Beyond Hispanics: sub-ethnic differences in depression, post-traumatic distress, and suicidal ideation among patients with coronary heart disease.

OBJECTIVES Our study of cardiac outpatients participating in a mental health screening program aimed to explore: a) sub-ethnic differences in the severity and/or prevalence of depression, post-traumatic stress disorder, and suicidal ideation, and b) whether intrusion and avoidance symptoms of distress equally or differentially predict severity of depression among sub-ethnic groups. DESIGN Five hundred ninety Caucasian (n = 103) and immigrant Hispanic (n = 487) cardiac outpatients were recruited. Participants completed measures of depression and post-traumatic stress symptoms and were categorized into sub-ethnic groups according to regional and national origins. RESULTS For regional comparisons, South American and Caribbean Hispanic patients exhibited greater symptoms of depression than US born Caucasians (UBC). Significant differences in the proportion of patients screening positive for depression were found among regional subethnic groups. When these groups were further stratified by national origin, Colombian and Dominican patients demonstrated higher levels of depression than UBC patients. Dominican patients reported greater levels of distress than UBC patients. Significant differences in rates of positive depression screens were found among comparisons between UBC and Hispanic national sub-ethnic groups. Finally, stepwise regression analyses revealed that intrusion symptoms predicted depression severity better than avoidance symptoms among all of sub-ethnic groups tested. CONCLUSION The findings suggest that collapsing ethnic sub-groups into catchall ethnic labels may undermine high resolution screening strategies for concurrent medical and psychiatric conditions.