The prevalence of depression in African Americans and Caribbean blacks is lower than in non-Hispanic whites. However, new study findings suggest that depression tends to be more severe, persistent, and disabling in blacks and they are less likely to be treated.

In the Archives of General Psychiatry, Dr. David R. Williams of the Harvard School of Public Health in Boston and his associates report their findings from the National Study of American Life, the largest survey of its kind to examine mental health among blacks in the U.S. Their sample included 3,570 African Americans without ties to the Caribbean, 1,621 Caribbean blacks, and 891 non-Hispanic whites.

The lifetime prevalence of major depression was 10.4 percent among African Americans, 12.9 percent among Caribbean blacks, and 17.9 percent among whites.

However, persistence of the illness for at least 12 months was 56.5 percent in African-Americans and 56.0 percent in Caribbean blacks, compared with 38.6 percent in whites.

Depression is a “chronic disorder for most blacks,” the authors write. Even among blacks that rated their symptoms as severe or very severe in at least year, only 48.5 percent of African Americans and 21.9 percent of Caribbean blacks received any treatment at all.

Patterns were similar for any health care, specialty mental health care, human services, and complementary and alternative medicine.

“It has not been previously recognized that Caribbean blacks - a group with higher income and education than African Americans - have such marked levels of underutilization of mental health services,” the investigators point out.

“The findings of this study,” they conclude, “highlight the importance of identifying high-risk subgroups in racial populations and the continuing need to target cost-effective interventions to them.”

SOURCE: Archives of General Psychiatry, March 2007.