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Liu X, Ngoubene-Atioky AJ, Yang X, Deng Y, Tang J, Wu L, Huang J, Zheng Y, Fang J, Kaur A, Chen L. The effect of childhood family adversity on adulthood depression among Chinese older migrant workers: gender differences in the mediating role of social-ecological systems. BMC Public Health 2024; 24:2005. [PMID: 39061001 PMCID: PMC11282819 DOI: 10.1186/s12889-024-19397-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Older migrant workers (OMWs) in China face unique challenges rooted in their early life experiences, which increase their vulnerability to psychological and behavioral problems in adulthood. By utilizing the cumulative disadvantage model and the social-ecological systems theory, this study explored the effect of childhood family adversity on adulthood depression in the mediating roles of OMWs' social-ecological microsystem and mesosystem and further examined gender differences in these associations. METHODS Data were collected from the China Health and Retirement Longitudinal Study (CHARLS), involving a sample of 4,309 OMWs aged 50 and above. The measures included the Center for Epidemiological Research Depression Scale, childhood family adversity, socioeconomic status, marital quality, and physical and cognitive health. RESULTS Childhood family adversity was positively associated with adulthood depression among OMWs. Social microsystem (physical and cognitive health) and mesosystem (marital quality and socioeconomic status) factors significantly mediated this relationship. Multi-group analysis revealed that the mediating effects of marital quality and socioeconomic status were stronger for female OMWs, while the mediating effects of physical and cognitive health were stronger for male OMWs. CONCLUSIONS The findings suggest that childhood family adversity has a lasting impact on the mental health of OMWs, and that social-ecological systems factors play an important role in this relationship. The study also highlights the need for gender-specific interventions to address the mental health needs of OMWs.
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Affiliation(s)
- Xiaoyue Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | | | - Xudong Yang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Cixi Biomedical Research Institute, Wenzhou Medical University, Ningbo, China
| | | | - Jiayi Tang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Cixi Biomedical Research Institute, Wenzhou Medical University, Ningbo, China
| | - Liujun Wu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Cixi Biomedical Research Institute, Wenzhou Medical University, Ningbo, China
| | - Jiahui Huang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Yawen Zheng
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Juan Fang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Amrita Kaur
- School of Psychology, Wenzhou-Kean University, Wenzhou, China.
| | - Li Chen
- School of Mental Health, Wenzhou Medical University, Wenzhou, China.
- The affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China.
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Epidemiology of depression among displaced people: A systematic review and meta-analysis. Psychiatry Res 2022; 311:114493. [PMID: 35316692 DOI: 10.1016/j.psychres.2022.114493] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 02/28/2022] [Accepted: 03/05/2022] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Displaced people are prone to develop mental health problems due to resettlement in new environments, traumatic events and forced migration. Depression is a mental health problem repeatedly observed among displaced people such as refugees, migrants, asylum seekers and internally displaced persons (IDPs). Therefore, estimating the global pooled prevalence of depression as well as pinpointing its determinants may support policymakers and health care workers to mitigate the disease burden and improve the psychological well-being of displaced people. METHODS PubMed, EMBASE, CINAHIL, Psych-INFO, and SCOPUS databases were searched for English written relevant observational studies conducted between 1984 and 2020. The methodological quality of studies was assessed using the Newcastle Ottawa Scale (NOS). Heterogeneity across studies was checked using the Q- and I2 test. Publication bias was checked by observing Funnel plot symmetry and using Egger's regression test. STATA 16 was used to combine studies using a random effect model. RESULTS Of the 4102 studies identified, 81 studies with an overall sample size of 53,458 were included in the current systematic review and meta-analysis. The pooled prevalence estimate of depression among displaced people was 26.4% (95% CI; 22.2-31.1). Also, three in five IDPs, one in three refugees and asylum seekers and one in four migrants suffer from depression globally. Being female migrant [AOR: 2.46 95% CI: 1.79-3.13, I2=34.5%), non-partnered marital status [AOR: 2.29, 95% CI: 1.29-3.30, I2= 0.00%], and perceived low social support [AOR: 1.76, 95% CI: 1.00-2.52, I2=34.6%] were significant determinants of depression among displaced people. CONCLUSION Overall, around 1 in 4 displaced people suffer from depression and exceed the prevalence of depression reported by community samples in different nations and demonstrate a need for culturally fitting and targeted responses from migrant/refugee host nations and their serving clinicians.
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A Mental Health Profile of 900 Newly Arrived Refugees in Denmark Using ICD-10 Diagnoses. SUSTAINABILITY 2021. [DOI: 10.3390/su14010418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
(1) Background: Recognizing mental health problems in newly arrived refugees poses a challenge. Little is known of the mental health profile of refugees currently arriving in Northern Europe. (2) Method: In total, we included 900 adult (≥18 years old) refugees arriving in Aarhus, Denmark, between 1 January 2014 and 1 January 2020. All participants accepted an offer of a voluntary systematic health assessment from the municipality in Aarhus, including a mental health screening. (3) Results: Within this cohort, 26% (237/900) of the participants were referred to the Department of Psychiatry, Aarhus University Hospital, 24% (212/900) were in contact with the department and 21% (185/900) received ≥1 psychiatric diagnosis. Within the subpopulation referred (n = 237), 64% (152/237) were diagnosed with post-traumatic stress disorder (PTSD) (DF431), 14% (34/237) with neurotic, stress-related and somatoform disorders (F40–F48) and 13% (30/237) with major mood disorders (F30–F39). Among the participants referred to the Department of Psychiatry and participants receiving a diagnosis, we found an overrepresentation of participants originating from the Southern Asian region (Pakistan, Afghanistan and Iran) and with an age above 44 years. (4) Conclusion: We found a high prevalence of both referrals and psychiatric diagnoses in newly arrived refugees. Attention to psychiatric conditions in refugees and systematic health assessments during resettlement are needed.
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Ali SH, Islam T, Pillai S, Kalasapudi L, Mammen S, Inala S, Kalasapudi V, Islam NS, Gunness H. Loneliness and mental health outcomes among South Asian older adult immigrants in the United States: a cross-sectional study. Int J Geriatr Psychiatry 2021; 36:1423-1435. [PMID: 33817827 DOI: 10.1002/gps.5549] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 03/21/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND There is growing concern of mental health issues among South Asian immigrant populations, although limited disaggregated data on determinants of these issues exists. The aim of this study was to examine factors associated with mental health outcomes among South Asian older adult immigrants living in New York City (NYC). METHODS Data were sourced from a needs assessment among self-identified South Asians aged 60+ conducted by an NYC-based frontline agency and nonprofit organization. Variables assessed included the 9-item Patient Health Questionnaire, degree of difficulty experienced due to depression, loneliness, emotional distress, as well as sociodemographic, living situation, acculturation, general health, and financial related indicators. RESULTS Among the 682 responses, 9.4% of participants displayed symptoms of mild or moderate depression (16% of Caribbean-origin, 10% of Pakistani, 9% of Bangladeshi, and 8% of Indian participants). About a third of participants (29.9%) reported feeling lonely sometimes and 39.1% experienced any type of emotional distress. When compared to those with excellent or very good self-rated health, having fair, poor, or terrible self-rated health was associated with a greater adjusted odds ratio (AOR) of having mild or moderate depression (AOR: 8.42, 95% confidence interval [CI]: 22.09) and experiencing emotional distress (AOR: 3.03, 95% CI: 1.88-4.94). Those experiencing emotional distress were more likely to be younger (AOR: 0.97, 95% CI: 0.95-1.00) and live alone (AOR: 2.06, 95% CI: 1.21-3.53). DISCUSSION Findings support the need for tailored mental health interventions targeting concerns, such as poor self-rated health, among South Asian older adult immigrants, as well as specific subpopulations such as Indo-Caribbeans who may be experiencing a disproportionate burden.
