BMJ 1999;319:1007 ( 9 October )

Letters

Rates of anxiety and depression in African-Caribbeans may not reflect reality

The first 150 words of the full text of this article appear below.

EDITOR---Shaw et al add welcome breadth to the literature concerning psychiatric disorders in African-Caribbeans.1 However, there are methodological problems which make interpretation of the results difficult.

Contrary to BMJ guidelines, there is no rationale for the choice of ethnic variables used.2 Hypotheses for why depression in the inner city should be expected to be related to Office for National Statistics' definitions of ethnicity may have led to the measurement of possible explanations or confounders such as financial worry, religion, housing, racism, and ecological variables such as community cohesion.

The use of a white European comparison group is problematic because of high rates of mental disorder in subgroups such as the Irish and refugees.3 Were white minority groups more likely to be cases?

It is unclear how representative the African-Caribbean population is. Compared with other studies the proportion of Caribbean born African-Caribbeans is high. The mean age of the . . . [Full text of this article]
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Relevant Article

Prevalence of anxiety and depressive illness and help seeking behaviour in African Caribbeans and white Europeans: two phase general population survey • Commentary: Counting heads may mask cultural and social factors
C M Shaw, F Creed, B Tomenson, L Riste, J K Cruickshank, and Greta Rait
BMJ 1999 318: 302-306. [Abstract] [Full Text] [PDF]

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