Population Health Research and PICOT Statement
Major depressive disorder is among the mental health disorders that affects a significant proportion of the population globally. It is estimated that it accounts for approximately 10% of the world’s disease burden. According to statistics, it is ranked as the fourth leading cause of disability as well as non-fatal disease burden in the US. In addition, one in every five people in the state has symptoms that are related to major depression. The symptoms include emotional behavioral, physiological, and cognitive symptoms of major depression (Sohail, Bailey & Richie, 2014). According to Bailey, Mokonogho and Kumar (2019), the prevalence rate of major depressive disorder among African-Americans is 10.4% while that of the Caucasians is 17.9%. However, the complications of the disease are more prevalent in African-Americans (56%) than in the Caucasians (38.6%). The difference is attributed to the fact that a majority of African-Americans do not seek treatment for the condition. Other factors such as poor access to the available mental health services and low quality of mental health service when compared to that offered to the whites also contribute to the increased prevalence of complications of the disease among them (Bailey et al., 2019). Therefore, this research will aim at analyzing the issue of major depressive disorder among African-Americans and propose appropriate interventions through a PICOT statement.
Population Analysis
African-Americans comprise a majority of the minority ethnicity in the US. It leads in the population of ethnic minority living in both urban and rural regions of the state. According to statistics, African-Americans comprise of
8.2% of the American population while the Hispanics lead with 9.3% of the population. A significant percentage of the African-American population in the US has their origin in the Caribbean, Haiti, Trinidad and Tobacco, and Jamaica (Lacey et al., 2015). The US Department of Health and Human Services Office of Minority Health reports that Texas, New York, Georgia, Florida, North Carolina, and Illinois were among the leading states with Africa-American populations as per 2017. The prevalence of major depressive disorder among African-Americans is lower than that of Caucasians. However, the severity of complications of the disease is high among African-Americans due to the effect of factors such as their low access to mental health services, poor utilization of the existing services, and access to low quality mental health services (Sohail et al., 2014). Norms and cultural values surrounding mental health conditions in most of the African-American populations also deter their utilization of the available mental health services. Therefore, despite the low prevalence of major depressive disorder among the African-American population in the state, the severity of complications among them is high, hence, the need for interventions to improve their mental health outcomes.
Given the severity of complications of major depressive disorder among African-Americans, it is important that health management practices that aim at addressing the disease are adopted. Nursing sciences play an important role in ensuring that the health needs of this population is addressed with the use of evidence-based practice. Nurses explore the best available evidence that can be used to inform the provision of safe, efficient, and high quality care to patients suffering from major depressive disorder. They also explore the nature of their environments to identify the factors that contribute to high prevalence of complications of major depressive disorder among them. Through it, nurses will advocate the creation of environments that reduce the incidence of the disease as well as increase the uptake of the available mental health services in the state.
Potential Solution
The treatment of major depressive disorder relies mainly on the use of pharmacological interventions. This includes the use of antidepressants to manage symptoms of the disease. Studies have shown that non-pharmacological interventions such as cognitive behavioral therapy are also effective in the management of the disease (Boschloo et al., 2019). However, few studies have examined the efficacy of combined use of cognitive behavioral therapy and antidepressants in the management of major depression. Therefore, the proposed intervention will entail the treatment of major depressive disorder using combined cognitive behavioral therapy and antidepressants v. the use of antidepressants alone. The intervention will be undertaken with the guidance of the following PICOT question:
In African-American patients with major depressive disorder, will the use of combined intervention involving cognitive behavioral therapy and antidepressants reduce severity of complications when compared to the use of antidepressants alone within 12 months?
Health Equity
The utilization of combined therapy in the management of major depressive disorder has been shown to be effective in optimizing the health outcomes in the patients suffering from the disease. The management of major depressive disorder relies mainly on the use of diverse approaches that target the different factors contributing to the disease. Besides managing the symptoms, it is important that interventions that focus on promoting behavioral and lifestyle changes are adopted. As a result, it increases the relevance of the combined therapy when compared to monotherapy in the management of major depressive disorder. Consequently, the utilization of combined therapy will promote health equity by lowering the adverse health effects of major depressive disorder among African-American patients.
Conclusion
In summary, major depressive disorder is one of the mental health illnesses affecting a significant proportion of African-Americans in the US. While the prevalence rate of the disease among them is lower than that of the Caucasians, its complications are significantly high in African-American populations. Generally, pharmacotherapy is the first line of therapy in the management of major depressive disorder. Evidence has shown that combining pharmacotherapy and cognitive behavioral therapy results in optimal health outcomes for patients suffering from major depressive disorder. Therefore, this proposed intervention seeks to explore the efficacy of this approach to management when compared to the use of antidepressants alone.
References
Bailey, R. K., Mokonogho, J., & Kumar, A. (2019). Racial and ethnic differences in depression: current perspectives. Neuropsychiatric disease and treatment, 15, 603.
Boschloo, L., Bekhuis, E., Weitz, E. S., Reijnders, M., DeRubeis, R. J., Dimidjian, S., … & Jarrett, R. B. (2019). The symptom‐specific efficacy of antidepressant medication vs. cognitive behavioral therapy in the treatment of depression: results from an individual patient data meta‐analysis. World Psychiatry, 18(2), 183-191.
Lacey, K. K., Parnell, R., Mouzon, D. M., Matusko, N., Head, D., Abelson, J. M., & Jackson, J. S. (2015). The mental health of US Black women: the roles of social context and severe intimate partner violence. BMJ open, 5(10), e008415.
Sohail, Z., Bailey, R. K., & Richie, W. D. (2014). Misconceptions of depression in African Americans. Frontiers in Psychiatry, 5, 65.