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Affiliation(s)
- Shahmir H Ali
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, USA
| | | | | | | | - Shinu Mammen
- Department of Population Health, NYU Grossman School of Medicine, New York, USA
| | | | | | - Nadia S Islam
- Department of Population Health, NYU Grossman School of Medicine, New York, USA
| | - Harlem Gunness
- Department of Pharmacy Administration and Public Health, St. John's University, New York, USA
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Anakwenze O, Rasmussen A. The impact of parental trauma, parenting difficulty, and planned family separation on the behavioral health of West African immigrant children in New York City. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2021; 13:457-466. [PMID: 33475411 DOI: 10.1037/tra0001011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The association between parental mental health difficulties and poor child outcomes is well documented. Few studies have investigated the intergenerational effects of trauma in immigrant populations. This study examined the relationships among parental trauma, parenting difficulty, duration of planned family separation, and child externalizing behavior in an archival dataset of West African voluntary and forced immigrants in New York City. We hypothesized that parenting difficulty would mediate the association between parental posttraumatic stress and child externalizing behavior and that this association would be stronger for parent-child dyads that had undergone lengthier separations during migration. METHOD Ninety-one parents reported on their posttraumatic stress symptoms using the Harvard Trauma Questionnaire (HTQ) and on the behavioral health of one child between the ages of 5 and 12 years using the externalizing items of the Child Behavior Checklist (CBCL Externalizing). A 4-item self-report scale assessed difficulty parenting in the last month. RESULTS Linear regression analyses showed that parenting difficulty partially mediated the relationship between HTQ and CBCL scores. The relationship between HTQ and CBCL scores was not significant for parents separated from their children for one year or less but was significant for those never separated or separated for longer than 1 year. Higher HTQ scores were most strongly associated with higher CBCL Externalizing scores for those separated longer than one year. CONCLUSIONS Findings suggest that children of immigrants recovering from trauma are at risk of exhibiting behavioral symptoms and highlight a potential intervention target for improving child outcomes in immigrant families. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Do HN, Nguyen AT, Nguyen HQT, Bui TP, Nguyen QV, Tran NTT, Nguyen LH, Pham HQ, Ha GH, Hoang CL, Tran BX, Latkin CA, Ho RCM, Ho CSH. Depressive Symptoms, Suicidal Ideation, and Mental Health Service Use of Industrial Workers: Evidence from Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2929. [PMID: 32340335 PMCID: PMC7216084 DOI: 10.3390/ijerph17082929] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 12/11/2022]
Abstract
Background: Depressive symptoms and suicidal ideation substantially reduce industrial workers' productivity and performance. This study was performed to examine the prevalence of depressive symptoms and suicidal ideation and identify associated factors among industrial workers in different provinces of Vietnam. Materials and Methods: We performed a cross-sectional study in industrial zones of four provinces of Vietnam. The Patient Health Questionnaire (PHQ-9) was employed to screen depressive symptoms and suicidal ideation. Multivariate logistic regression was performed to determine factors related to depressive symptoms and suicidal ideation. Results: Of 1200 industrial workers, 30.5% and 33.6% industrial workers had positive depressive symptoms and suicidal ideation in the last two weeks, respectively. There were 38.3% ever using mental health services in the last 12 months. High school education (OR = 0.64, 95% CI = 0.44-0.95); living in dormitory (OR = 3.07, 95% CI = 1.51-6.24), living with siblings (OR = 2.98; 95% CI = 1.32-6.75), having two children or more (OR = 1.45, 95% CI = 1.03-2.03), high years of experience (OR = 0.94; 95% CI = 0.89-0.98), suffering from burnout, alcohol use disorder (OR = 2.38; 95% CI = 1.72-3.28), and smoking status (OR = 0.38, 95% CI = 0.23-0.61) were associated with positive depressive symptoms. Living with children, working in mechanical/metallurgy/electronics factories, completely exhausted and often thinking of quitting, and alcohol use disorder were positively related to suicidal ideation. Conclusions: This study found a high prevalence of depressive symptoms and suicidal ideation among industrial workers in Vietnam. Regular screening and detecting high-risk groups, along with interventions to reduce health risk behaviors, burnout and on-site medical service quality improvement, are recommended to alleviate the burden of depression in industrial workers.
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Affiliation(s)
- Ha Ngoc Do
- Youth Research Institute, Ho Chi Minh Communist Youth Union, Hanoi 100000, Vietnam;
| | - Anh Tuan Nguyen
- Department of Research on Youth Culture and Lifestyle, Youth Research Institute, Ho Chi Minh Communist Youth Union, Hanoi 100000, Vietnam; (A.T.N.); (H.Q.T.N.); (Q.V.N.)
| | - Hoa Quynh Thi Nguyen
- Department of Research on Youth Culture and Lifestyle, Youth Research Institute, Ho Chi Minh Communist Youth Union, Hanoi 100000, Vietnam; (A.T.N.); (H.Q.T.N.); (Q.V.N.)
| | - Thanh Phuong Bui
- Department of Research on Children’s Issues, Youth Research Institute, Ho Chi Minh Communist Youth Union, Hanoi 100000, Vietnam;
| | - Quy Van Nguyen
- Department of Research on Youth Culture and Lifestyle, Youth Research Institute, Ho Chi Minh Communist Youth Union, Hanoi 100000, Vietnam; (A.T.N.); (H.Q.T.N.); (Q.V.N.)
| | - Ngan Thu Thi Tran
- Department of Research on Youth and Legal issues, Youth Research Institute, Ho Chi Minh Communist Youth Union, Hanoi 100000, Vietnam;
| | - Long Hoang Nguyen
- VNU School of Medicine and Pharmacy, Vietnam National University, Hanoi 100000, Vietnam;
| | - Hai Quang Pham
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam;
- Faculty of Medicine, Duy Tan University, Da Nang 550000, Vietnam
| | - Giang Hai Ha
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam;
- Faculty of Pharmacy, Duy Tan University, Da Nang 550000, Vietnam
| | - Chi Linh Hoang
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam; (C.L.H.); (R.C.M.H.)
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam;
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Roger C. M. Ho
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam; (C.L.H.); (R.C.M.H.)
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119077, Singapore
| | - Cyrus S. H. Ho
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore;
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Aichberger M, Schouler-Ocak M, Mundt A, Busch M, Nickels E, Heimann H, Ströhle A, Reischies F, Heinz A, Rapp M. Depression in middle-aged and older first generation migrants in Europe: Results from the Survey of Health, Ageing and Retirement in Europe (SHARE). Eur Psychiatry 2020; 25:468-75. [DOI: 10.1016/j.eurpsy.2009.11.009] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Revised: 11/22/2009] [Accepted: 11/30/2009] [Indexed: 11/26/2022] Open
Abstract
AbstractObjectiveTo determine the prevalence of depression in migrants aged 50 years or older in comparison to residents without a history of migration in 11 European countries.Methods and subjectsThe Survey of Health, Ageing and Retirement in Europe (SHARE), a cross-national, multidisciplinary, household-based panel survey using nationally representative probability samples (n = 28,517) of 11 European countries of the non-institutionalized population aged 50 years and older. Depression was measured using the EURO-D scale, and odds ratios (OR) were estimated for migration status. Effects of sociodemographic variables, somatic comorbidities, functional impairment, cognitive function, geographic region, and time lived in current country of residence were assessed in multivariate logistic regression analysis.ResultsAdjusting for confounds, the OR for depression in migrants was 1.42 (95% CI, 1.28–1.59). The influence of migration status on the prevalence of depression was significantly greater in Northern (OR, 1.85; 95% CI, 1.39–2.46) and Western Europe (OR, 1.38; 95% CI, 1.22–1.57), compared to Southern Europe (OR, 1.16; 95% CI, 0.79–1.70) (p < 0.05 for the interaction).ConclusionWe found a higher prevalence of depression in first-generation migrants aged 50 years or older, together with relevant geographical variation. This difference was not due to other known predictors of depression in older age.
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Grassi L, Caruso R, Da Ronch C, Härter M, Schulz H, Volkert J, Dehoust M, Sehner S, Suling A, Wegscheider K, Ausín B, Canuto A, Muñoz M, Crawford MJ, Hershkovitz Y, Quirk A, Rotenstein O, Santos-Olmo AB, Shalev A, Strehle J, Weber K, Wittchen HU, Andreas S, Belvederi Murri M, Zerbinati L, Nanni MG. Quality of life, level of functioning, and its relationship with mental and physical disorders in the elderly: results from the MentDis_ICF65+ study. Health Qual Life Outcomes 2020; 18:61. [PMID: 32143635 PMCID: PMC7060594 DOI: 10.1186/s12955-020-01310-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 03/02/2020] [Indexed: 02/06/2023] Open
Abstract
Background An ageing population worldwide needs to investigate quality of life (QoL) and level of functioning (LoF) in the elderly and its associated variables. We aimed to study the relationship between Quality of Life (QoL) and Level of Functioning (LoF) in an elderly population in Europe. Method As part of the Ment_Dis65+ European Project, 3142 community-dwelling adults aged 65–84 years in six countries were assessed by using the adaptation for the elderly of the Composite International Diagnostic Interview (CIDI65+) to provide psychiatric diagnosis according to the International Classification of Diseases (10th edition) (ICD-10 Classification of Mental and Behavioural Disorders). Socio-demographic and clinical interviews, and two self-report tools, the World Health Organization QoL assessment (WHO QoL BREF), to assess QoL, and the WHO Disability Assessment Schedule -II (WHODAS-II), to assess LoF, were also administered. Results Most subjects reported good levels of QoL (56.6%) and self-rated health (62%), with no or mild disability (58.8%). There was a linear decrease of the QoL and the LoF by increase of age. Elderly with ICD-10 mental disorder (e.g. somatoform, affective and anxiety disorders) had poorer QoL and lower LoF. There were a number of predictors of lower levels of QoL and disability, including both socio-demographic variables (e.g. male gender, increase in age, poor financial situation, retirement, reduced number of close significant others), ICD-10 psychiatric diagnosis (mainly anxiety, somatoform disorders) and presence of medical disorders (mainly heart and respiratory diseases). Conclusions The study indicates that QoL and LoF were quite acceptable in European elderly people. A series of variables, including psychiatric and somatic disorders, as well as socio-demographic factor influenced in a negative way both QoL and LoF. More specific links between mental health, social and health services dedicated to this segment of the population, should be implemented in order to provide better care for elderly people with conditions impacting their QoL and functioning.
