How doctors’ communication style and race concordance influence African–Caribbean patients when disclosing depression

A. Adams, A. Realpe, L. Vail, C.D. Buckingham, L.H. Erby, D. Roter

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)
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Objective To determine the impact of doctors’ communication style and doctor–patient race concordance on UK African–Caribbeans’ comfort in disclosing depression. Methods 160 African–Caribbean and 160 white British subjects, stratified by gender and history of depression, participated in simulated depression consultations with video-recorded doctors. Doctors were stratified by black or white race, gender and a high (HPC) or low patient-centred (LPC) communication style, giving a full 2 × 2 × 2 factorial design. Afterwards, participants rated aspects of doctors’ communication style, their comfort in disclosing depression and treatment preferences Results Race concordance had no impact on African–Caribbeans’ comfort in disclosing depression. However a HPC versus LPC communication style made them significantly more positive about their interactions with doctors (p = 0.000), their overall comfort (p = 0.003), their comfort in disclosing their emotional state (p = 0.001), and about considering talking therapy (p = 0.01); but less positive about considering antidepressant medication (p = 0.01). Conclusion Doctors’ communication style was shown to be more important than patient race or race concordance in influencing African Caribbeans’ depression consultation experiences. Changing doctors’ communication style may help reduce disparities in depression care.
Original languageEnglish
Pages (from-to)1266-1273
JournalPatient Education and Counseling
Issue number10
Early online dateAug 2015
Publication statusPublished - Oct 2015
Externally publishedYes

Bibliographical note

This paper was given at the Conference on Communication in Healthcare, Amsterdam, The Netherlands, 28 September - 1 October 2014
Copyright 2015 The Authors. Published by Elsevier Ireland Ltd. All rights reserved. This is an open access article
under the CC BY license (


Economic and Social Research Council


  • Racial disparities
  • African–Caribbean
  • Doctor–patient communication
  • Depression disclosure
  • Depression treatment
  • Primary care


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