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Órgano Oficial del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz

2012, Number 1

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Salud Mental 2012; 35 (1)

Enfocando la depresión como problema de salud pública en México

Wagner FA, González-Forteza C, Sánchez-García S, García-Peña C, Gallo JJ

Language: Spanish
References: 130
Page: 3-11
PDF size: 126.87 Kb.


ABSTRACT

The present review aims at analyzing the magnitude and social impact of depression, as well as exploring models that help to understand the strategies needed to address this public health problem. The literature reveals that 9.2% of the general population has had a depressive episode and one in five persons will have an episode by age 75. Lower rates are observed in low and mid income in comparison to those with high income. These differences are not due to personal income, the probability of greater severity or delay in diagnosis, and are more likely related to cultural differences. Greater risk is observed among females, people younger than 60 years, marital status as single, widowed or divorced, and low educational attainment. The deleterious effect of depression on productivity is well established (27 days lost in the past year, on average, per case). The association with diabetes, hypertension, cardio vascular disease, drug use, suicide, and other risk behaviors has been frequently observed. Although unresolved questions remain about the presence or not of common risk factors and the chain of causality, it is a known fact that the combination of physical and mental disorders causes greater disability. With regard to the healthcare system, patients with depression and/or anxiety have higher utilization rates and healthcare costs, particularly among elderly patients. This healthcare overutilization is related with the low rates of diagnosis and adequate treatment of depression. About 26% of depression cases will not be diagnosed and, although a large proportion of patients have contact with healthcare services, nearly 30% never receive help for their depression. New treatment models that overcome barriers, understanding the sociocultural factors related with the problem, and addressing depression at the primary level of healthcare are urgent in Mexico.


REFERENCES

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  2. Robins LN, Wing J, Wittchen HU et al. The Composite International Diagnostic Interview: An epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch Gen Psychiatry 1988; 45:1069-1077.

  3. Kessler RC, Ustun TB. The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res 2004;13:93-121.

  4. World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research; 1993.

  5. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (4a ed.). APA; 1994.

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  7. Demyttenaere K, Bruffaerts R, Posada-Villa J, Gasquet I et al. WHO World Mental Health Survey Consortium. Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 2004; 291(21):2581-2590.

  8. Slone LB, Norris FH, Murphy AD, Baker CK et al. Epidemiology of major depression in four cities in Mexico. Depress Anxiety 2006; 23(3):158-167.

  9. Medina-Mora ME, Borges G, Benjet C, Lara C, Berglund P. Psychiatric disorders in Mexico: Lifetime prevalence in a nationally representative sample. Br J Psychiatry 2007; 190:521-528.

  10. Benjet C, Borges G, Medina-Mora ME, Zambrano J et al. Youth mental health in a populous city of the developing world: Results from the Mexican Adolescent Mental Health Survey. J Child Psychol Psychiatry 2009;50(4):386-395.

  11. Seedat S, Scott KM, Angermeyer MC, Berglund P et al. Cross-national associations between gender and mental disorders in the World Health Organization World Mental Health Surveys. Arch Gen Psychiatry 2009; 66(7):785-795.

  12. Bromet E, Andrade LH, Hwang I, Sampson NA et al. Cross-national epidemiology of DSM-IV major depressive episode. BMC Med 2011; 26; 9(1) En prensa. PMID: 21791035.

  13. Andrade L, Caraveo-Anduaga JJ, Berglund P, Bijl RV et al. The epidemiology of major depressive episodes: Results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys. Int J Methods Psychiatr Res 2003; 12(1):3-21.

  14. Ormel J, Petukhova M, Chatterji S, Aguilar-Gaxiola S et al. Disability and treatment of specific mental and physical disorders across the world. Br J Psychiatry 2008; 192(5):368-375.

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  16. Carney RM, Freedland KE, Jaffe AS. Depression as a risk factor for coronary heart disease mortality. Arch Gen Psychiatry 2001; 58:229–230.

  17. Lett HS, Blumenthal JA, Babyak MA et al. Depression as a risk factor for coronary artery disease: Evidence, mechanisms, and treatment. Psychosom Med 2004; 66:305–315.

  18. Ormel J, Von Korff M, Burger H, Scott K et al. Mental disorders among persons with heart disease - results from World Mental Health surveys. Gen Hosp Psychiatry 2007; 29(4):325-334.