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Affiliation(s)
- Luigi Grassi
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a -, 44121, Ferrara, Italy.
| | - Rosangela Caruso
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a -, 44121, Ferrara, Italy
| | - Chiara Da Ronch
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a -, 44121, Ferrara, Italy
| | - Martin Härter
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, Building W 26, D-20246, Hamburg, Germany
| | - Holger Schulz
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, Building W 26, D-20246, Hamburg, Germany
| | - Jana Volkert
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, Building W 26, D-20246, Hamburg, Germany.,Department of Psychosocial Prevention, University of Heidelberg, Bergheimer Str. 54, 69115, Heidelberg, Germany
| | - Maria Dehoust
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, Building W 26, D-20246, Hamburg, Germany
| | - Susanne Sehner
- Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Martinistr, 52, Building W 34, D-20246, Hamburg, Germany
| | - Anna Suling
- Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Martinistr, 52, Building W 34, D-20246, Hamburg, Germany
| | - Karl Wegscheider
- Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Martinistr, 52, Building W 34, D-20246, Hamburg, Germany
| | - Berta Ausín
- School of Psychology, University Complutense of Madrid, Campus de Somosaguas s/n, 28223, Madrid, Spain
| | - Alessandra Canuto
- Nant Foundation, East Vaud Psychiatric Institute, Route de Nant, 1804, Corsier-sur-Vevey, Switzerland
| | - Manuel Muñoz
- School of Psychology, University Complutense of Madrid, Campus de Somosaguas s/n, 28223, Madrid, Spain
| | - Mike J Crawford
- Royal College of Psychiatrists, Mansell Street 21, E18AA, London, UK
| | - Yael Hershkovitz
- Hadassah University Medical Centre, P.O.B 12000, 91120, Jerusalem, Israel
| | - Alan Quirk
- Royal College of Psychiatrists, Mansell Street 21, E18AA, London, UK
| | - Ora Rotenstein
- Hadassah University Medical Centre, P.O.B 12000, 91120, Jerusalem, Israel
| | - Ana Belén Santos-Olmo
- School of Psychology, University Complutense of Madrid, Campus de Somosaguas s/n, 28223, Madrid, Spain
| | - Arieh Shalev
- Department of Psychiatry, Langone Medical Center, New York, NY, USA
| | - Jens Strehle
- Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Kerstin Weber
- Curabilis, Medical Direction, University Hospitals of Geneva, Chemin de Champ-Dollon 20, 1241, Puplinge, Switzerland
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Sylke Andreas
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, Building W 26, D-20246, Hamburg, Germany.,Institute for Psychology, Alpen-Adria Universität Klagenfurt, A-9020, Klagenfurt, Austria
| | - Martino Belvederi Murri
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a -, 44121, Ferrara, Italy
| | - Luigi Zerbinati
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a -, 44121, Ferrara, Italy
| | - Maria Giulia Nanni
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Via Fossato di Mortara 64a -, 44121, Ferrara, Italy
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The Effect of Ethnic Community on Acculturation and Cultural Adaptation: the Case of Russian-Speaking Older Adults. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2019. [DOI: 10.1007/s12134-019-00698-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Depressive Symptoms among Industrial Workers in Vietnam and Correlated Factors: A Multi-Site Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091642. [PMID: 31083499 PMCID: PMC6539422 DOI: 10.3390/ijerph16091642] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/30/2019] [Accepted: 05/08/2019] [Indexed: 02/05/2023]
Abstract
Depressive disorders have been found to be a significant health issue among industrial workers, resulting from work-related factors and causing serious burdens for the workers as well as their employers. Literature on mental health problems of Vietnamese industrial workers has been limited, despite the rapid foreign investment-fueled industrialization process of the country. This study aimed to fill the gap in literature by examining the prevalence of depressive disorders and their potential associated factors among a cohort of Vietnamese industrial workers. A cross-sectional study was conducted in 3 industrial areas in Hanoi and Bac Ninh. A total of 289 workers agreed to participate in the study. Generalized linear mixed models were applied to identify associated factors with depression status of respondents. 38.6% of participants reported suffering depression. Factors found to be positively associated with the possibility of having depression and higher PHQ9 score were long working hours, suffering more health problems, and health hazards exposure at work. Meanwhile, being females, having more children, living with parents, engaging in smoking, and being local workers were found to correlate with lower likelihood of being depressed. The findings suggested the importance of regular health screening, work safety assurance, and social support outside of workplace on the mental health of the workers.
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Zhong BL, Liu TB, Chan SSM, Jin D, Hu CY, Dai J, Chiu HFK. Common mental health problems in rural-to-urban migrant workers in Shenzhen, China: prevalence and risk factors. Epidemiol Psychiatr Sci 2018; 27:256-265. [PMID: 28067189 PMCID: PMC6998856 DOI: 10.1017/s2045796016001141] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 12/07/2016] [Indexed: 12/18/2022] Open
Abstract
AIMS Rural-to-urban migrant workers are a large marginalised population in urban China. Prevalence estimates of common mental health problems (CMHPs) in previous studies varied widely and very few studies have investigated migration-related factors of CMHPs in migrant workers. The objective of this study was to determine the prevalence and risk factors of CMHPs among Chinese migrant workers. METHODS A random sample of 3031 migrant workers of ten manufacturing factories in Shenzhen, China, completed a standardised questionnaire containing socio-demographic and migration-related variables and the Chinese 12-item General Health Questionnaire (GHQ-12). A GHQ-12 score of three or higher was used to denote the presence of CMHPs. RESULTS The prevalence of CMHPs was 34.4% in Chinese migrant workers. In multiple logistic regression, risk factors for CMHPs included being 16-25 years old (odd ratio [OR] 1.65, 95% confidence interval [CI] 1.28, 2.12), being 26-35 years old (OR 1.36, 95% CI: 1.05, 1.75), low monthly income (OR 1.42, 95% CI 1.04, 1.92), poor living condition (OR: 1.76, 95% CI: 1.22, 2.54), physical illness in the past 2 weeks (OR 1.72, 95% CI 1.43, 2.05), having worked in many cities (OR 1.34, 95% CI 1.03, 1.74), infrequently visiting hometown (OR 1.56, 95% CI 1.22, 1.99), poor Mandarin proficiency (OR 1.51, 95%CI 1.13, 2.01), a low level of perceived benefits of migration (OR 1.33, 95% CI 1.14, 1.55) and working more than 8 h/day (OR 1.39, 95% CI 1.14, 1.70). CONCLUSIONS CMHPs are very prevalent among Chinese migrant workers. Given the large number of Chinese migrant workers, there is an urgent need to address the mental health burden of China's migrant worker population.
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Affiliation(s)
- B. L. Zhong
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
- Affiliated Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei, People's Republic of China
| | - T. B. Liu
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, People's Republic of China
| | - S. S. M. Chan
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - D. Jin
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, People's Republic of China
| | - C. Y. Hu
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, People's Republic of China
| | - J. Dai
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, People's Republic of China
| | - H. F. K. Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
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12
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Lanari D, Bussini O, Minelli L. The Effects of Immigrant Status and Age at Migration on Changes in Older Europeans’ Health. INTERNATIONAL MIGRATION REVIEW 2018. [DOI: 10.1177/0197918318766359] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to determine the differences between natives and immigrants in regard to transition probabilities among health states in self-rated health (SRH), depression, and activities of daily living for middle-aged and older adults in Europe. The Survey of Health, Aging, and Retirement allows us to investigate how successfully the immigrants have aged from 2004 to 2011 compared to natives, according to country of origin and age at migration. We showed that some groups, such as Eastern European immigrants, have higher probabilities of health deterioration in terms of SRH. Moreover, those immigrants who arrived in the host country during adulthood experienced relatively fast health decline.
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13
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Abstract
About 6% of older people in the UK are immigrants. Concentrated in deprived inner-city areas, their numbers are rising rapidly, with the ageing of those arriving after the Second World War. Cultural, language and educational differences cause problems in studying this group's mental health. Idioms of distress may affect presentation, help-seeking behaviour and acceptability of treatment. Ethnic elders may be considered vulnerable to depression because of socio-economic deprivation, immigrant status and old age but studies are contradictory and may use inappropriate screening instruments. Relatively few consider immigrant status and dementia. Uncontrolled hypertension could relate to higher dementia rates in Black immigrants which are not reflected in the country of origin. No genetic risk has been found. There is potential for prevention in this population.
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14
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Puri N, Shannon K, Nguyen P, Goldenberg SM. Burden and correlates of mental health diagnoses among sex workers in an urban setting. BMC WOMENS HEALTH 2017; 17:133. [PMID: 29258607 PMCID: PMC5735638 DOI: 10.1186/s12905-017-0491-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 12/05/2017] [Indexed: 01/08/2023]
Abstract
Background Women involved in both street-level and off-street sex work face disproportionate health and social inequities compared to the general population. While much research has focused on HIV and sexually transmitted infections (STIs) among sex workers, there remains a gap in evidence regarding the broader health issues faced by this population, including mental health. Given limited evidence describing the mental health of women in sex work, our objective was to evaluate the burden and correlates of mental health diagnoses among this population in Vancouver, Canada. Methods An Evaluation of Sex Workers Health Access (AESHA) is a prospective, community-based cohort of on- and off-street women in sex work in Vancouver, Canada. Participants complete interviewer-administered questionnaires semi-annually. We analyzed the lifetime burden and correlates of self-reported mental health diagnoses using bivariate and multivariable logistic regression. Results Among 692 sex workers enrolled between January 2010 and February 2013, 338 (48.8%) reported ever being diagnosed with a mental health issue, with the most common diagnoses being depression (35.1%) and anxiety (19.9%). In multivariable analysis, women with mental health diagnoses were more likely to identify as a sexual/gender minority (LGBTQ) [AOR=2.56, 95% CI: 1.72—3.81], to use non-injection drugs [AOR=1.85, 95% CI: 1.12—3.08], to have experienced childhood physical/sexual trauma [AOR=2.90, 95% CI: 1.89—4.45], and work in informal indoor [AOR=1.94, 95% CI: 1.12 – 3.40] or street/public spaces [AOR=1.76, 95% CI: 1.03–2.99]. Conclusions This analysis highlights the disproportionate mental health burden experienced by women in sex work, particularly among those identifying as a sexual/gender minority, those who use drugs, and those who work in informal indoor venues and street/public spaces. Evidence-informed interventions tailored to sex workers that address intersections between trauma and mental health should be further explored, alongside policies to foster access to safer workspaces and health services.
