To What Factors Do Rural-Dwelling Hispanics Attribute Depressive Symptoms?

This study is a retrospective chart review comparing rural-dwelling Caucasian and Hispanic outpatients’ attribution of depressive symptoms. Based on the data gathered at intake, Hispanics were more likely to attribute depression to curse/spell and supernatural causes, while Caucasians were more likely to attribute symptoms to hereditary factors or job stress. Among both groups, higher CESD score was associated with problems with significant others or how they got along with others. Among Hispanics, depression severity was additionally associated with problems related to job or finances. Our findings point to a consequential role for clinical inquiry into attributed causes of depressive symptoms. 1. Introduction Identification and adequate treatment of mood spectrum disorders, particularly depression and subsyndromal depression, is a major public health concern [1]. Recent data from the 2010 US Census showed that Hispanics are the largest and fastest growing minority group in the USA, and will have considerable impact on the delivery of services, treatment, and healthcare costs [2]. Moreover, it has been suggested that the prevalence of depression in Hispanics (especially immigrants and less acculturated persons) may be higher than the general population [3, 4]. Little, however, is known about how cultural differences and attributions of cultural beliefs impact depression [3], especially among Mexican-Americans. Even less is known about rural populations of Hispanics, though they represent a large group [5]. It is unclear if existing explanatory models of attribution (e.g., the health belief model or the explanatory model of illness) apply to Hispanics [6], and studies on the role of culture in depression among Mexican-Americans [7] have focussed more on adapting to American culture, rather than the role of culture-related beliefs such as superstitions or beliefs in the supernatural. In addition, there is little in the existing literature on the interaction of beliefs about mental illness with socioeconomic factors or the possible impact of beliefs about illness on care-seeking. However, theoretical models indicate that cultural meanings and norms about mental illness are likely to influence expression, and subsequently diagnosis and treatment for psychiatric conditions [8]. In light of the increase in the population, the number of Hispanic patients who have mental health problems will increase, and thus there is an urgent need to broaden our understanding of factors that influence what Hispanics attribute as the cause of depressive symptoms, and how