  19. O’Neil A, Williams ED, Stevenson CE, Oldenburg B et al. Co-morbid cardiovascular disease and depression: sequence of disease onset is linked to mental but not physical self-rated health. Results from a crosssectional, population-based study. Soc Psychiatry Psychiatr Epidemiol 2011 Aug 10. [Epub ahead of print].

  20. Scott KM, Von Korff M, Alonso J, Angermeyer MC et al. Mental-physical co-morbidity and its relationship with disability: results from the World Mental Health Surveys. Psychol Med 2009; 39(1):33-43.

  21. Castillo-Quan JI, Barrera-Buenfil DJ, Pérez-Osorio JM, Alvarez-Cervera FJ. Depression and diabetes: From epidemiology to neurobiology. Rev Neurol 2010; 51(6):347-359.

  22. Reséndiz-Figueroa FE, Ortiz-Garrido OM, Pulido D, Arcila-Martínez D et al. Impacto de los rasgos de ansiedad y depresión sobre aspectos clínicos y calidad de vida en pacientes con síndrome de intestino irritable. Rev Gastroenterol Mex 2008; 73(1):3-10.

  23. Sartorius N, Üstün TB, Lecrubier Y, Wittchen HU. Depression comorbid with anxiety: Results from the WHO Study on Psychological Disorders in Primary Health Care. Br J Psychiatry 1996; 168(supl)30:38-43.

  24. Borges G, Nock MK, Medina-Mora ME, Hwang I et al. Psychiatric disorders, comorbidity, and suicidality in Mexico. J Affect Disord 2010; 124(1-2):98-107.

  25. Téllez L, Galindo O, Álvarez MA, González-Forteza C et al. Ansiedad y depresión en pacientes con cáncer testicular en tratamiento y seguimiento; una revisión. Gaceta Mexicana Oncología 2011; 10(3):129-135.

  26. Téllez-Zenteno JF, Cardiel MH. Risk factors associated with depression in patients with type 2 diabetes mellitus. Arch Med Res 2002; 33(1):53-60.

  27. Lerman I, Lozano L, Villa AR, Hernández-Jiménez S et al. Psychosocial factors associated with poor diabetes self-care management in a specialized center in Mexico City. Biomed Pharmacother 2004; 58(10):566-570.

  28. Fisher L, Chesla CA, Mullan JT, Skaff MM et al. Contributors to depression in Latino and European-American patients with type 2 diabetes. Diabetes Care 2001; 24(10):1751-1757.

  29. González-Forteza C, Arana D, Jiménez A. Problemática suicida en adolescentes y el contexto escolar: Vinculación autogestiva con los servicios de salud mental. Salud Mental 2008; 31(1): 23-27.

  30. Roth KB, Borges G, Medina-Mora ME, Orozco R et al. Depressed mood and antisocial behavior problems as correlates for suicide-related behaviors in Mexico. J Psychiatr Res 2011; 45(5):596-602. Epub 2010 Nov 4.

  31. Illescas-Rico R, Amaya-Ayala F, Jiménez-López JL, Caballero-Méndez ME et al. Increased incidence of anxiety and depression during bone marrow transplantation. Arch Med Res. 2002; 33(2):144-147.

  32. Norris FH, Murphy AD, Baker CK, Perilla JL. Severity, timing, and duration of reactions to trauma in the population: an example from Mexico. Biol Psychiatry 2003; 53(9):769-778.

  33. Morales-Jaimes R, Salazar-Martínez E, Flores-Villegas FJ, Bochicchio-Riccardelli T et al. The role of depression in the quality of life among patients undergoing renal substitutive therapy. Gac Med Mex 2008; 144(2):91-98.

  34. Castilla-Puentes RC, Secin R, Grau A, Galeno R et al. A multicenter study of major depressive disorder among emergency department patients in Latin-American countries. Depress Anxiety 2008; 25(12):E199-204.

  35. Fernald LC, Jones-Smith JC, Ozer EJ, Neufeld LM et al. Maternal depressive symptoms and physical activity in very low-income children. J Dev Behav Pediatr 2008; 29(5):385-393.

  36. Simon G, Ormel J, VonKorff M, Barlow W. Health care costs associated with depressive and anxiety disorders in primary care. Am J Psychiatry 1995; 152(3):352-357.

  37. García-Peña C, Wagner F, Sánchez-García S, Juárez-Cedillo T et al. Depressive symptoms among older adults in Mexico City. J Gen Intern Med 2008; 12: 1973-1980.