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Affiliation(s)
- Nitasha Puri
- Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.,Department of Family Practice, University of British Columbia, 3rd Floor David Strangway Building, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Kate Shannon
- Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.,School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Paul Nguyen
- Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Shira M Goldenberg
- Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. .,Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
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15
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Anjara SG, Nellums LB, Bonetto C, Van Bortel T. Stress, health and quality of life of female migrant domestic workers in Singapore: a cross-sectional study. BMC Womens Health 2017; 17:98. [PMID: 29017558 PMCID: PMC5634837 DOI: 10.1186/s12905-017-0442-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 09/19/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a global increase in migrant workers. In Singapore, there are over 230,000 migrant domestic workers (MDWs). Female MDWs may experience high levels of stress and social isolation, which may negatively impact on their health and quality of life. There have also been documented cases of abuse and exploitation. However, there is a lack of empirical research with this population. This study aimed to investigate factors impacting on the health and quality of life of female MDWs in Singapore, including socio-demographic and job related characteristics, stress, social isolation, and working management style. METHODS A cross-sectional survey was carried out with 182 female MDWs in Singapore. The survey examined health and quality of life (WHOQoL-Bréf), social connectedness (the Friendship Scale), and preferred and experienced working management style (the Theory X and Theory Y Questionnaire). Descriptive analyses were carried out in addition to ANOVA, t-tests, and chi-square tests, followed by a multivariate analysis using linear regression. RESULTS Participants were found to have good overall quality of life and satisfaction with health. Age and working experience were found to be significantly (p < 0.05) associated with overall quality of life and three domains (psychological, social, and environmental health). Agreement between experienced and preferred working management style was also found to be associated with higher quality of life scores (with the exception of the social relationships domain). Though women reported relatively good overall quality of life, more than half of participants reported feeling stressed. In addition, nearly 20% of participants reported being isolated or very isolated. Stress was identified to be associated with isolation. In the multivariate analysis, stress was found to contribute to worse quality of life in all domains except social relationships, after adjusting for confounders. Social connectedness was positively associated with all domains of quality of life, and agreement of working management style was positively associated with physical health, psychological health and environmental quality of life. CONCLUSIONS The findings serve as an evidence-base pointing to the need for policies aimed at decreasing stress and social isolation among female MDWs in order to improve their health and quality of life.
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Affiliation(s)
- S. G. Anjara
- Cambridge Institute of Public Health, University of Cambridge School of Clinical Medicine, Box 113 Cambridge Biomedical Campus, Forvie Site, Robinson Way, Cambridge, CB2 0SR UK
| | - L. B. Nellums
- Section of Infectious Diseases and Immunity, Department of Medicine, Imperial College London, 8th Floor Commonwealth Building, Hammersmith Hospital, Du Cane Road, London, W12 0NN UK
| | - C. Bonetto
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - T. Van Bortel
- Cambridge Institute of Public Health, University of Cambridge School of Clinical Medicine, Box 113 Cambridge Biomedical Campus, Forvie Site, Robinson Way, Cambridge, CB2 0SR UK
- Institute for Health and Human Development, University of East London, Stratford Campus, Suite 250, University House, The Green, Water Lane, London, E15 4LZ UK
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Abstract
The purpose of this article is to empirically determine the factor structure of the original Radloff's (1977) Center for Epidemiological Studies-Depression Scale (CES-D), on Indian caregivers of the elderly population. The CES-D was administered to 255 caregivers via face to face interviews. The confirmatory factor analysis results did not support the original four-factor theoretical structure, but did suggest a three-factor model. In addition the three-factor version showed high internal consistency among the sub scales. The results of the present study indicate that the revised CES-D scale reflects the difference in the manifestation of depression in caregivers of the elderly in the Indian community in Allahabad, India. This scale should be validated further by replication. Implications for future research are presented.
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17
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East or West, Home is the Best: Effect of Intergenerational and Social Support on the Subjective Well-Being of Older Adults: A Comparison Between Migrants and Local Residents in Shenzhen, China. AGEING INTERNATIONAL 2015. [DOI: 10.1007/s12126-015-9234-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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18
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Wong EC, Miles JNV. Prevalence and correlates of depression among new U.S. immigrants. J Immigr Minor Health 2015; 16:422-8. [PMID: 23400525 DOI: 10.1007/s10903-013-9781-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Although immigrants comprise one of the fastest growing segments of society, information on their adjustment to life in the US remains limited. The present study examined the prevalence of depression and associated correlates among a national sample of immigrants newly admitted to legal permanent residence to the US. Data were derived from the baseline adult cohort of the New Immigrant Survey, a national representative sample of immigrants who had obtained legal permanent residence between May and November 2003. Approximately 3% of respondents met criteria for probable depression in the past 12 months. Respondents who were female, younger in age, in the US for a longer period of time, and exposed to political violence in their country of origin were more likely to meet criteria for probable depression. Both pre-immigration and resettlement related factors were associated with probable depression. Further research is needed to better understand how processes in the country of origin and in the resettlement country influence the adjustment of immigrants.
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Affiliation(s)
- Eunice C Wong
- RAND Corporation, 1776 Main Street, PO BOX 2138, Santa Monica, CA, 90407, USA,
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19
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Zhong BL, Liu TB, Chan SSM, Jin D, Hu CY, Dai J, Chiu HFK. Prevalence and correlates of major depressive disorder among rural-to-urban migrant workers in Shenzhen, China. J Affect Disord 2015; 183:1-9. [PMID: 25989590 DOI: 10.1016/j.jad.2015.04.031] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 04/15/2015] [Accepted: 04/16/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND In China, rural-to-urban migrant workers (MWs) are a large and vulnerable population that may be at high risk for depression, but previous studies focused on depressive symptoms of MWs and no study has investigated the epidemiology of major depressive disorder (MDD). The objective of this study was to determine the prevalence and correlates of one-month and lifetime MDD among MWs in Shenzhen, China, and mental health services utilization of MWs with lifetime MDD. METHODS A total of 3031 MWs were recruited from 10 manufacturing factories and interviewed with the Chinese version of the Mini International Neuropsychiatric Interview. RESULTS The one-month and lifetime prevalence rates of MDD were 1.39% (95% CI: 0.97%, 1.80%) and 5.08% (95% CI: 4.30%, 5.86%), respectively. No significant gender and age-group differences were found in these rates. The risk factors for lifetime MDD included lower education, worse living condition, poorer self-perceived physical health, migration before adulthood, infrequently calling family members, and having done lots of jobs. Only 3.25% of the respondents with lifetime MDD had sought professional help prior to the interview. LIMITATIONS The MW sample was selected from manufacturing factories, we should be cautious in generalizing our findings to MWs of other industries. CONCLUSIONS Compared with the Chinese general population, MWs may have a similar prevalence of MDD, but the rate of lifetime mental health services use of MWs with lifetime MDD is extremely low. MDD is a major public health concern for this population. There is an urgent need to improve mental health services for MWs.
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Affiliation(s)
- Bao-Liang Zhong
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR
| | - Tie-Bang Liu
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, PR China
| | - Sandra S M Chan
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR
| | - Dong Jin
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, PR China
| | - Chi-Yi Hu
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, PR China
| | - Jing Dai
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, PR China
| | - Helen F K Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR.
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20
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Ethnic Clusters in Public Housing and Independent Living of Elderly Immigrants from the Former Soviet Union. J Cross Cult Gerontol 2015; 30:353-76. [PMID: 26310209 DOI: 10.1007/s10823-015-9271-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The study examines the effects of ethnic clusters and independent living arrangements on adaptation of elderly immigrants from the Former Soviet Union. The multigenerational living arrangements were compared with independent living in a dispersed ethnic community and in an ethnic cluster of public housing. The residents of the ethnic clusters of public housing reported poorer health, were more reliant on government resources, and experienced greater acculturative hassles. However, public housing residents reported significantly larger Russian-speaking and American social networks, greater American acculturation, higher social support from neighbors, as well as lower cultural alienation. In contrast, the multigenerational living arrangements were related to greater social support from extended family and higher extended family satisfaction. While, the independent living in the dispersed ethnic community was associated with smaller American social networks and higher levels of cultural alienation. The results highlight how the ecologies of different living arrangements are reflected in the nature of acculturative, social, and psychological experiences of elderly immigrants.
