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Objective: Untreated depression among persons with chronic general health conditions (chronic health conditions) affects mortality, functional disability, quality of life, and health care costs. Currently, studies of the association between depression care and chronic health conditions report inconsistent results, and studies of depression care among persons with specific health conditions are rare. This study investigated the association between chronic health conditions and the likelihood of receiving depression care among individuals with depression., Methods: Retrospective data from physician claims, hospital separations, vital statistics, and insurance plan registries were used to identify a cohort of individuals with depression and track 12-month use of health services among those with and without a chronic health condition. Disparities were analyzed by using generalized linear models., Results: Individuals with depression and a chronic health condition had higher use of psychological therapy, higher use of any depression care, greater continuity of care, and better adherence to antidepressant therapy compared with individuals with depression only. However, they were less likely, in general, to be on antidepressant therapy, and individuals with diabetes had fewer visits to general practitioners for a mental health-related reason compared with individuals without diabetes. A trend toward lower use of any depression care was observed among patients with cerebrovascular disease., Conclusions: Use of depression care was generally higher among individuals with chronic health conditions, although there were differences in patterns of use by type of health condition. Some patients with specific health conditions could be at risk of being inappropriately treated for depression.

Objective: This study examined ethnic disparities in antipsychotic therapy in a population with significant Asian representation., Methods: Using a cross-sectional retrospective study design, self-reported ethnicity data pooled from three cycles of the Canadian Community Health Survey were linked to 2005 administrative data on physician, hospital, and pharmaceutical use in British Columbia, Canada. Logistic regression was used to model the association between ethnicity and the likelihood of filling one or more prescriptions for any antipsychotic, with controls for sex, age, residence, immigrant status, income, health status, and diagnoses of schizophrenia, bipolar disorder, depression, and dementia., Results: Of the 27,658 individuals in the sample, 2.2% filled at least one antipsychotic prescription. The proportion varied across ethnic groups: Chinese, 1.0%; other Asians, 1.2%; whites, 2.3%; nonwhite non-Asians, 2.8%; and mixed ethnicity, 4.3%. After adjustment for patient characteristics and diagnoses of schizophrenia and bipolar disorder, the likelihood of filling a prescription was found to be lower among Chinese (odds ratio [OR] = .47, 95% confidence interval [CI] = .24-.90) and higher among persons of mixed ethnicity (OR = 3.19, CI = 1.49-6.83). Further adjustment for depression and dementia diagnoses did not significantly change the ORs for the Chinese (OR = .49, CI = .25-.98) and the mixed ethnic groups (OR = 2.97, CI = 1.30-6.80)., Conclusions: Consistent with the existing literature on ethnic disparities in antipsychotic therapy, the study found evidence of persistent disparities in a population that has a significant number of Asians. Further studies should be done to identify possible causes of these disparities and to identify potential interventions that may reduce or eliminate them.