  38. Borges G, Medina-Mora ME, Wang PS, Lara C et al. Treatment and adequacy of treatment of mental disorders among respondents to the Mexico National Comorbidity Survey. Am J Psychiatry 2006; 163(8):1371-1378.

  39. Gater R, Almeida e Sousa D, Barrientos G, Caraveo J et al. The pathways to psychiatric care: A cross-cultural study. Psychol Med 1991; 21:761-774.

  40. Borges G, Wang PS, Medina-Mora ME, Lara C et al. Delay of first treatment of mental and substance use disorders in Mexico. Am J Public Health 2007; 97(9):1638-1643.

  41. Borges G, Benjet C, Medina-Mora M, Orozco R et al. Treatment of mental disorders for adolescents in Mexico City. Bull World Health Organ 2008; 86(10):757-764.

  42. Goldberg D, Huxley P. Mental illness in the community: The pathway to psychiatric care. London: Tavistock Publications; 1980.

  43. Goldberg D, Huxley P. Common mental disorders. A bio-social model. London: Tavistock/Routledge; 1992.

  44. Goldberg D. Epidemiology of mental disorders in primary care settings. Epidemiol Rev 1995; 17:182-190.

  45. Alonso J, Buron A, Bruffaerts R, He Y et al. World Mental Health Consortium. Association of perceived stigma and mood and anxiety disor ders: Results from the World Mental Health Surveys. Acta Psychiatr Scand 2008; 118(4):305-314.

  46. Weller SC, Baer RD, Garcia de Alba Garcia J, Salcedo Rocha AL. Susto and nervios: Expressions for stress and depression. Cult Med Psychiatry 2008; 32(3):406-420.

  47. Barg FK, Huss-Ashmore R, Wittink MN, Murray GF et al. A mixed-methods approach to understanding loneliness and depression in older adults. J Gerontol B Psychol Sci Soc Sci 2006; 61(6):S329-39.

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  50. National Institute of Mental Health. National Institute of Mental Health Strategic Plan. Washington, D.C.: National Institutes of Health; 2008.

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  54. Switzer J, Wittink M, Karsch BB, Barg FK. «Pull yourself up by your bootstraps»: A response to depression in older adults. Qualitative Health Research 2006; 16(9):1207-1216.

  55. Bogner HR, Dahlberg B, de Vries HF, Cahill E et al. Older patients’ views on the relationship between depression and heart disease. Fam Med 2008;40(9):652-657.

  56. Bogner HR, Richie MB, de Vries HF, Morales KH et al. Depression, cognition, apolipoprotein e genotype: Latent class approach to identifying subtype. American J of Geriatric Psychiatry 2009; 17:344-352.

  57. Joo JH, Wittink M, Dahlberg B. Shared Conceptualizations and Divergent Experiences of Counseling Among African American and White Older Adults. Qual Health Res 2011;21(8):1065-1074.

  58. Wittink MN, Dahlberg B, Biruk C, Barg FK. How older adults combine medical and experiential notions of depression? Qualitative Health Research 2008;18(9):1174-1183.

  59. Wiittink MN, Joo JH, Lewis LM, Barg FK. Losing faith and using faith: Older African Americans discuss spirituality, religious activities and depression. J Gen Intern Med 2009; 24(3):402-407.

  60. Moreno P, Saravanan Y, Levav I, Kohn R et al. Evaluation of the PAHO/ WHO training program on the detection and treatment of depression for primary care nurses in Panama. Acta Psychiatr Scand 2003; 108(1):61-65.

  61. Gilbody S, Bower P, Fletcher J, Richards D et al. Collaborative care for depression: A cumulative meta-analysis and review of longer-term outcomes. Arch Intern Med 2006; 166(21):2314-2321.

  62. Christensen H, Griffiths KM, Gulliver A, Clack D et al. Models in the delivery of depression care: A systematic review of randomized and controlled intervention trials. BMC Fam Pract 2008; 9:25.

  63. Katon WJ, Schoenbaum M, Fan MY, Callahan CM et al. Cost-effectiveness of improving primary care treatment of late-life depression. Arch Gen Psychiatry 2005; 62(12):1313-1320.

  64. Waitzkin H, Getrich C, Heying S, Rodríguez L et al. Promotoras as mental health practitioners in primary care: A multi-method study of an intervention to address contextual sources of depression. J Community Health 2011; 36(2):316-331.

