Association between stigma and depression outcomes among Chinese immigrants in a primary care setting

Justin A. Chen, Benjamin G. Shapero, Nhi Ha T. Trinh, Trina E. Chang, Susannah Parkin, Jonathan E. Alpert, Maurizio Fava, Albert S. Yeung

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective: Stigma has been proposed to be a major underlying factor contributing to lower rates of mental health service utilization among racial/ethnic minorities in the United States. Yet, surprisingly little research has specifically explored associations between stigma, race/ethnicity, and psychiatric morbidity. This study aims to assess the impact of stigmatizing attitudes on depression outcomes among a psychiatrically underserved, immigrant Chinese population. Methods: Between 2009 and 2012, 190 Chinese immigrants with major depressive disorder as diagnosed by the Mini International Neuropsychiatric Interview were enrolled in a trial of culturally sensitive collaborative care for depression. Participants? selfreported stigma regarding their symptoms was assessed at study entry using the Explanatory Model Interview Catalogue, and depressive symptoms were assessed with the Hamilton Depression Rating Scale (HDRS) at baseline and follow-up. Hierarchical linear regression was used to assess the association between baseline stigma score and change in HDRS score, adjusting for potential confounders. Results: Higher stigma scores at baseline were significantly associated with attenuated improvement in both HDRS score and quality of life at 6 months (P < .05 for both). Conclusions: Stigma has a directly harmful effect on depression outcomes, even after individuals have been accurately diagnosed within a culturally sensitive community health center and agreed to treatment. These results support further research into interventions targeting stigma to improve mental health outcomes among minority populations. Trial Registration: This study is a secondary analysis of prospectively collected data from the randomized controlled trial registered by ClinicalTrials.gov identifier: NCT00854542.

Original languageEnglish (US)
Pages (from-to)e1287-e1292
JournalJournal of Clinical Psychiatry
Volume77
Issue number10
DOIs
StatePublished - Oct 1 2016
Externally publishedYes

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Primary Health Care
Depression
Interviews
Community Health Centers
Major Depressive Disorder
Mental Health Services
Research
Population
Psychiatry
Linear Models
Mental Health
Randomized Controlled Trials
Quality of Life
Morbidity

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Chen, J. A., Shapero, B. G., Trinh, N. H. T., Chang, T. E., Parkin, S., Alpert, J. E., ... Yeung, A. S. (2016). Association between stigma and depression outcomes among Chinese immigrants in a primary care setting. Journal of Clinical Psychiatry, 77(10), e1287-e1292. https://doi.org/10.4088/JCP.15m10225

Association between stigma and depression outcomes among Chinese immigrants in a primary care setting. / Chen, Justin A.; Shapero, Benjamin G.; Trinh, Nhi Ha T.; Chang, Trina E.; Parkin, Susannah; Alpert, Jonathan E.; Fava, Maurizio; Yeung, Albert S.

In: Journal of Clinical Psychiatry, Vol. 77, No. 10, 01.10.2016, p. e1287-e1292.

Research output: Contribution to journalArticle

Chen, JA, Shapero, BG, Trinh, NHT, Chang, TE, Parkin, S, Alpert, JE, Fava, M & Yeung, AS 2016, 'Association between stigma and depression outcomes among Chinese immigrants in a primary care setting', Journal of Clinical Psychiatry, vol. 77, no. 10, pp. e1287-e1292. https://doi.org/10.4088/JCP.15m10225
Chen, Justin A. ; Shapero, Benjamin G. ; Trinh, Nhi Ha T. ; Chang, Trina E. ; Parkin, Susannah ; Alpert, Jonathan E. ; Fava, Maurizio ; Yeung, Albert S. / Association between stigma and depression outcomes among Chinese immigrants in a primary care setting. In: Journal of Clinical Psychiatry. 2016 ; Vol. 77, No. 10. pp. e1287-e1292.
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