To examine ethnic differences in depression identification, symptom reporting and phenotypes among middle-aged and older adults in the UK.
Approach:
Study Design: Cross-sectional cohort study using UK Biobank data from over 500,000 adults aged 40–69 years.
Data Collection: Depression symptoms assessed using Composite International Diagnostic Interview-Short Form; lifetime depression assessed via established algorithm.
Analysis: Logistic regression models adjusted for age, sex, deprivation, and physical health; latent class analysis identified depression phenotypes.
Key Findings:
23.7% of participants met criteria for a lifetime history of depression.
Depression identification was significantly lower in all ethnic minority groups except the mixed group compared to White participants.
Black, other Asian, and South Asian participants were less likely to report core depression symptoms.
Latent class analysis identified four phenotypes: major depression, somatic depression, non-somatic depression, and subthreshold depression.
Black (aOR 1.70, 95% CI 1.32 to 2.20), other Asian (aOR 1.73, 95% CI 1.21 to 2.46), and South Asian (aOR 1.63, 95% CI 1.26 to 2.10) participants were more likely to belong to the somatic depression phenotype.
Interpretation:
Lower rates of depression identification among ethnic minority groups may reflect limitations in how depression is defined, perceived, and detected within these populations.
Limitations:
UK Biobank cohort may not be representative of the general UK population due to selection biases, which may affect the generalizability of the findings.
Prevalence estimates reflect patterns within the UK Biobank cohort.
Conclusion:
Lower rates of depression identification among ethnic minority groups may reflect limitations in how depression is defined, perceived, and detected within these populations.