  65. Ozer EJ, Fernald LC, Weber A, Flynn EP et al. Does alleviating poverty affect mothers’ depressive symptoms? A quasi-experimental investigation of Mexico’s Oportunidades Programme. Int J Epidemiol 2011;40(6): 1565-1576 (first published online July 7, 2011) .

  66. Medina-Mora ME, Borges G, Lara C, Benjet C, Blanco J et al. Prevalence, service use, and demographic correlates of 12-month DSM-IV psychiatric disorders in Mexico: results from the Mexican National Comorbidity Survey. Psychol Med 2005; 35(12):1773-1783.

  67. Robins LN, Wing J, Wittchen HU et al. The Composite International Diagnostic Interview: An epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch Gen Psychiatry 1988; 45:1069-1077.

  68. Kessler RC, Ustun TB. The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res 2004;13:93-121.

  69. World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research; 1993.

  70. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (4a ed.). APA; 1994.

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  73. Slone LB, Norris FH, Murphy AD, Baker CK et al. Epidemiology of major depression in four cities in Mexico. Depress Anxiety 2006; 23(3):158-167.

  74. Medina-Mora ME, Borges G, Benjet C, Lara C, Berglund P. Psychiatric disorders in Mexico: Lifetime prevalence in a nationally representative sample. Br J Psychiatry 2007; 190:521-528.

  75. Benjet C, Borges G, Medina-Mora ME, Zambrano J et al. Youth mental health in a populous city of the developing world: Results from the Mexican Adolescent Mental Health Survey. J Child Psychol Psychiatry 2009;50(4):386-395.

  76. Seedat S, Scott KM, Angermeyer MC, Berglund P et al. Cross-national associations between gender and mental disorders in the World Health Organization World Mental Health Surveys. Arch Gen Psychiatry 2009; 66(7):785-795.

  77. Bromet E, Andrade LH, Hwang I, Sampson NA et al. Cross-national epidemiology of DSM-IV major depressive episode. BMC Med 2011; 26; 9(1) En prensa. PMID: 21791035.

  78. Andrade L, Caraveo-Anduaga JJ, Berglund P, Bijl RV et al. The epidemiology of major depressive episodes: Results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys. Int J Methods Psychiatr Res 2003; 12(1):3-21.

  79. Ormel J, Petukhova M, Chatterji S, Aguilar-Gaxiola S et al. Disability and treatment of specific mental and physical disorders across the world. Br J Psychiatry 2008; 192(5):368-375.

  80. Burvill PW. Recent progress in the epidemiology of major depression. Epidemiol Rev 1995; 17:21-31.

  81. Carney RM, Freedland KE, Jaffe AS. Depression as a risk factor for coronary heart disease mortality. Arch Gen Psychiatry 2001; 58:229–230.

  82. Lett HS, Blumenthal JA, Babyak MA et al. Depression as a risk factor for coronary artery disease: Evidence, mechanisms, and treatment. Psychosom Med 2004; 66:305–315.

  83. Ormel J, Von Korff M, Burger H, Scott K et al. Mental disorders among persons with heart disease-results from World Mental Health surveys. Gen Hosp Psychiatry 2007; 29(4):325-334.

  84. O’Neil A, Williams ED, Stevenson CE, Oldenburg B et al. Co-morbid cardiovascular disease and depression: sequence of disease onset is linked to mental but not physical self-rated health. Results from a crosssectional, population-based study. Soc Psychiatry Psychiatr Epidemiol 2011 Aug 10. [Epub ahead of print].

  85. Scott KM, Von Korff M, Alonso J, Angermeyer MC et al. Mental-physical co-morbidity and its relationship with disability: results from the World Mental Health Surveys. Psychol Med 2009; 39(1):33-43.

  86. Castillo-Quan JI, Barrera-Buenfil DJ, Pérez-Osorio JM, Alvarez-Cervera FJ. Depression and diabetes: From epidemiology to neurobiology. Rev Neurol 2010; 51(6):347-359.

  87. Reséndiz-Figueroa FE, Ortiz-Garrido OM, Pulido D, Arcila-Martínez D et al. Impacto de los rasgos de ansiedad y depresión sobre aspectos clínicos y calidad de vida en pacientes con síndrome de intestino irritable. Rev Gastroenterol Mex 2008; 73(1):3-10.