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21
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Williams ED, Tillin T, Richards M, Tuson C, Chaturvedi N, Hughes AD, Stewart R. Depressive symptoms are doubled in older British South Asian and Black Caribbean people compared with Europeans: associations with excess co-morbidity and socioeconomic disadvantage. Psychol Med 2015; 45:1861-1871. [PMID: 25677948 PMCID: PMC4803046 DOI: 10.1017/s0033291714002967] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 11/19/2014] [Accepted: 11/19/2014] [Indexed: 12/03/2022]
Abstract
BACKGROUND Despite elevated risk profiles for depression among South Asian and Black Caribbean people in the UK, prevalences of late-life depressive symptoms across the UK's three major ethnic groups have not been well characterized. METHOD Data were collected at baseline and 20-year follow-up from 632 European, 476 South Asian and 181 Black Caribbean men and women (aged 58-88 years), of a community-based cohort study from north-west London. The 10-item Geriatric Depression Scale was interviewer-administered during a clinic visit (depressive symptoms defined as a score of ⩾4 out of 10), with clinical data (adiposity, diabetes, cardiovascular disease, cognitive function) also collected. Sociodemographic, psychosocial, behavioural, disability, and medical history information was obtained by questionnaire. RESULTS Prevalence of depressive symptoms varied by ethnic group, affecting 9.7% of White European, 15.5% of South Asian, and 17.7% of Black Caribbean participants. Compared with White Europeans, South Asian and Black Caribbean participants were significantly more likely to have depressive symptoms (odds ratio 1.79, 95% confidence interval 1.24-2.58 and 1.80, 1.11-2.92, respectively). Adjustment for co-morbidities had most effect on the excess South Asian odds, and adjustment for socioeconomic position had most effect on the elevated Black Caribbean odds. CONCLUSIONS Higher prevalence of depressive symptoms observed among South Asian people were attenuated after adjustment for physical health, whereas the Black Caribbean increased prevalence was most explained by socioeconomic disadvantage. It is important to understand the reasons for these ethnic differences to identify opportunities for interventions to address inequalities.
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Affiliation(s)
- E. D. Williams
- International Centre for Circulatory Health, Imperial College London, UK
- Institute of Cardiovascular Science, University College London, UK
| | - T. Tillin
- International Centre for Circulatory Health, Imperial College London, UK
- Institute of Cardiovascular Science, University College London, UK
| | - M. Richards
- MRC Unit for Lifelong Health and Ageing, University College London, UK
| | - C. Tuson
- International Centre for Circulatory Health, Imperial College London, UK
| | - N. Chaturvedi
- International Centre for Circulatory Health, Imperial College London, UK
- Institute of Cardiovascular Science, University College London, UK
| | - A. D. Hughes
- International Centre for Circulatory Health, Imperial College London, UK
- Institute of Cardiovascular Science, University College London, UK
| | - R. Stewart
- King's College London (Institute of Psychiatry), London, UK
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22
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Agrawal S, Taylor FC, Moser K, Narayanan G, Kinra S, Prabhakaran D, Reddy KS, Davey Smith G, Ebrahim S. Associations Between Sociodemographic Characteristics, Pre Migratory and Migratory Factors and Psychological Distress Just After Migration and After Resettlement: The Indian Migration Study. INDIAN JOURNAL OF SOCIAL PSYCHIATRY 2015; 31:55-66. [PMID: 28856341 PMCID: PMC5573174 DOI: 10.4103/0971-9962.162028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND/OBJECTIVES Migration is suspected to increase the risk for psychological distress for those who enter a new cultural environment. We investigated the association between sociodemographic characteristics, premigratory and migratory factors and psychological distress in rural-to-urban migrants just after migration and after resettlement. METHODS Data from the cross-sectional sib-pair designed Indian Migration Study (IMS, 2005-2007) were used. The analysis focused on 2112 participants aged ≥18 years from the total IMS sample (n = 7067) who reported being migrant. Psychological distress was assessed based on the responses of the 7-questions in a five-point scale, where the respondents were asked to report about their feelings now and also asked to recall these feelings when they first migrated. The associations were analyzed using multiple logistic regression models. RESULTS High prevalence of psychological distress was found just after migration (7.3%; 95% confidence interval [CI]: 6.2-8.4) than after settlement (4.7%; 95% CI: 3.8-5.6). Push factors as a reason behind migration and not being able to adjust in the new environment were the main correlates of psychological distress among both the male and female migrants, just after migration. CONCLUSIONS Rural-urban migration is a major phenomenon in India and given the impact of premigratory and migratory related stressors on mental health, early intervention could prevent the development of psychological distress among the migrants.
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Affiliation(s)
- Sutapa Agrawal
- Centre for Control of Chronic Conditions, Public Health Foundation of India, New Delhi, India
| | - Fiona C Taylor
- Departments of Epidemiology and Population Health and Cochrane Heart Group, London School of Hygiene and Tropical Medicine, London.,Departments of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London
| | - Kath Moser
- Departments of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London
| | | | - Sanjay Kinra
- Departments of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London
| | | | | | - George Davey Smith
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Shah Ebrahim
- Centre for Control of Chronic Conditions, Public Health Foundation of India, New Delhi, India.,Departments of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London
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Verhagen I, Steunenberg B, de Wit NJ, Ros WJG. Community health worker interventions to improve access to health care services for older adults from ethnic minorities: a systematic review. BMC Health Serv Res 2014; 14:497. [PMID: 25391432 PMCID: PMC4241213 DOI: 10.1186/s12913-014-0497-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 10/06/2014] [Indexed: 11/10/2022] Open
Abstract
Background The health status of older adults belonging to ethnic minorities in Western countries is an important public issue because their health is often less favourable than that of older adults from the majority population. In addition, the number of older adults belonging to ethnic minorities is increasing rapidly in Western countries. The introduction of community health workers (CHWs) has proven to be successful in addressing health disparities among ethnic minorities; however, an overview of CHW’s benefits for older adults is absent in the literature. We reviewed the literature to explore whether CHWs are also effective in improving the health and the delivery of health care services to ethnic minority older adults in Western countries. Methods We searched the PubMed database (2002-Present) for RCTs published on the use of CHWs in Western countries. Results Out of the 729 studies identified, seven studies met our inclusion criteria. The effectiveness of the implementation of CHW programmes in older adults belonging to ethnic minorities is not univocal. In two studies, we found no significant differences. In five studies, we found some positive effects. We did not find negative effects in any of the studies. For better interpretation of the results, effect ratios (ERs) were calculated as the number of positive findings divided by the total number of measured findings. Substantial effects on the access to care (mean ER = 0.58) and on health behaviour (mean ER = 0.45) were found. The mean ER for health outcomes was considerably lower (mean ER = 0.17). Conclusion We found indications that CHWs serve as a means of improving health care use and health behaviour and, to a lesser extent, health outcomes among ethnic minority older adults. Further research is required to draw more solid conclusions on the effectiveness of CHW interventions in this target group. This is particularly important for Western countries in which the number of ethnic minority older adults has increased significantly because their health status is mostly unfavourable and their access to health care services is often limited. Electronic supplementary material The online version of this article (doi:10.1186/s12913-014-0497-1) contains supplementary material, which is available to authorized users.
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Mölsä M, Punamäki RL, Saarni SI, Tiilikainen M, Kuittinen S, Honkasalo ML. Mental and somatic health and pre- and post-migration factors among older Somali refugees in Finland. Transcult Psychiatry 2014; 51:499-525. [PMID: 24648488 DOI: 10.1177/1363461514526630] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Mental and somatic health was compared between older Somali refugees and their pair-matched Finnish natives, and the role of pre-migration trauma and post-migration stressors among the refugees. One hundred and twenty-eight Somalis between 50-80 years of age were selected from the Somali older adult population living in the Helsinki area (N = 307). Participants were matched with native Finns by gender, age, education, and civic status. The BDI-21 was used for depressive symptoms, the GHQ-12 for psychological distress, and the HRQoL was used for health-related quality of life. Standard instruments were used for sleeping difficulties, somatic symptoms and somatization, hypochondria, and self-rated health. Clinically significant differences in psychological distress, depressive symptoms, sleeping difficulties, self-rated health status, subjective quality of life, and functional capacity were found between the Somali and Finnish groups. In each case, the Somalis fared worse than the Finns. No significant differences in somatization were found between the two groups. Exposure to traumatic events prior to immigrating to Finland was associated with higher levels of mental distress, as well as poorer health status, health-related quality of life, and subjective quality of life among Somalis. Refugee-related traumatic experiences may constitute a long lasting mental health burden among older adults. Health care professionals in host countries must take into account these realities while planning for the care of refugee populations.
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Kuittinen S, Punamäki RL, Mölsä M, Saarni SI, Tiilikainen M, Honkasalo ML. Depressive Symptoms and Their Psychosocial Correlates Among Older Somali Refugees and Native Finns. JOURNAL OF CROSS-CULTURAL PSYCHOLOGY 2014. [DOI: 10.1177/0022022114543519] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this study, we analyzed the manifestation of somatic-affective and cognitive depressive symptoms among older Somali refugees and native Finns. Second, we explored how depressive symptoms, alexithymia, and somatization are associated in the two groups. Finally, we analyzed how two psychosocial factors, sense of coherence (SOC) and social support, are connected to depressive symptoms among Somalis and Finns. The participants were examined with the Beck Depression Inventory (BDI) for depressive symptoms, the Symptom Checklist–90–Revised (SCL-90-R) for somatization, Toronto Alexithymia Scale (TAS-20) for alexithymia, and the Sense of Coherence (SOC-13) concept for SOC. Social support was indicated by help received from social networks and marital status. Results showed that Somalis manifested more somatic-affective symptoms of depression than Finns, whereas Finns manifested more cognitive symptoms than Somalis. The association between depressive symptoms and alexithymia was stronger in the Finnish group, whereas the association between depressive symptoms and somatization was stronger in the Somali group. The association between alexithymia and somatization did not differ between the groups. A weak SOC explained depressive symptoms among Somalis and Finns, but poor social support did not explain depression in either group. The results are discussed in relation to Somali and Finnish cultures, mental health beliefs, and immigrant populations.
