Latino Patients with MS Struggle with Depression, Fewer Resources

Lilyana Amezcua, MD

A new study has found that half of Latino patients with multiple sclerosis (MS) also suffer from depression.

In analysis presented at the 70^th annual meeting of the American Academy of Neurology (AAN) in Los Angeles, CA, researchers from Mount Sinai Beth Israel reported that depression is more prevalent in minorities with MS and low-income backgrounds.

Led by Britany Klenofsky, MD, the team performed a chart review on 57 randomly selected patients with MS insured by Medicaid that had been previously observed at Mount Sinai’s neurology department. There were no set preferences for age, gender, or level of disability. To gauge depression, researchers reviewed progress notes over 6 months for reports of symptoms, and conducted reviews of 28 available patient self-assessment forms.

Among the observed patients, 42 (73.7%) were minorities (either Latino or African American). Another 22 (38.6%) of patients reported feelings of depression — but 50% of Latino patients. In gauging for gender, a greater rate of Latino men (57.1%) reported feelings of depression than did Latina women (46.2%).

Just 28.6% of African American patients (20% male; 31.25% female) reported feelings of depression.

The pilot study doubled down on previous clinical indications that depression is very prevalent — and very detrimental — in the MS community. Approximately 30-50% of patients with MS report depression, researchers wrote, and the mental health condition common worsens patients’ quality of life, cognition, and MS-related fatigue, while accelerating disability.

This new found prevalence in minorities, and most notably Latino men, led researchers to speculate whether neurological, medical, and social issues may influence the overlook of mental health in these patients.

“Disparities in care of low income and minority patients with MS have been well documented,” researchers wrote.

Lilyana Amezcua, MD, an associate professor of clinical neurology at the Keck School of Medicine at the University of Southern California (USC), told MD Magazine that studies several years ago found that less than 1% of all research papers dedicated to MS were dedicated to minorities.

“While we think that there are probably health disparities, there could be also biological differences that, by serving these populations, would lead us to a closer way of curing MS,” Amezcua said.

Through a patient-submitted registry at USC, Amezcua and colleagues have recently found notable disparities among white and Latino patients with MS. Among them: Latino patients often report symptoms at a younger age, are more frequently struggle to gain access to treatment, and are therefore more at-risk of disability due to the disease.

Further research into the disparity will include longitudinal analysis of socio-cultural factors, Amezcua said, which she believes are a modifiable influence on the condition.

Inconsistencies in physician inquiry regarding patient depression, as well as unreliability on patients reporting feelings of depression, led Klenofsky and her team to believe their reported rates may be undersold.

“A larger study using a validated, depression screening tool would provide a more accurate assessment of depression and clarify the ethnic/cultural risk factors in this population,” researchers wrote.

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