  88. Sartorius N, Üstün TB, Lecrubier Y, Wittchen HU. Depression comorbid with anxiety: Results from the WHO Study on Psychological Disorders in Primary Health Care. Br J Psychiatry 1996; 168(supl)30:38-43.

  89. Borges G, Nock MK, Medina-Mora ME, Hwang I et al. Psychiatric disorders, comorbidity, and suicidality in Mexico. J Affect Disord 2010; 124(1-2):98-107.

  90. Téllez L, Galindo O, Álvarez MA, González-Forteza C et al. Ansiedad y depresión en pacientes con cáncer testicular en tratamiento y seguimiento; una revisión. Gaceta Mexicana Oncología 2011; 10(3):129-135.

  91. Téllez-Zenteno JF, Cardiel MH. Risk factors associated with depression in patients with type 2 diabetes mellitus. Arch Med Res 2002; 33(1):53-60.

  92. Lerman I, Lozano L, Villa AR, Hernández-Jiménez S et al. Psychosocial factors associated with poor diabetes self-care management in a specialized center in Mexico City. Biomed Pharmacother 2004; 58(10):566-570.

  93. Fisher L, Chesla CA, Mullan JT, Skaff MM et al. Contributors to depression in Latino and European-American patients with type 2 diabetes. Diabetes Care 2001; 24(10):1751-1757.

  94. González-Forteza C, Arana D, Jiménez A. Problemática suicida en adolescentes y el contexto escolar: Vinculación autogestiva con los servicios de salud mental. Salud Mental 2008; 31(1): 23-27.

  95. Roth KB, Borges G, Medina-Mora ME, Orozco R et al. Depressed mood and antisocial behavior problems as correlates for suicide-related behaviors in Mexico. J Psychiatr Res 2011; 45(5):596-602. Epub 2010 Nov 4.

  96. Illescas-Rico R, Amaya-Ayala F, Jiménez-López JL, Caballero-Méndez ME et al. Increased incidence of anxiety and depression during bone marrow transplantation. Arch Med Res. 2002; 33(2):144-147.

  97. Norris FH, Murphy AD, Baker CK, Perilla JL. Severity, timing, and duration of reactions to trauma in the population: an example from Mexico. Biol Psychiatry 2003; 53(9):769-778.

  98. Morales-Jaimes R, Salazar-Martínez E, Flores-Villegas FJ, Bochicchio-Riccardelli T et al. The role of depression in the quality of life among patients undergoing renal substitutive therapy. Gac Med Mex 2008; 144(2):91-98.

  99. Castilla-Puentes RC, Secin R, Grau A, Galeno R et al. A multicenter study of major depressive disorder among emergency department patients in Latin-American countries. Depress Anxiety 2008; 25(12):E199-204.

  100. Fernald LC, Jones-Smith JC, Ozer EJ, Neufeld LM et al. Maternal depressive symptoms and physical activity in very low-income children. J Dev Behav Pediatr 2008; 29(5):385-393.

  101. Simon G, Ormel J, VonKorff M, Barlow W. Health care costs associated with depressive and anxiety disorders in primary care. Am J Psychiatry 1995; 152(3):352-357.

  102. García-Peña C, Wagner F, Sánchez-García S, Juárez-Cedillo T et al. Depressive symptoms among older adults in Mexico City. J Gen Intern Med 2008; 12: 1973-1980.

  103. Borges G, Medina-Mora ME, Wang PS, Lara C et al. Treatment and adequacy of treatment of mental disorders among respondents to the Mexico National Comorbidity Survey. Am J Psychiatry 2006; 163(8):1371-1378.

  104. Gater R, Almeida e Sousa D, Barrientos G, Caraveo J et al. The pathways to psychiatric care: A cross-cultural study. Psychol Med 1991; 21:761-774.

  105. Borges G, Wang PS, Medina-Mora ME, Lara C et al. Delay of first treatment of mental and substance use disorders in Mexico. Am J Public Health 2007; 97(9):1638-1643.

  106. Borges G, Benjet C, Medina-Mora M, Orozco R et al. Treatment of mental disorders for adolescents in Mexico City. Bull World Health Organ 2008; 86(10):757-764.

  107. Goldberg D, Huxley P. Mental illness in the community: The pathway to psychiatric care. London: Tavistock Publications; 1980.