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Affiliation(s)
| | | | - Mulki Mölsä
- University of Helsinki, Finland
- National Institute for Health and Welfare, Helsinki, Finland
| | - Samuli I. Saarni
- University of Helsinki, Finland
- National Institute for Health and Welfare, Helsinki, Finland
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Rondet C, Cornet P, Kaoutar B, Lebas J, Chauvin P. Depression prevalence and primary care among vulnerable patients at a free outpatient clinic in Paris, France, in 2010: results of a cross-sectional survey. BMC FAMILY PRACTICE 2013; 14:151. [PMID: 24118896 PMCID: PMC3852793 DOI: 10.1186/1471-2296-14-151] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 10/01/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND Data on the prevalence of depression and on how a depressive episode prompts the sufferer to seek primary care are not scarce, but the available evidence on the prevalence of depression among immigrants and poor people who frequent general practice facilities is scarce. The Baudelaire Outpatient Clinic at the Saint-Antoine Hospital in Paris provides free medical and social assistance to the poor and/or uninsured. The goal of our study was to estimate the prevalence of depression among these outpatients, to characterize this depressed population, and to analyze its demand for primary care for depressive episodes. METHODS From September to December 2010, we conducted a cross-sectional, observational survey among users of the Baudelaire Outpatient Clinic. French-speaking patients attending the clinic between September 15 and December 30, 2010 who agreed to answer a questionnaire administered face-to-face before their consultation were included in the study. The chi-squared test (or Fisher's exact test for small samples) was used for the comparisons of proportions. Logistic regression models were estimated, along with the odds ratios (OR) and their 95% confidence intervals (95% CIs), for the multivariate analysis of factors associated with depression and healthcare-seeking. Models were estimated separately for men and women, since sex was an interaction factor. The statistical analyses were performed using Stata v. 10 software (StataCorp LP, College Station, Texas, USA). RESULTS Of the 250 patients included (mean age: 45 years), 52.0% were men and 52.4% were immigrants. Close to 40% of them reported having no supplemental health insurance. The estimated prevalence of depression in this population was 56.7%. Depression was more prevalent among the women, immigrants, and people from the poorer socioeconomic groups. Only half of these depressed patients, mostly women, reported having discussed their depression with a physician. French nationality and complete health insurance coverage were associated with more-frequent healthcare-seeking. Few patients reported having been asked about their morale by the physician they consulted, and almost 80% would have liked to be asked about this more often. CONCLUSION Depression is a real public health problem, particularly among people from disadvantaged backgrounds, and should be included in their overall management.
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Affiliation(s)
- Claire Rondet
- INSERM, U707, Research Group on the Social Determinants of Health and Health Care, Paris F-75012, France
- UPMC Univ Paris 06, School of Medicine, Department of General Practice, Paris F-75012, France
| | - Philippe Cornet
- UPMC Univ Paris 06, School of Medicine, Department of General Practice, Paris F-75012, France
| | - Bacha Kaoutar
- AP-HP, Hôpital Saint-Antoine, Polyclinique Baudelaire, Paris F-75012, France
| | - Jacques Lebas
- INSERM, U707, Research Group on the Social Determinants of Health and Health Care, Paris F-75012, France
- AP-HP, Hôpital Saint-Antoine, Polyclinique Baudelaire, Paris F-75012, France
| | - Pierre Chauvin
- INSERM, U707, Research Group on the Social Determinants of Health and Health Care, Paris F-75012, France
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Aichberger MC, Bromand Z, Heredia Montesinos A, Temur-Erman S, Mundt A, Heinz A, Rapp MA, Schouler-Ocak M. Socio-economic status and emotional distress of female Turkish immigrants and native German women living in Berlin. Eur Psychiatry 2013; 27 Suppl 2:S10-6. [PMID: 22863244 DOI: 10.1016/s0924-9338(12)75702-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Many immigrants face more economic strains and hardship than non-immigrants. Income inequality and an increasing social gap between immigrants and non-immigrants in Europe warrant further studies on the impact of socioeconomic factors on health in immigrant groups. The purpose of this study was to examine the association of socioeconomic status (SES) and emotional distress in women of Turkish descent and in women of German descent. METHODS AND SUBJECTS A total of 405 women of German or Turkish descent residing in Berlin were interviewed. Emotional distress was assessed by the General Health Questionnaire-28 (GHQ-28), and SES was examined by level of education, employment status, and income. The associations of emotional distress and SES were estimated in multivariate linear regression analyses. RESULTS Unemployment was associated with increased levels of emotional distress in all women, with the highest level of distress in the group of unemployed Turkish women. The overall SES level was related to a greater level of emotional distress in Turkish women, but not in German women (-3.2, 95%CI -5.9 - -.5; p=.020 vs. -.8, 95%CI -2.7 - 1.2; p=.431). Further stratified analyses by relationship status revealed that the association of SES and emotional distress only remained significant among single women. CONCLUSION The impact of socioeconomic hardship appears to be complicated by social roles and expectations related to these. Further in-depth study of the complex nature of the interaction of social roles and socioeconomic position in female Turkish immigrants in Germany is needed to better understand differing risk patterns for emotional distress.
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Affiliation(s)
- M C Aichberger
- Department of Psychiatry and Psychotherapy at St Hedwig Hospital, Charité - University Medicine Berlin, Große Hamburger Straße 5-11, 10115 Berlin, Germany.
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Heredia Montesinos A, Rapp MA, Temur-Erman S, Heinz A, Hegerl U, Schouler-Ocak M. The influence of stigma on depression, overall psychological distress, and somatization among female Turkish migrants. Eur Psychiatry 2013; 27 Suppl 2:S22-6. [PMID: 22863246 DOI: 10.1016/s0924-9338(12)75704-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Even though some studies suggest that in Mediterranean and non-western cultures more somatic and less psychological symptoms are reported, this so-called 'somatization' hypothesis has been challenged. Reviews show that somatic symptoms are a core component of depressive episodes regardless of cultural background. The expression of symptoms might be related to the psychosocial, social and cultural context surrounding the patient rather than 'ethnicity' or related constructs. Also, stigma associated with mental disorders can affect patients'symptom presentation. METHODS The interrelationships of perceived stigmatization (Explanatory Model Interview Catalogue - Stigma Scale), depression (Beck Depression Index II), overall psychological distress (Symptom Checklist-90-R), and somatic symptoms (The screening for SOMATOFORM SYMPTOMS II) was assessed in a sample of female patients with Turkish descent with a diagnosis of depression (N=63). RESULTS Depression, overall psychological distress, and somatic symptoms were positively and significantly related. Stigma was positively related to depression and overall psychological distress. There was no significant relationship between stigma and somatic symptoms, neither among the severely depressed group (N=39), nor among the less depressed group (N=24). CONCLUSION The positive relationships between stigma, depression, and overall psychological distress indicate that patients who are more depressed and who have higher levels of overall psychological distress experience their condition as more stigmatizing. Since somatic symptoms and stigma were not related (neither positively, nor negatively), it appears that depressive symptoms and other symptoms of psychological distress affect concerns about stigmatizing attitudes in a way that somatic symptoms do not. This result challenges common assumption of the 'somatization'hypothesis, i.e. that depression is 'somatized'because of concern about stigmatizing attitudes.
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Affiliation(s)
- A Heredia Montesinos
- Department of Psychiatry and Psychotherapy at St Hedwig Hospital, Charité - University Medicine Berlin, Germany. Grosse Hamburger Straße 5-11, 10115 Berlin, Germany. amanda.heredia-
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Martens WH. Prevalence of Depression in Various Ethnic Groups of Immigrants and Refugees: Suggestions for Prevention and Intervention. INTERNATIONAL JOURNAL OF MENTAL HEALTH PROMOTION 2012. [DOI: 10.1080/14623730.2007.9721831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Cross-country variation in sleep disturbance among working and older age groups: an analysis based on the European Social Survey. Int Psychogeriatr 2011; 23:1413-20. [PMID: 21554795 DOI: 10.1017/s1041610211000664] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Sleep disturbance is a common complaint in the general population. There is, however, little cross-national comparative evidence on the prevalence of sleep disturbance and its association with age. METHODS Cross-sectional data from the third wave of the European Social Survey were used to compare both the prevalence of sleep disturbances and its relationship to age among 27,103 respondents over the age of 40 years from 23 European countries. The outcome measures for the study were based on the proportion of respondents reporting restless sleep over the past week and percentage change in the reporting of restless sleep between the 41-65 age group and the 66 and over age group. RESULT The prevalence rate of sleep disturbance varied between and within age groups, as well as between the 23 European countries. Depressive symptoms (OR = 4.14), anxiety (OR = 2.80), and general health (OR = 1.52) were the strongest correlates of sleep disturbance among both the 41-65 age group and the over 66 age group. The highest positive correlation with change in restless sleep reports occurred with respect to health deterioration. Satisfaction with living standards showed the strongest negative association with change in restless sleep reports. CONCLUSION There is considerable variation in reports of sleep disturbance across different European countries. Being in an older age group appears to be associated with worsening sleep, though not always. Different patterns of sleep disturbance seem to indicate the considerable variability of the aging experience across Europe.
