Articles & Special Issues Race, Inequality & Social Mobility

Differences in the Clinical Recognition of Depression in Diabetes Patients: The Diabetes Study of Northern California (Distance)

It is unknown to what extent the gap between need and care for depression among patients with diabetes differs across racial/ethnic groups. We compared, by race/ethnicity, the likelihood of clinical recognition of depression (diagnosis or treatment) of patients who reported depressive symptoms in a well-characterized community-based population with diabetes. We used a survey follow-up study of 20,188 patients with diabetes from Kaiser Permanente Northern California. Analyses were limited to 910 patients who scored 10 or higher on the Patient Health Questionnaire (PHQ-8) which was included in the survey and who had no clinical recognition of depression in the 12 months prior to survey. Clinical recognition of depression was defined by a depression diagnosis, referral to mental health services, or antidepressant medication prescription. Among the 910 patients reporting moderate to severe depressive symptoms on the survey and who had no clinical recognition in the prior year, 12%, 8%, 8%, 14%, and 15% of African American, Asian, Filipino, Latino and white patients were clinically recognized for depression in the subsequent 12 months. After adjusting for sociodemographics, limited English proficiency, and depressive symptom severity, racial/ethnic minorities were less likely to be clinically recognized for depression compared to whites.

Project: Estimating Mental Health Needs


Hudson, D. L., Karter, A. J., Fernandez, A., Adams, A. S., Zhou, J., & Adler, N. E. (2013). Differences in the clinical recognition of depression in diabetes patients: The Diabetes Study of Northern California (DISTANCE). American Journal of Managed Care, 19(5), 344–352.