  108. Goldberg D, Huxley P. Common mental disorders. A bio-social model. London: Tavistock/Routledge; 1992.

  109. Goldberg D. Epidemiology of mental disorders in primary care settings. Epidemiol Rev 1995; 17:182-190.

  110. Alonso J, Buron A, Bruffaerts R, He Y et al. World Mental Health Consortium. Association of perceived stigma and mood and anxiety disor ders: Results from the World Mental Health Surveys. Acta Psychiatr Scand 2008; 118(4):305-314.

  111. Weller SC, Baer RD, Garcia de Alba Garcia J, Salcedo Rocha AL. Susto and nervios: Expressions for stress and depression. Cult Med Psychiatry 2008; 32(3):406-420.

  112. Barg FK, Huss-Ashmore R, Wittink MN, Murray GF et al. A mixed-methods approach to understanding loneliness and depression in older adults. J Gerontol B Psychol Sci Soc Sci 2006; 61(6):S329-39.

  113. Office of Behavioral and Social Sciences Research, A. Best practices for mixed methods research in the health sciences; http://obssr.od.nih.gov/scientific_areas/methodology/mixed_methods_research/index.aspx; consultado el 29 agosto de 2011.

  114. Glass TA, McAtee M. Behavioral science at the crossroads in public health: Extending horizons, envisioning the future. Soc Sci Med 2006; 62:1650-1671.

  115. National Institute of Mental Health. National Institute of Mental Health Strategic Plan. Washington, D.C.: National Institutes of Health; 2008.

  116. Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders. Improving the Quality of Care for Mental and Substance-Use Conditions: Quality Chasm Series. Washington D.C.: National Academies Press; 2006.

  117. U.S. Department of Health and Human Services. Mental Health: A Report of the surgeon general — older adults and mental health. Rockville, Maryland: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health; 1999.

  118. U.S. Department of Health and Human Services. Mental Health: Culture, Race and Ethnicity. A supplement to mental health: A report of the surgeon general. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services; 2001.

  119. Switzer J, Wittink M, Karsch BB, Barg FK. «Pull yourself up by your bootstraps»: A response to depression in older adults. Qualitative Health Research 2006; 16(9):1207-1216.

  120. Bogner HR, Dahlberg B, de Vries HF, Cahill E et al. Older patients’ views on the relationship between depression and heart disease. Fam Med 2008;40(9):652-657.

  121. Bogner HR, Richie MB, de Vries HF, Morales KH et al. Depression, cognition, apolipoprotein e genotype: Latent class approach to identifying subtype. American J of Geriatric Psychiatry 2009; 17:344-352.

  122. Joo JH, Wittink M, Dahlberg B. Shared Conceptualizations and Divergent Experiences of Counseling Among African American and White Older Adults. Qual Health Res 2011;21(8):1065-1074.

  123. Wittink MN, Dahlberg B, Biruk C, Barg FK. How older adults combine medical and experiential notions of depression? Qualitative Health Research 2008;18(9):1174-1183.

  124. Wiittink MN, Joo JH, Lewis LM, Barg FK. Losing faith and using faith: Older African Americans discuss spirituality, religious activities and depression. J Gen Intern Med 2009; 24(3):402-407.

  125. Moreno P, Saravanan Y, Levav I, Kohn R et al. Evaluation of the PAHO/ WHO training program on the detection and treatment of depression for primary care nurses in Panama. Acta Psychiatr Scand 2003; 108(1):61-65.

  126. Gilbody S, Bower P, Fletcher J, Richards D et al. Collaborative care for depression: A cumulative meta-analysis and review of longer-term outcomes. Arch Intern Med 2006; 166(21):2314-2321.

  127. Christensen H, Griffiths KM, Gulliver A, Clack D et al. Models in the delivery of depression care: A systematic review of randomized and controlled intervention trials. BMC Fam Pract 2008; 9:25.

  128. Katon WJ, Schoenbaum M, Fan MY, Callahan CM et al. Cost-effectiveness of improving primary care treatment of late-life depression. Arch Gen Psychiatry 2005; 62(12):1313-1320.

  129. Waitzkin H, Getrich C, Heying S, Rodríguez L et al. Promotoras as mental health practitioners in primary care: A multi-method study of an intervention to address contextual sources of depression. J Community Health 2011; 36(2):316-331.

  130. Ozer EJ, Fernald LC, Weber A, Flynn EP et al. Does alleviating poverty affect mothers’ depressive symptoms? A quasi-experimental investigation of Mexico’s Oportunidades Programme. Int J Epidemiol 2011;40(6): 1565-1576 (first published online July 7, 2011).




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