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Kirmayer LJ, Narasiah L, Munoz M, Rashid M, Ryder AG, Guzder J, Hassan G, Rousseau C, Pottie K. Common mental health problems in immigrants and refugees: general approach in primary care. CMAJ 2011. [PMID: 20603342 DOI: 10.1503/cmaj.090292;10.1503/cmaj.090292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Recognizing and appropriately treating mental health problems among new immigrants and refugees in primary care poses a challenge because of differences in language and culture and because of specific stressors associated with migration and resettlement. We aimed to identify risk factors and strategies in the approach to mental health assessment and to prevention and treatment of common mental health problems for immigrants in primary care. METHODS We searched and compiled literature on prevalence and risk factors for common mental health problems related to migration, the effect of cultural influences on health and illness, and clinical strategies to improve mental health care for immigrants and refugees. Publications were selected on the basis of relevance, use of recent data and quality in consultation with experts in immigrant and refugee mental health. RESULTS The migration trajectory can be divided into three components: premigration, migration and postmigration resettlement. Each phase is associated with specific risks and exposures. The prevalence of specific types of mental health problems is influenced by the nature of the migration experience, in terms of adversity experienced before, during and after resettlement. Specific challenges in migrant mental health include communication difficulties because of language and cultural differences; the effect of cultural shaping of symptoms and illness behaviour on diagnosis, coping and treatment; differences in family structure and process affecting adaptation, acculturation and intergenerational conflict; and aspects of acceptance by the receiving society that affect employment, social status and integration. These issues can be addressed through specific inquiry, the use of trained interpreters and culture brokers, meetings with families, and consultation with community organizations. INTERPRETATION Systematic inquiry into patients' migration trajectory and subsequent follow-up on culturally appropriate indicators of social, vocational and family functioning over time will allow clinicians to recognize problems in adaptation and undertake mental health promotion, disease prevention or treatment interventions in a timely way.
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Affiliation(s)
- Laurence J Kirmayer
- Division of Social and Transcultural Psychiatry, McGill University, Montréal, Que.
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Kirmayer LJ, Narasiah L, Munoz M, Rashid M, Ryder AG, Guzder J, Hassan G, Rousseau C, Pottie K. Common mental health problems in immigrants and refugees: general approach in primary care. CMAJ 2011; 183:E959-67. [PMID: 20603342 PMCID: PMC3168672 DOI: 10.1503/cmaj.090292] [Citation(s) in RCA: 569] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Recognizing and appropriately treating mental health problems among new immigrants and refugees in primary care poses a challenge because of differences in language and culture and because of specific stressors associated with migration and resettlement. We aimed to identify risk factors and strategies in the approach to mental health assessment and to prevention and treatment of common mental health problems for immigrants in primary care. METHODS We searched and compiled literature on prevalence and risk factors for common mental health problems related to migration, the effect of cultural influences on health and illness, and clinical strategies to improve mental health care for immigrants and refugees. Publications were selected on the basis of relevance, use of recent data and quality in consultation with experts in immigrant and refugee mental health. RESULTS The migration trajectory can be divided into three components: premigration, migration and postmigration resettlement. Each phase is associated with specific risks and exposures. The prevalence of specific types of mental health problems is influenced by the nature of the migration experience, in terms of adversity experienced before, during and after resettlement. Specific challenges in migrant mental health include communication difficulties because of language and cultural differences; the effect of cultural shaping of symptoms and illness behaviour on diagnosis, coping and treatment; differences in family structure and process affecting adaptation, acculturation and intergenerational conflict; and aspects of acceptance by the receiving society that affect employment, social status and integration. These issues can be addressed through specific inquiry, the use of trained interpreters and culture brokers, meetings with families, and consultation with community organizations. INTERPRETATION Systematic inquiry into patients' migration trajectory and subsequent follow-up on culturally appropriate indicators of social, vocational and family functioning over time will allow clinicians to recognize problems in adaptation and undertake mental health promotion, disease prevention or treatment interventions in a timely way.
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Affiliation(s)
- Laurence J Kirmayer
- Division of Social and Transcultural Psychiatry, McGill University, Montréal, Que.
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Abstract
ABSTRACTThe aim of this paper is to ascertain the existence of differences in self-perceived health and depression between immigrants and native-born populations aged 50 years and older living in Western and Northern European countries. We examine the effect of country of origin, length of time in the host country and citizenship on the health of adults, using data from the Survey on Health, Ageing and Retirement in Europe (SHARE). As the logistic regressions reveal, some immigrant groups are more likely to perceive worse self-rated health and to suffer from depression than native-born groups, even when demographic and socio-economic variables are taken into account. In particular, people born in Eastern Europe living in Germany, France and Sweden have the highest odds ratio of poor health with respect to natives. Nativity status, duration and citizenship clearly contribute towards explaining health differences which are shown to vary significantly across countries. Furthermore, the perception of poor health rises as the length of stay increases, although a non-linear pattern was found. Results indicate that greater efforts by policy makers are needed in order to improve the health of specific middle-aged and older groups of immigrants in Europe.
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Rugkåsa J, Canvin K. Researching mental health in minority ethnic communities: reflections on recruitment. QUALITATIVE HEALTH RESEARCH 2011; 21:132-43. [PMID: 20682968 DOI: 10.1177/1049732310379115] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
In this article we reflect on the recruitment of research participants to two related studies of experiences of mental health problems in Black and minority ethnic communities in the United Kingdom. A total of 65 people were recruited via three main strategies: the employment of bicultural recruiters, intensive information sharing about the studies, and work through local community groups. Three main issues seemed to affect recruitment: gatekeepers' attitudes, the (non)payment of participants, and reciprocal arrangements with local community groups. The type of strategy employed resulted in recruits with differing characteristics (although our sample was too small to draw generalizable conclusions). We conclude that to ensure that research participation is accessible to all, researchers must employ flexible recruitment methods that permit adaptation to specific needs arising out of health status, level of involvement with services, culture, and socioeconomic status. Systematic research into this part of the research process is needed.
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Venters H, Adekugbe O, Massaquoi J, Nadeau C, Saul J, Gany F. Mental Health Concerns Among African Immigrants. J Immigr Minor Health 2010; 13:795-7. [DOI: 10.1007/s10903-010-9357-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Types and Factor Structure of Barriers to Utilization of Health Services among Aging South Asians in Calgary, Canada. Can J Aging 2010; 29:249-58. [DOI: 10.1017/s0714980810000188] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
RÉSUMÉSouvent, les personnes aînés de groupes ethniques minoritaires éprouvent obstacles différents à l’access aux services de santé. Généralement, les études ont porté sur les groupes combinés d’immigrants âgés ou sur minorités ethno-culturels importantes, tels que les Chinois au Canada ou les Afro-américains et Latino-Américains aux États-Unis. Cette étude visait à examiner les types des facteurs qui constituent des obstacles à l’utilization des services de santé rencontrés à Calgary, Alberta, Canada, par les immigrés vieillissants d’Asie du Sud. Un sondage téléphonique a été utilisé pour rassembler des données d’un échantillon aléatoire d’immigrants d’Asie du Sud âgés de 55 ans et plus. L’analyse des éléments principaux a révélé quatre types principaux d’obstacles: l’incompatibilité culturelle; les attitudes personnelles; les problèmes administratifs dans la livraison et les défis posés par les circonstances.
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Mölsä ME, Hjelde KH, Tiilikainen M. Changing conceptions of mental distress among Somalis in Finland. Transcult Psychiatry 2010; 47:276-300. [PMID: 20603389 DOI: 10.1177/1363461510368914] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article examines how the conceptions, expressions and treatment of mental distress are changing among Somalis living in Finland. The data derive from two focus group interviews with Somali seniors and two individual interviews with Islamic healers. Conditions conceptualized by the Finnish biomedical system as mental disorders, are seen by most Somalis as spiritual and/or social problems. Somali migrants face new sources of suffering and new ways of interpreting them. Consequently, traditional conceptions of mental distress both persist and change. Islamic understandings of healing, including notions of jinn spirits and treatment, continue to be important in exile.
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Abstract
SummaryThis review examines the demographic changes, the epidemiology of mental disorders and suicides, the potential risk and protective factors, access to secondary care old age psychiatry services (OAPSs) and the policy context pertaining to older people from ethnic minority groups in the United Kingdom. The number of older people from ethnic minority groups is increasing. The prevalence of mental disorders in older people from ethnic minority groups is either similar to or higher than that in the indigenous population. Therefore, the number of older people from ethnic minority groups with psychiatric morbidity is also increasing. Ethnic minority older people also have inequity of access to secondary care OAPSs. There is an urgent need to develop and implement practical strategies to improve access by older people from ethnic minority groups to OAPSs.
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Venters H, Gany F. African immigrant health. J Immigr Minor Health 2009; 13:333-44. [PMID: 19347581 DOI: 10.1007/s10903-009-9243-x] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Accepted: 03/05/2009] [Indexed: 12/21/2022]
Abstract
As the number and diversity of Africans in the U.S. increases, there is a growing need to assess their health care needs and practices. Although infectious diseases have been a traditional point of contact between health care systems and African immigrants, there is a clear and unmet need to determine the risks and prevalence for chronic diseases. This review includes what has been published concerning the health of African immigrants in the U.S. and draws on European studies to supplement this assessment. While African immigrants arrive in the U.S. with some unique health problems, namely infectious diseases, they are generally healthier than African Americans of the same age. This 'healthy immigrant effect' has been well documented, but the acquisition of risk factors for chronic diseases such as coronary artery disease, hypertension, diabetes and cancer is poorly understood among African immigrants. More information must be gathered in the broad categories of chronic disease, health attitudes and health access to better promote the health of African immigrants.
