Spanish-only Latinos respond more poorly to antidepressants than English-speaking Latinos

For Latinos who speak only Spanish and who suffer from depression, the road back to mental health is longer and rockier than for those who speak English, a UCLA study has found. A team led by the Los Angeles Biomedical Research Center at UCLA's Harbor campus found that among Spanish-only speakers -- a group that makes up about one-third of American Latinos -- those seeking help for depressive symptoms were slower to respond to and less likely to get relief from antidepressant medications.

For physicians who see these patients, the lesson is clear, says Dr. Ira Lesser, the lead author of the article, published in the November issue of Psychiatric Services: These patients, who tend to be older, poorer, less educated and have more medical issues than English-speaking Latinos, may need more than just antidepressants for relief of their depression. The patients are also more likely to be women, and the physicians they seek out more likely to be primary-care providers, not psychiatrists.

The study, which looked at the records of 195 English- and Spanish-speaking Latinos who sought treatment for depression in Los Angeles and San Diego, was an offshoot of one of the mental health field's most comprehensive trials of treatments for depression. Among the best known of the findings emerging from that trial -- called the Sequenced Treatment Alternatives to Relieve Depression, or STAR-D, was that among patients who do not immediately respond to antidepressants, a switch in medicine and the addition of psychotherapy is highly successful in banishing depressive symptoms.

More recent studies have upheld the value of psychotherapy, along with antidepressants, for depressed teenagers and for children suffering from anxiety, as well as for those suffering panic disorder. 

Researchers have found many obstacles to improved mental health for Latinos, including cultural resistance to admitting mental health problems, insurance rates, the availability of Spanish-speaking mental health professionals and compliance with medication. 

-- Melissa Healy