Toward a cultural adaptation of pharmacotherapy: Latino views of depression and antidepressant therapy
Open accessAbstract
Relative to non-Latino Whites, Latinos in the United States with major depressive disorder (MDD) show low engagement in antidepressant therapy, whether engagement is defined as pharmacotherapy access, medication initiation, pill-taking, or treatment retention. One potential reason for this disparity in depression care is the low cultural congruence of pharmacotherapy for this population. To examine Latinos’ views of depression and antidepressant therapy, we conducted qualitative interviews with 30 Latino outpatients initiating antidepressants prior to their first treatment visit using the semistructured Treatment Adherence and Retention Questionnaire. These baseline interviews were randomly selected from data collected for a randomized controlled trial testing a novel intervention to enhance engagement by depressed Latino outpatients. Participant narratives were analyzed using open coding and the iterative analytical approach derived from grounded theory. Patient views about depression addressed stigmatizing views held by others in their social circle. Most participants directly refuted these views by providing alternate explanations to depression experiences. Antidepressant therapy narratives also revealed marked stigmatization, but participants tended not to refute these views. Instead, patients expressed concerns about antidepressants and showed marked ambivalence about seeking psychiatric care. Participants, however, did suggest ways in which clinicians and patients might collaborate to address their concerns about antidepressants. Some cultural views, such as concerns about addiction to or dependence on medication, may be negotiable barriers to treatment. Prescribing clinicians should address cultural views and concerns in order to improve Latino engagement in antidepressant therapy.
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Resistance to psychiatric medication is likely higher among Latinx who often report stigmatizing attitudes toward psychopharmacology.
“Many women will not consider taking psychiatric medications while pregnant (Cohen et al., 2010), and resistance is likely to be higher among Latinx who often report stigmatizing attitudes toward psychopharmacology (Vargas et al., 2015).”
From Exposure Therapy Acceptability Among Pregnant Latinas With Anxiety: A Qualitative Content Analysis (2025) · cites this paper as Vargas et al., 2015
The passage under “Abstract” (page not given) reports lower engagement in antidepressant therapy among Latinos than non-Latino Whites with major depressive disorder. It also describes stigmatizing views of antidepressants and patients’ ambivalence about psychiatric care. It does not examine pregnancy or establish that resistance to psychiatric medication is higher among pregnant Latinx people than among other pregnant women. (LLM, conf=0.85)
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- Authors
- Vargas, S. M., Cabassa, L. J., Nicasio, A., De La Cruz, A. A., Jackson, E., Rosario, M., Guarnaccia, P. J., & Lewis-Fernández, R.
- Affiliations
- University of Southern California (US)
- New York State Psychiatric Institute (US)
- University of Central Florida (US)
- Columbia University Medical Center
- Rutgers, The State University of New Jersey (US)
- Venue
- Transcultural Psychiatry
- Publisher
- SAGE Publications
- Published
- 2015-03-03
- Volume
- 52
- Issue
- 2
- Pages
- 244-273
- ISSN
- 1363-4615 (ISSN-L)
- 1461-7471
- OpenAlex
- W2099860444
- Cited by
- 55
- References
- 13
- Citations by year
- 2026: 6 · 2025: 2 · 2024: 5 · 2023: 5 · 2022: 3 · 2021: 2 · 2020: 7 · 2019: 7 · 2018: 6 · 2017: 5 · 2016: 5 · 2015: 2
- FWCI
- 9.84
- Type
- journal article
- Language
- en
- Open access
- Locations
- Transcultural Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Journal of International Crisis and Risk Communication Research (submittedVersion)
- Funders
- New York State Office of Mental Health
- National Institutes of Health
- National Institute of Mental Health (R21MH066388, R01MH077226)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Sociology and Political Science › Cultural Competency in Health Care
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- Hispanic patients, major depressive disorder, antidepressant treatment, treatment engagement, stigma, medication concerns, cultural congruence
- MeSH terms
- Adaptation, Psychological, Adult, Antidepressive Agents, Major Depressive Disorder, Depressive Disorder, Major, Female, Hispanic or Latino, Humans, Interviews as Topic, Male, Middle Aged, Stereotyping, United States, Qualitative Research, Medication Adherence
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