Clinical presentations of depression in African American and white outpatients

The objective of this study was to compare the nature and severity of depressive symptoms in moderately depressed, medically healthy African American and White patients. Twenty age- and gender-matched subjects from each ethnic group who met criteria for a major depression were assessed with structured interviews, and their depression was evaluated with the Hamilton Depression Rating Scale (HAM-D). Overall severity of the depression was comparable between groups. When the individual HAM-D items were grouped into factors, Whites showed significantly more articulated/observed mood and anxiety symptoms, whereas African Americans had significantly more diurnal variation to their depression. There were no differences on other neurovegetative symptoms. These results are discussed in the context of past studies, which often used very heterogeneous populations not matched for socioeconomic status, and included those with comorbid psychiatric and medical illnesses. Although our sample size was relatively modest, the results suggest that clinicians should be aware of potential differences in symptom presentation when treating patients from different ethnic groups.