RESEARCH ARTICLE


Discord of Biological and Psychological Measures in a Group of Depressed African American and White Cancer Patients



Amy Y. Zhang*
Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4904, USA


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© Amy Y. Zhang; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4904, USA; Tel: (216) 368-0968; Fax: (216) 368-3542; E-mail: axz16@case.edu


Abstract

Objective:

This study examined racial differences in the self-report of depressive symptoms by reference to biological states.

Methods:

The study used a convenience sample of 20 depressed cancer patients (CES-D ≥16) (15 African Americans and 5 Whites). Subjects completed depression assessment on a battery of psychological measures and provided blood and saliva samples. Laboratory tests were performed on biomarkers (serotonin, cortisol and IL-6). T-test was computed to examine racial differences on biological and psychological measures.

Results:

Depressed Whites had a significantly higher cortisol level than depressed African Americans, but no significant group difference was found on any self-reported psychological measures of depression. There was a trend that African Americans reported fewer depressive symptoms on psychological measures but exceeded Whites on the domain of somatization; however, such group differences did not approach statistic significance in this small sample.

Conclusion:

African Americans did not appear to underreport depression in consideration of their biological states, but had a tendency to report more somatic symptoms than Whites; this may be attributable to non-depression diseases or reporting behavior rather than somatic sensitivity. African Americans exhibited more mistrust in the health care system, which could affect the self-report of depression. There is a discord between biological and psychological measures of depression. Biomarkers prove to be useful for evaluating racial difference in the self-report of depression.

Implication for Nursing:

Nurses should be cautious of somatic complaints when assessing African American cancer patient’s depression. Establishing trust is essential for an accurate assessment of depression in African American cancer patients.

Keywords: African American, biomarker, cancer, cortisol, depression, race.