Ethnicity and Cultural Issues

This special journal issue was devised to solicit original manuscripts on current research findings, review studies, or conceptual papers pertaining to clinical or community level interventions, innovative treatment approaches, and discussions of cross-cultural issues pertinent to reducing ethnic disparities while improving care provided to patients with depression. Envisioning a collection of quality studies that encompassed a range of diverse topics reflecting the complexity of this issue, we broadly sought papers on areas including, but not limited to health beliefs, stigma, the care-seeking process, genetics and pharmacodynamics, financial barriers or other access problems, informal sources of care, healthcare reform and policy implications for mental health parity, the contribution and burden of medical comorbidities and care coordination, therapeutic alliance and cultural views of clinical power dynamics, unique issues regarding age, gender, and religious or sexual orientation, treatment retention and medication adherence, familial or social dynamics, specific treatment modalities, and special concerns of community patients and large insured populations alike. Although older national epidemiology surveys, such as the National Comorbidity Study and the Epidemiological Catchment Area study, found relatively similar prevalence rates for all mental health conditions across ethnic groups, [1] some evidence from recent studies like the National Survey of American Lives (NSAL) and National Latino and Asian America Study (NLAAS) is beginning to document possible rate differences in depression [2, 3]. However, forty years of evidence from actual diagnostic rates in research or clinical practice continues to indicate that Hispanic and African-American patients, for example, are diagnosed far less frequently with affective disorders and far more often for psychosis than white patients [4, 5]. Hence, for many reasons, the appropriate detection of depression may be underreported in ethnic minority groups, subsequently leading to insufficient treatment. An increasing body of research is accumulating that focuses on a variety of pertinent issues, including perceived stigma and discrimination leading to lower health status, with depression as a significant factor [6], the interaction of gender with ethnicity and depression [7], how one's culture and worldview can help moderate hopelessness and suicidality [8], and the role of comorbid medical illnesses and substance abuse upon appropriate treatment seeking for depression in minority patients [9, 10]. These scholarly inquiries, in addition to numerous recent studies investigating other psychosocial dimensions, offer tremendous promise regarding the academic community and its aspiration to tackle these challenges. Yet despite this positive research trend and an ongoing emphasis of promoting cultural competence to …