  52. Ring JM, Marquis P. Depression in a Latino immigrant medical population: an exploratory screening and diagnosis. Am J Orthopsychiatry. 1991;61(2):298–302.

    Article  CAS  PubMed  Google Scholar 

  53. Aguilar-Navarro SG, Fuentes-Cantú A, Avila-Funes JA, García-Mayo EJ. Validity and reliability of the screening questionnaire for geriatric depression used in the Mexican Health and Age Study. Salud Publica Mex. 2007;49(4):256–62.

    Article  PubMed  Google Scholar 

  54. Vega-Dienstmaier JM, Mazzotti Suárez G, Campos Sánchez M. Validation of a Spanish version of the Edinburgh Postnatal Depression Scale. Actas Esp Psiquiatr. 2002;30(2):106–11.

    CAS  PubMed  Google Scholar 

  55. Wulsin L, Somoza E, Heck J. The feasibility of using the Spanish PHQ-9 to screen for depression in primary care in Honduras. Prim Care Companion J Clin Psychiatry. 2002;4(5):191–5.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Aragonès Benaiges E, Masdèu Montalà RM, Cando Guasch G, Coll Borràs G. Diagnostic validity of Zung’s self-rating depression scale on primary care patients. Actas Esp Psiquiatr. 2001;29(5):310–6.

    PubMed  Google Scholar 

  57. Baca E, Saiz J, Agüera L, et al. Validation of the Spanish version of PRIME-MD: a procedure for diagnosing mental disorders in primary care. Actas Esp Psiquiatr. 1999;27(6):375–83.

    CAS  PubMed  Google Scholar 

  58. Fernández-San Martín MI, Andrade-Rosa C, Molina JD, et al. Validation of the Spanish version of the geriatric depression scale (GDS) in primary care. Int J Geriatr Psychiatry. 2002;17(3):279–87. Erratum in: Int J Geriatr Psychiatry. 2007;22(7):704

  59. Garcia-Esteve L, Ascaso C, Ojuel J, Navarro P. Validation of the Edinburgh Postnatal Depression Scale (EPDS) in Spanish mothers. J Affect Disord. 2003;75(1):71–6.

    Article  PubMed  Google Scholar 

  60. Martínez de la Iglesia J, Onís Vilches MC, Dueñas Herrero R, Aguado Taberné C, Albert Colomer C, Arias Blanco MC. Abbreviating the brief. Approach to ultra-short versions of the Yesavage questionnaire for the diagnosis of depression. Aten Primaria. 2005;35(1):14–21.

    Article  PubMed  Google Scholar 

  61. Ortega OR, Salinero FM, Kazemzadeh KA, Vidal AS, de Dios DVR. Validation of 5 and 15 items Spanish version of the geriatric depression scale in elderly subjects in primary health care setting. Rev Clin Esp. 2007;207(11):559–62.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Child Development and Family Relations, East Carolina University, 612 East 10th Street, Greenville, NC, 27858, USA

    Francisco J. Limon, Angela L. Lamson & Jennifer Hodgson

  2. Department of Psychology, East Carolina University, 612 East 10th Street, Greenville, NC, 27858, USA

    Mark Bowler

  3. Broody School of Medicine, Psychiatric Medicine, East Carolina University, 612 East 10th Street, Greenville, NC, 27858, USA

    Sy Saeed

Authors
  1. Francisco J. Limon
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  2. Angela L. Lamson
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  3. Jennifer Hodgson
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  4. Mark Bowler
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  5. Sy Saeed
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Corresponding author

Correspondence to Francisco J. Limon.

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Appendix: Data Extraction Form

Appendix: Data Extraction Form

Study ID

First author

Years

Country

Language of administration

Date of reviewing

Reviewers initials

Any missed References (yes, no, do separate list)

Where sample was recruited

Clinical type: community, depressed, women

Outcomes: (verify depression is included, yes, no)

Study designs:

Case study

Cross-section

RCT

Other

Inclusion criteria

Exclusion criteria

Cut-off(s) reported

Was cut-off compared to minor, major, depression or unstated? Indicate for both cut-offs

Recruitment procedures: consecutive/random/add hock

Type of depression

All tests used

Quality grade (see table provided)

Name of interview used

Structured/semi-structured

Interviewer’s qualification

Interviewer trained to use interview?

Reference for interview

No. of participants available (original population)

% of those below cut-off

% of those above cut-off

% of sample not completing instrument

How was the instrument administered?

Delay b/w instrument interview?

Sensitivity

Specificity

LR +ve (1-sens)/spec

Diagnostic OR (LR +ve/LR −ve

PPV

NPV

Data to be requested from authors

*Study design

Case–control The comparison of individuals with a certain illness to similar healthy individuals. Matched by age, sex or other factors in order t define risk factors for the illness.

Cross-sectional The observation of a defined population at a single point in time or time interval. Exposure and outcomes are determined simultaneously.

RCT A true prospective experiment in which investigators randomly assign an eligible sample of patients to one or more groups and a control group and follow patient’s outcomes.

**Interview

Structured The interview has been specifically designed to diagnose depression in a given individual (it may also define other psychiatric conditions). There are specific questions and all relevant questions are asked of all interviews—the focus is quantitative.

Semi-structured The interview has been designed to elicit a number of different subjects or themes. Although there are set questions, the interviewer may choose to enquire further about areas of interest—the focus is qualitative. For this study, only structured interviews are eligible for inclusion.

Grade

Test accuracy

A

High quality studies with a blind comparison of test to reference standard in an appropriate population spectrum

B

Any one or two of the following

 Narrow population spectrum

 Differential use of reference standard

 Reference standard not blind

 Case control study

C

Any three or more of the above

D

Expert opinion

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Limon, F.J., Lamson, A.L., Hodgson, J. et al. Screening for Depression in Latino Immigrants: A Systematic Review of Depression Screening Instruments Translated into Spanish. J Immigrant Minority Health 18, 787–798 (2016). https://doi.org/10.1007/s10903-015-0321-y

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