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



© BMJ 1999
Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?

Relevant Articles

Rates of anxiety and depression in African-Caribbeans may not reflect reality
Kwame McKenzie
BMJ 1999 319: 1007. [Extract] [Full Text]

Depression is common in African Caribbeans in UK inner cities
BMJ 1999 318: 0. [Full Text]

This article has been cited by other articles:

  • Pascual, J. C., Malagon, A., Corcoles, D., Gines, J. M., Soler, J., Garcia-Ribera, C., Perez, V., Bulbena, A. (2008). Immigrants and borderline personality disorder at a psychiatric emergency service. Br. J. Psychiatry 193: 471-476 [Abstract] [Full text]  
  • Koffman, J, Morgan, M, Edmonds, P, Speck, P, Higginson, I. (2008). Cultural meanings of pain: a qualitative study of Black Caribbean and White British patients with advanced cancer. Palliat Med 22: 350-359 [Abstract]  
  • Williams, D. R., Gonzalez, H. M., Neighbors, H., Nesse, R., Abelson, J. M., Sweetman, J., Jackson, J. S. (2007). Prevalence and Distribution of Major Depressive Disorder in African Americans, Caribbean Blacks, and Non-Hispanic Whites: Results From the National Survey of American Life. Arch Gen Psychiatry 64: 305-315 [Abstract] [Full text]  
  • Williams, D. R., Haile, R., Gonzalez, H. M., Neighbors, H., Baser, R., Jackson, J. S. (2007). The Mental Health of Black Caribbean Immigrants: Results from the National Survey of American Life. Am. J. Public Health 97: 52-59 [Abstract] [Full text]  
  • SWINNEN, S. G. H. A., SELTEN, J.-P. (2007). Mood disorders and migration: Meta-analysis. Br. J. Psychiatry 190: 6-10 [Abstract] [Full text]  
  • Whitley, R. (2005). Book Review: Cultural Diversity, Mental Health and Psychiatry: The Struggle Against Racism. Transcultural Psychiatry 42: 507-509  
  • Bhui, K., Bhugra, D., Goldberg, D., Sauer, J., Tylee, A. (2004). Assessing the Prevalence of Depression in Punjabi and English Primary Care Attenders: The Role of Culture, Physical Illness and Somatic Symptoms. Transcultural Psychiatry 41: 307-322 [Abstract]  
  • Freeman, E. W., Sammel, M. D., Liu, L., Gracia, C. R., Nelson, D. B., Hollander, L. (2004). Hormones and Menopausal Status as Predictors of Depression in Women in Transition to Menopause. Arch Gen Psychiatry 61: 62-70 [Abstract] [Full text]  
  • BHUGRA, D., MASTROGIANNI, A. (2004). Globalisation and mental disorders: Overview with relation to depression. Br. J. Psychiatry 184: 10-20 [Abstract] [Full text]  
  • SAYAL, K., TAYLOR, E., BEECHAM, J., BYRNE, P. (2002). Pathways to care in children at risk of attention-deficit hyperactivity disorder. Br. J. Psychiatry 181: 43-48 [Abstract] [Full text]  
  • Bhui, K., Bhugra, D. (2002). Mental illness in Black and Asian ethnic minorities: pathways to care and outcomes. Adv. Psychiatr. Treat. 8: 26-33 [Full text]  
  • Bhugra, D., Ayonrinde, O. (2001). Racism, racial life events and mental ill health. Adv. Psychiatr. Treat. 7: 343-349 [Full text]  
  • SHARPLEY, M. S., HUTCHINSON, G., MURRAY, R. M., McKENZIE, K. (2001). Understanding the excess of psychosis among the African--Caribbean population in England: Review of current hypotheses. Br. J. Psychiatry 178 : s60-s68 [Abstract] [Full text]  
  • Pill, R., Prior, L., Wood, F. (2001). Lay attitudes to professional consultations for common mental disorder: a sociological perspective: Depression and public health. Br Med Bull 57: 207-219 [Abstract] [Full text]  
  • McKenzie, K. (1999). Rates of anxiety and depression in African-Caribbeans may not reflect reality. BMJ 319: 1007a-1007 [Full text]  
Doc2Doc Vacancy
Access jobs at BMJ Careers
Whats new online at Student BMJ