Depression in South Asian and White Older People.

This thesis reports an interview study of depression in 96 South Asian and 96 white older people (aged between 58 and 85) in South London. Depression is underdiagnosed in older people and improving recognition by GPs is a target of national policy. The question of whether South Asian older people present depression more somatically, making it harder to recognise, is unresolved in the current literature. The research explored the hypotheses that depression is no more common in South Asian older people than white older people, that South Asian older people report more somatic symptoms than white older people and that South Asian older people have different beliefs about the causes of and treatment for depression from those of white older people. It also hypothesised that women would be more depressed and report more somatic symptoms than men. Participants were interviewed, in their own first language, using a semi-structured interview and questionnaires, including the Hospital Anxiety and Depression Scale (HADS) and the Bradford Somatic Inventory. Measures of physical health and functional status (ADL) were included. The study found that South Asian older people were more depressed than white older people, but women were no more depressed than men. South Asian older people had poorer health and functional status than the white older people, but this did not wholly account for differences in depression. Although South Asian older people did report more somatic symptoms, these appeared to be linked to their functional abilities and physical illnesses rather than being an alternative expression of mental distress. Finally women did report more somatic symptoms even when their ADL status was taken into account. There were more similarities than differences in beliefs about depression and its causes and treatment. Methodological issues, the generalisability of findings and implications for research and practice are discussed