Cited by 193Health disparities and outcomesRacial and Ethnic Identity ResearchMental Health Treatment and Access

Do racial patterns in psychological distress shed light on the Black–White depression paradox? A systematic review

Barnes, David M., Bates, Lisa M.·2017·Social Psychiatry and Psychiatric Epidemiology

Abstract

Purpose Major epidemiologic studies in the US reveal a consistent "paradox" by which psychiatric outcomes such as major depressive disorder (MDD) are less prevalent among Blacks relative to Whites, despite greater exposure to social and economic stressors and worse physical health outcomes. A second paradox, which has received less attention and has never been systematically documented, is the discrepancy between these patterns and Black-White comparisons in psychological distress, which reveal consistently higher levels among Blacks. By systematically documenting the latter paradox, this paper seeks to inform efforts to explain the first paradox. Methods We conduct a systematic review of the literature estimating the prevalence of MDD and levels of psychological distress in Blacks and Whites in the US. Results The literature review yielded 34 articles reporting 54 relevant outcomes overall. Blacks have a lower prevalence of MDD in 8 of the 9 comparisons observed. In contrast, Blacks have higher levels of psychological distress (in terms of "high distress" and mean scores) than Whites in 42 of the 45 comparisons observed. Tests of statistical significance, where available, confirm this discrepant pattern. Conclusions A systematic review of the epidemiologic evidence supports the existence of a "double paradox" by which Blacks' lower prevalence of MDD relative to Whites' is inconsistent with both the expectations of social stress theory and with the empirical evidence regardin…

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Crossref · 10.1007/s00127-017-1394-9

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Authors
Barnes, D. M., & Bates, L. M.
Affiliations
  • Icahn School of Medicine at Mount Sinai (US)
  • Columbia University (US)
Corresponding author
Barnes, David M.
Venue
Social Psychiatry and Psychiatric Epidemiology
Published
2017-05-29
Volume
52
Issue
8
Pages
913-928
ISSN
  • 0933-7954 (ISSN-L)
  • 1433-9285
OpenAlex
W2619634349
Cited by
193
References
110
Citations by year
2026: 14 · 2025: 21 · 2024: 27 · 2023: 33 · 2022: 30 · 2021: 30 · 2020: 14 · 2019: 18 · 2018: 5 · 2017: 1
FWCI
1.79
Type
journal article
Language
en
Open access
closed
Locations
  • Social Psychiatry and Psychiatric Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
major depressive disorder, psychological distress, racial disparities, African Americans, White Americans, depression prevalence
MeSH terms
Black or African American, Depressive Disorder, Major, Major Depressive Disorder, Humans, Stress, Psychological, United States, Prevalence, White People, Health Status Disparities

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