Bridging the gap for ethnic minority adult outpatients with depression and anxiety disorders by culturally adapted treatments

Background: Culturally adapted guideline driven depression and anxiety treatments have been developed for ethnic minority patients in Western countries to boost effectiveness for these growing and vulnerable groups. The aims of this study are to systematically review the empirical literature of outcomes associated with culturally adapted guideline driven depression and anxiety interventions, to describe the cultural adaptation and to identify the contribution of the cultural adaptation and approach as such. Method: Comprehensive search of the major bibliographical databases (Cochrane Central Register of Controlled Trials, Pubmed; Psychinfo) for randomized controlled trials. Results: Nine eligible studies were identified and all were conducted in the USA. The pooled random standardized differences in means of the culturally adapted depression and anxiety treatment on clinical outcome was 1.06 (CI 95% 0.51-1.62, P=0.00). Two studies demonstrated effectiveness of the population specific cultural adaptation per se. All studies incorporated a focus on cultural values and beliefs as a cultural adaptation. Limitation: We only identified a small number of USA studies so generalisation of the findings to other western countries can be discussed. Conclusion: Culturally adapted guideline driven depression and anxiety treatment was effective for USA minority patients from different cultural backgrounds. There is some evidence for the effectiveness of the population specific cultural adaptation as such. © 2013 Elsevier B.V. All rights reserved.