Abstract
BackgroundEvidence relating to ethnic differences in the prevalence of depression in the UK is mixed, and the suitability of current screening tools is under question. We aimed to examine the prevalence of depression, depression symptoms, and depression phenotypes across middle-aged and older adults from ethnic minority groups in the UK.MethodsWe assessed lifetime depression prevalence across ethnic groups using an established algorithm in 502,140 adults enrolled in the UK Biobank who completed the baseline assessment (2006-2010). CIDI-SF data from the 2022 mental health follow-up were used to examine ethnic differences in depression symptoms. We applied latent class analysis (LCA) to CIDI-SF data to determine depression phenotypes. Logistic regression models adjusted for age, sex, deprivation, and physical health status assessed ethnic differences in depression prevalence, symptoms, and phenotypes.ResultsThe lifetime prevalence of depression in the overall sample was 23.7%. Relative to White participants, depression prevalence was lower in all ethnic minority groups, except for the Mixed ethnic group. Participants from Black, Other Asian, and South Asian groups were less likely than the White group to report core symptoms of depression (prolonged sadness, prolonged loss of interest). LCA produced four depression phenotypes: major depression; somatic depression; non-somatic depression; subthreshold depression. Participants from Black (adjusted odds ratio (aOR)= 1.70, 95% confidence interval (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) groups were more likely than the White group to belong to the somatic depression phenotype.ConclusionAlthough depression prevalence may be lower among middle-aged and older adults from ethnic minority groups in the UK, this disparity might reflect limitations in how depression is defined, perceived, and detected within these populations. Further research is required to deepen understanding of depression in ethnic minority populations and to advance culturally competent approaches to screening and diagnosis.