Undiagnosed depression, persistent depressive symptoms and seeking mental health care: analysis of immigrant and non-immigrant participants of the Canadian Longitudinal Study of Aging

Epidemiol Psychiatr Sci. 2020 Aug 14:29:e158. doi: 10.1017/S2045796020000670.

Abstract

Aims: Early diagnosis and treatment of depression are associated with better prognosis. We used baseline data of the Canadian Longitudinal Study on Aging (2012-2015; ages 45-85 years) to examine differences in prevalence and predictors of undiagnosed depression (UD) between immigrants and non-immigrants at baseline and persistent and/or emerging depressive symptoms (DS) 18 months later. At this second time point, we also examined if a mental health care professional (MHCP) had been consulted.

Methods: We excluded individuals with any prior mood disorder and/or current anti-depressive medication use at baseline. UD was defined as the Center for Epidemiological Studies Depression 10 score ⩾10. DS at 18 months were defined as Kessler 10 score ⩾19. The associations of interest were examined in multivariate logistic regression models.

Results: Our study included 4382 immigrants and 18 620 non-immigrants. The mean age (standard deviation) in immigrants was 63 (10.3) years v. 65 (10.7) years in non-immigrants and 52.1% v. 57.1% were male. Among immigrants, 12.2% had UD at baseline of whom 34.2% had persistent DS 18 months later v. 10.6% and 31.4%, respectively, among non-immigrants. Female immigrants were more likely to have UD than female non-immigrants (odds ratio 1.50, 95% confidence interval 1.25-1.80) but no difference observed for men. The risk of persistent DS and consulting an MHCP at 18 months did not differ between immigrants and non-immigrants.

Conclusions: Female immigrants may particularly benefit from depression screening. Seeking mental health care in the context of DS should be encouraged.

Keywords: CLSA; cohort; depression; immigrant; mental health; national representative sample.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aging / psychology*
  • Canada / epidemiology
  • Depression / epidemiology
  • Depression / ethnology*
  • Depression / psychology
  • Emigrants and Immigrants / psychology*
  • Emigrants and Immigrants / statistics & numerical data
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Services Accessibility
  • Help-Seeking Behavior*
  • Humans
  • Longitudinal Studies
  • Male
  • Mental Health
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Sex Factors