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      Help Wanted: Mental Health and Social Stressors Among Latino Day Laborers

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          Abstract

          Latino day laborers may be especially vulnerable to poor mental health due to stressful life experiences, yet few studies have described patterns of mental health outcomes and their correlates in this population. Patterns of depression (PHQ-9) and anxiety (GAD-7), and associations with demographic characteristics, social stressors, and substance use in a recruited sample of male Latino day laborers ( n = 101) are described. High rates of depression and anxiety were identified. Specifically, 39% screened positive for moderate or severe depression and 25% for moderate or severe anxiety. Higher levels of depression and anxiety symptoms were associated with being single, being homeless or in temporary housing, experiencing discrimination, acculturation stress, and marijuana use. While tobacco and unhealthy alcohol use were common in this sample (39% and 66%, respectively), they were not associated with depression and anxiety. These findings suggest that depression and anxiety are common among Latino day laborers and associated with stressful life experiences. Future research should further assess ways to ameliorate social stressors and reduce risk for poor mental health.

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          Monitoring depression treatment outcomes with the patient health questionnaire-9.

          Bernd Löwe, Jürgen Unützer, Christopher M Callahan … (2004)
          Although effective treatment of depressed patients requires regular follow-up contacts and symptom monitoring, an efficient method for assessing treatment outcome is lacking. We investigated responsiveness to treatment, reproducibility, and minimal clinically important difference of the Patient Health Questionnaire-9 (PHQ-9), a standard instrument for diagnosing depression in primary care. This study included 434 intervention subjects from the IMPACT study, a multisite treatment trial of late-life depression (63% female, mean age 71 years). Changes in PHQ-9 scores over the course of time were evaluated with respect to change scores of the SCL-20 depression scale as well as 2 independent structured diagnostic interviews for depression during a 6-month period. Test-retest reliability and minimal clinically important difference were assessed in 2 subgroups of patients who completed the PHQ-9 twice exactly 7 days apart. The PHQ-9 responsiveness as measured by effect size was significantly greater than the SCL-20 at 3 months (-1.3 versus -0.9) and equivalent at 6 months (-1.3 versus -1.2). With respect to structured diagnostic interviews, both the PHQ-9 and the SCL-20 change scores accurately discriminated patients with persistent major depression, partial remission, and full remission. Test-retest reliability of the PHQ-9 was excellent, and its minimal clinically important difference for individual change, estimated as 2 standard errors of measurement, was 5 points on the 0 to 27 point PHQ-9 scale. Well-validated as a diagnostic measure, the PHQ-9 has now proven to be a responsive and reliable measure of depression treatment outcomes. Its responsiveness to treatment coupled with its brevity makes the PHQ-9 an attractive tool for gauging response to treatment in individual patient care as well as in clinical research.
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            Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study.

            D A Regier, M. Farmer, D Rae … (1990)
            The prevalence of comorbid alcohol, other drug, and mental disorders in the US total community and institutional population was determined from 20,291 persons interviewed in the National Institute of Mental Health Epidemiologic Catchment Area Program. Estimated US population lifetime prevalence rates were 22.5% for any non-substance abuse mental disorder, 13.5% for alcohol dependence-abuse, and 6.1% for other drug dependence-abuse. Among those with a mental disorder, the odds ratio of having some addictive disorder was 2.7, with a lifetime prevalence of about 29% (including an overlapping 22% with an alcohol and 15% with another drug disorder). For those with either an alcohol or other drug disorder, the odds of having the other addictive disorder were seven times greater than in the rest of the population. Among those with an alcohol disorder, 37% had a comorbid mental disorder. The highest mental-addictive disorder comorbidity rate was found for those with drug (other than alcohol) disorders, among whom more than half (53%) were found to have a mental disorder with an odds ratio of 4.5. Individuals treated in specialty mental health and addictive disorder clinical settings have significantly higher odds of having comorbid disorders. Among the institutional settings, comorbidity of addictive and severe mental disorders was highest in the prison population, most notably with antisocial personality, schizophrenia, and bipolar disorders.
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              Validity of the Brief Patient Health Questionnaire Mood Scale (PHQ-9) in the general population.

              Alexandra M. Martin, Winfried Rief, Antje Klaiberg … (2005)
              The aim of this study was to assess the validity of the Patient Health Questionnaire depression module (PHQ-9). It has been subject to studies in medical settings, but its validity as a screening for depression in the general population is unknown. A representative population sample (2,066 subjects, 14-93 years) filled in the PHQ-9 for diagnosis [major depressive disorder, other depressive disorder, depression screen-positive (DS+) and depression screen-negative (DS-)] and other measures for distress (GHQ-12), depression (Brief-BDI) and subjective health perception (EuroQOL; SF-36). A prevalence rate of 9.2% of a current PHQ depressive disorder (major depression 3.8%, subthreshold other depressive disorder 5.4%) was identified. The two depression groups had higher Brief-BDI and GHQ-12 scores, and reported lower health status (EuroQOL) and health-related quality of life (SF-36) than did the DS- group (P's < .001). Strong associations between PHQ-9 depression severity and convergent variables were found (with BDI r = .73, with GHQ-12 r = .59). The results support the construct validity of the PHQ depression scale, which seems to be a useful tool to recognize not only major depression but also subthreshold depressive disorder in the general population.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Am J Mens Health
                Journal ID (iso-abbrev): Am J Mens Health
                Journal ID (publisher-id): JMH
                Journal ID (hwp): spjmh
                Title: American Journal of Men's Health
                Publisher: SAGE Publications (Sage CA: Los Angeles, CA )
                ISSN (Print): 1557-9883
                ISSN (Electronic): 1557-9891
                Publication date (Electronic): 17 March 2019
                Publication date Collection: Mar-Apr 2019
                Volume: 13
                Issue: 2
                Electronic Location Identifier: 1557988319838424
                Affiliations
                [1 ]Veterans Health Administration (VA), Seattle-Denver Center of Innovation for Veteran-Centered & Value-Driven Care, VA Puget Sound Health Services Research & Development, Seattle, WA, USA
                [2 ]Department of Health Services, University of Washington, Seattle, WA, USA
                Author notes
                [*]India J. Ornelas, University of Washington, Department of Health Services, 4333 Brooklyn Ave NE, Box 359455, Seattle, WA 98105, USA. Email: iornelas@ 123456uw.edu
                Author information
                https://orcid.org/0000-0003-2957-6452
                Article
                Publisher ID: 10.1177_1557988319838424
                DOI: 10.1177/1557988319838424
                PMC ID: 6438433
                PubMed ID: 30880547
                SO-VID: 542584c5-5fa0-4191-8d17-9c8798c99b6b
                Copyright © © The Author(s) 2019
                License:

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Date received : 28 September 2018
                Date revision received : 28 January 2019
                Date accepted : 22 February 2019
                Funding
                Funded by: National Institute of Alcoholism and Alcohol Abuse, ;
                Award ID: R34AA022696
                Categories
                Subject: Original Article
                Custom metadata
                cover-date March-April 2019

                Keywords: latino immigrants,day laborers,mental health,acculturation stress,substance use,depression,anxiety
                Data availability:
                Keywords: latino immigrants, day laborers, mental health, acculturation stress, substance use, depression, anxiety

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