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Idioms of Distress Among Depressed White-Non-Mexican and Mexican-Origin Older Men

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Abstract

Older men are less likely than older women to receive depression treatment. Latino older men in particular have been found to have significantly lower rates of depression treatment than their white-non-Mexican (WNM) counterparts. Prior research has shown that men are less likely than women to express overt affect and/or report depression symptoms that may prompt primary care physicians’ inquiry about depression. Previous studies have overlooked the idioms of distress common among older men. This study investigates: a) the range of idioms of distress that emerge in the narratives of depressed older men, and b) the use of these idioms among depressed WNM and Mexican-origin older men. The present report is based on qualitative data collected through the Men’s Health and Aging Study (MeHAS), a mixed-method study of clinically depressed WNM and Mexican-origin older (65 and above) men recruited in primary care settings. Qualitative analysis of 77 interviews led to identification of idioms of distress and informed idiom categories. Study findings show that: a) both groups of men utilized a range of idioms of distress that met current DSM criteria for depression, b) both groups were also likely to utilize idioms that feel outside clinical depression criteria, and c) there were similarities as well as differences between WNM and Mexican-origin men. This study provides a larger vocabulary that clinicians might consider in recognizing depression and initiating depression care for older men from diverse ethnic backgrounds. This is important to improve depression care among older men in general and those of Mexican-origin in particular.

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Acknowledgments

We wish to thank Mauricio Rodriguez for his role in screening older men, Erika Rivas for her transcription and translation of interviews, and Yarin Gomez for her assistance with manuscript formatting. We also thank Dr. Charles Varano for his comments and editing suggestions.

Conflict of interest

The authors report no conflicts of interest in the preparation and submission of this manuscript.

Funding sources

National Institute of Mental Health (NIMH) R01MH080067H080067NIMH

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Authors and Affiliations

  1. University of California, Davis, CA, USA

    Ester Carolina Apesoa-Varano, Sergio Aguilar-Gaxiola, Cindy Tran & Ladson Hinton

  2. University of California, San Francisco, CA, USA

    Judith C. Barker

  3. University of Washington, Seattle, CA, USA

    Jurgen Unutzer

  4. RAND Institute, Santa Monica, CA, USA

    Megan Dwight Johnson

  5. Rutgers University, Newark, NJ, USA

    Peter Guarnaccia

  6. 4610 X Street, Suite 4202, Sacramento, CA, 95817, USA

    Ester Carolina Apesoa-Varano

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  1. Ester Carolina Apesoa-Varano
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Correspondence to Ester Carolina Apesoa-Varano.

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Apesoa-Varano, E.C., Barker, J.C., Unutzer, J. et al. Idioms of Distress Among Depressed White-Non-Mexican and Mexican-Origin Older Men. J Cross Cult Gerontol 30, 305–318 (2015). https://doi.org/10.1007/s10823-015-9267-8

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