BMJ 1999;318:302-306 ( 30 January )

General Practice

Prevalence of anxiety and depressive illness and help seeking behaviour in African Caribbeans and white Europeans: two phase general population survey

C M Shaw, Wellcome clinical epidemiology training fellow, a F Creed, professor of psychological medicine, a B Tomenson, statistician, a L Riste, research associate, b J K Cruickshank, director. b

a School of Psychiatry and Behavioural Sciences, University of Manchester, Manchester M13 9WL, b Clinical Epidemiology Unit, University of Manchester

Correspondence to: Dr Shaw, Consultant Psychiatrist, Department of Psychiatry, Tameside and Glossop Community and Priority Services NHS Trust, Tameside General Hospital, Ashton-under-Lyne OL6 9RW

Objective: To determine the prevalence of common mental disorders (anxiety and depression) and help seeking behaviour in African Caribbeans and white Europeans.
Design: Two phase survey in a general population sample. The first phase comprised screening with the 12 item general health questionnaire; the second phase was standardised psychiatric assessment and interview about help seeking.
Setting: People registered with four general practices in central Manchester.
Participants: Of 1467 people randomly selected from family health services authority lists, 864 were still resident. 337 African Caribbeans and 275 white Europeans completed the screening phase (response rate 71%); 127 African Caribbeans and 103 white Europeans were interviewed in the second phase.
Main outcome measures: One month period prevalence of anxiety and depressive disorders in each ethnic group.
Results: 13% of African Caribbeans (95% confidence interval 10% to 16%) and 14% (10% to 18%) of white Europeans had one or more disorder. Anxiety disorders were significantly less common among African Caribbeans (3% (1% to 5%) v 9% (6% to 12%) in white Europeans). Depressive disorders were significantly more common among African Caribbean women than white women (difference 8% (1% to 15%)). Medical help seeking was similar in the two groups, but African Caribbeans with mental disorders were more likely to seek additional help from non-medical sources (12/29 v 5/29, P=0.082).
Conclusions: In an inner city setting the prevalence of common mental disorders is similar in these two ethnic groups.


Key messages

  • Most studies of ethnic differences in mental health focus on psychotic illness rather than common mental disorders

  • In this inner city study the prevalence of anxiety and depression was similar in African Caribbeans and white Europeans

  • Anxiety disorders were less common, and depression more common, in African Caribbeans than white Europeans

  • Improved recognition and treatment of non-psychotic disorders are necessary, taking into account patients' views of their illnesses



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