ABSTRACT

Background

Studies suggest Black Americans have a lower prevalence of depression than White Americans despite greater exposure to risk factors for depression across the life course. We examined whether this paradox exists among students in higher education, and whether the paradox may be partly explained by racial differences in reports of impairment from depression, which is a required criterion for clinical diagnosis.

Methods

We analyzed data from the Healthy Minds Study (2020–2021), restricting the sample to young adults (18–29) who identified as either Black or White. Using modified Poisson regression models to estimate risk ratios, we examined associations between race and depression impairment across five levels of depression severity, adjusting for age and gender.

Results

Approximately 23% of Black students reported depression impairment, which is significantly lower than the 28% of White students who reported depression impairment. For all students, greater depression severity was associated with greater probability of impairment; however, the relationship was more modest among Black students. At severe, moderately severe, and moderate depression levels, Black students had lower risk of depression impairment compared with White students.

Conclusion

White students may be more likely than Black students to report significant impairment at high levels of depression. These findings open the possibility that racial differences in the impairment criterion of clinical diagnoses may explain some the racial depression paradox.

中文翻译：

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年轻大学生的抑郁障碍：探索种族悖论

摘要

背景

研究表明，尽管在整个生命过程中接触抑郁症的危险因素较多，但美国黑人的抑郁症患病率低于美国白人。我们研究了高等教育学生中是否存在这种悖论，以及这种悖论是否可以部分地用抑郁症损害报告中的种族差异来解释，而抑郁症是临床诊断的必要标准。

方法

我们分析了健康心态研究（2020-2021）的数据，将样本限制为黑人或白人的年轻人（18-29 岁）。我们使用改进的泊松回归模型来估计风险比，研究了五个抑郁严重程度级别的种族和抑郁障碍之间的关联，并根据年龄和性别进行了调整。

结果

大约 23% 的黑人学生有抑郁障碍，显着低于 28% 的白人学生有抑郁障碍。对于所有学生来说，抑郁程度越严重，出现障碍的可能性就越大。然而，黑人学生之间的关系更为温和。在重度、中度和中度抑郁水平下，黑人学生患抑郁症的风险低于白人学生。

结论

白人学生可能比黑人学生更有可能报告在抑郁程度较高时出现严重损害。这些发现揭示了临床诊断损伤标准中的种族差异可能解释一些种族抑郁悖论的可能性。