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Affiliation(s)
- Homer Venters
- Division of General Internal Medicine, New York University, VA NY Harbor HCS 423 E 23rd St., New York, NY, 10010, USA.
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Lai DWL. Older chinese' attitudes toward aging and the relationship to mental health: an international comparison. SOCIAL WORK IN HEALTH CARE 2009; 48:243-259. [PMID: 19360529 DOI: 10.1080/00981380802591957] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This study examined the predictive effects of attitude toward aging on mental health of aging Chinese. Data were obtained from community surveys utilizing mixed sampling methods of 4,240 elderly Chinese 55 years or older in China, Hong Kong, Taiwan, Canada, and the United States. Hierarchical multiple regression analysis was used, with sociodemographic variables entered first, followed by the health variables, and then attitude toward aging. The effect of attitude toward aging on mental health was stronger than most other predictive factors. Social workers should focus on creating social/community environments that build a positive attitude toward aging.
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Fountoulakis KN, Siamouli M, Magiria S, Kaprinis G. Late-life depression, religiosity, cerebrovascular disease, cognitive impairment and attitudes towards death in the elderly: Interpreting the data. Med Hypotheses 2008; 70:493-6. [PMID: 17825997 DOI: 10.1016/j.mehy.2007.01.093] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2007] [Accepted: 01/11/2007] [Indexed: 10/22/2022]
Abstract
Geriatric depression is considered to be a major health problem in the elderly. Passing the age, the speed of mental process is decreasing and personality obtains more mature functioning (better coping) while most of its traits remain stable. Empirical studies have shown that fear of death is most prominent during midlife and not late-life. Neuroimaging studies led to the "vascular depression" hypothesis. Depression was found to be a strong predictive factor leading to stroke, while religiosity seemed to be a 'protective' factor. A possible interpretation of these reports could consider late-life depression to be an early symptomatology of an undergoing vascular disease. Religiosity could be interpreted as absence of depression, and therefore, mainly as absence of vascular lesions. The above have profound implications in the understanding of late-life depression and to the therapeutic design, especially in the primary care setting.
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Affiliation(s)
- Konstantinos N Fountoulakis
- 3rd Department of Psychiatry, Aristotle University of Thessaloniki, 1 St. Kyriakidi Street, 546 36 Thessaloniki, Greece.
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Predictors of depression in aging South Asian Canadians. J Cross Cult Gerontol 2007; 23:57-75. [PMID: 17990088 DOI: 10.1007/s10823-007-9051-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2006] [Accepted: 10/15/2007] [Indexed: 01/22/2023]
Abstract
This study examined the prevalence and factors of depression among aging South Asians in Canada. Telephone surveys were conducted with a random sample of aging South Asians aged 55 and above. Hierarchical regression analysis was used to determine the factors of depression, which was measured by an adapted 15-item Geriatric Depression Scale. Over one in five (21.4%) participants reported at least a mild level of depression. A stronger agreement with South Asian cultural values was significantly related to a higher probability of being depressed. Physical health variables were the most significant factors after controlling for socio-demographic and culture-related factors. The findings have demonstrated the linkages between the relationships among socio-cultural factors and depression in older South Asians. Mental health interventions should consider the cultural uniqueness of this target population and the service delivery system should ensure that services are known and accessible to the increasingly culturally diverse aging population.
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Clark C, Myron R, Stansfeld S, Candy B. A systematic review of the evidence on the effect of the built and physical environment on mental health. JOURNAL OF PUBLIC MENTAL HEALTH 2007. [DOI: 10.1108/17465729200700011] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Inal S, Subasi F, Ay SM, Hayran O. The links between health-related behaviors and life satisfaction in elderly individuals who prefer institutional living. BMC Health Serv Res 2007; 7:30. [PMID: 17326842 PMCID: PMC1817646 DOI: 10.1186/1472-6963-7-30] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2006] [Accepted: 02/27/2007] [Indexed: 11/10/2022] Open
Abstract
Background Life satisfaction among residents of institutions is becoming an important issue in a rapidly aging population. The aim of this cross-sectional study was to investigate the links between life satisfaction and health-related behaviors amongst functionally independent elderly people who prefer institutional living in İstanbul, Turkey. Methods The socio-demographic characteristics, health-related behaviors, leisure-time activities and fall histories of 133 residents of an institution in Istanbul were assessed by a structured questionnaire during face-to-face interviews. A validated life-satisfaction index questionnaire (LSI-A) was completed. Results The mean age of the study group was 73.9 ± 8.0 (range 60–90 years). Within the group, 22.6% had never married and 14.3% had university degrees. The majority (71.4%) were in the low income bracket. The overall mean LSI-A score was 20.3 ± 5.9. Participants who declared moderate/high income levels had a significantly higher mean LSI-A score than those in the low-income bracket (p = 0.009). Multivariate analysis of the data suggested that leisure-time activities and participation in regular physical activities are significant predictors of LSI-A scores (R2: 0.112; p = 0.005 and p = 0.02, respectively). Conclusion The findings imply that regular physical activity and leisure-time activities are significantly related to life satisfaction among residents in institutions. Participation in physical activity and leisure-time activity programs may help to improve the life satisfaction of elderly people living in institutions.
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Affiliation(s)
- Serap Inal
- School of Physical Education and Sports, İstanbul University, 34310 Avcılar, Istanbul, Turkey
| | - Feryal Subasi
- Department of Health Education, Faculty of Health Education, Marmara University, 34865, Kartal, Istanbul, Turkey
| | - Serap M Ay
- School of Physical Education and Sports, Marmara University, Anadolu Hisarı, Beykoz, Istanbul, Turkey
| | - Osman Hayran
- Department of Public Health, School of Medicine, Marmara University, 34668, Haydarpasa, Istanbul, Turkey
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Chou KL. Psychological distress in migrants in Australia over 50 years old: a longitudinal investigation. J Affect Disord 2007; 98:99-108. [PMID: 16890296 DOI: 10.1016/j.jad.2006.07.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2006] [Revised: 07/01/2006] [Accepted: 07/03/2006] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although it is a well-known fact that migration is a risk factor contributing to psychopathology, little is known in migrants who migrated in their old age. The present study examined whether origin of countries and visa types predicted psychological distress over a period of 1 year and whether their association changed after factors in health, social roles, cohort effect and social support were adjusted. METHODS A nationwide representative sample of 431 migrants who aged 50 and above were interviewed in 2000-2001 and 359 of them were re-interviewed 1 year after the baseline assessment. 12-item General Health Questionnaire (GHQ-12) was used measure psychological distress and a series of questions regarding socio-demographic characteristics (age, gender, living alone), days in Australia, origin of countries, visa types, health, social role, cohort effect, and social support were also included. RESULTS GHQ-12 scores did deteriorate over a period of 1 year among older migrants to Australia. In multiple regression analyses, origin of countries and visa types were significant predictors of future GHQ-12 scores. Baseline GHQ-12 scores, age, gender, living alone, days in Australia, poor self-rated health, the presence of heart disease, diabetes, and asthma, being a student or economically inactive, widowhood or divorce, as well as education were also significant predictors of GHQ-12 scores at 1-year follow-up. CONCLUSIONS The status of refugees predicts future psychological distress in older migrants even when other known correlates of psychological distress are controlled.
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Affiliation(s)
- Kee-Lee Chou
- Department of Politics and Sociology, Lingnan University, Tuen Mun, Hong Kong, China.
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Simich L, Hamilton H, Baya BK. Mental distress, economic hardship and expectations of life in Canada among Sudanese newcomers. Transcult Psychiatry 2006; 43:418-44. [PMID: 17090626 DOI: 10.1177/1363461506066985] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
As part of a settlement needs assessment of 220 recently arrived Sudanese refugees and immigrants in seven cities, we examined overall health status, indicators of mental distress, economic hardship and expectations of life in Canada. Data were collected in a community-based study using qualitative and quantitative techniques. Results indicate that those Sudanese for whom life in Canada was not what they expected and those who experienced economic hardship as measured by worry over having enough money for food or medicine experienced poorer overall health and reported a greater number of symptoms of psychological distress. After controlling for demographic and related variables, we found that individuals who were experiencing economic hardship were between 2.6 and 3.9 times as likely to experience loss of sleep, constant strain, unhappiness and depression, and bad memories as individuals who do not experience hardship. Healthcare providers should be aware of how postmigration social disadvantages may increase the risk of mental distress particularly among refugees.
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Affiliation(s)
- Laura Simich
- Centre for Addiction and Mental Health, University of Toronto, Ontario, Canada.
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Syed HR, Dalgard OS, Dalen I, Claussen B, Hussain A, Selmer R, Ahlberg N. Psychosocial factors and distress: a comparison between ethnic Norwegians and ethnic Pakistanis in Oslo, Norway. BMC Public Health 2006; 6:182. [PMID: 16831229 PMCID: PMC1544334 DOI: 10.1186/1471-2458-6-182] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2005] [Accepted: 07/10/2006] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND In the Norwegian context, higher mental distress has been reported for the non-Western immigrants compared to the ethnic Norwegians and Western immigrants. This high level of distress is often related to different socio-economic conditions in this group. No efforts have been made earlier to observe the impact of changed psychosocial conditions on the state of mental distress of these immigrant communities due to the migration process. Therefore, the objective of the study was to investigate the association between psychological distress and psychosocial factors among Pakistani immigrants and ethnic Norwegians in Oslo, and to investigate to what extent differences in mental health could be explained by psychosocial and socioeconomic conditions. METHOD Data was collected from questionnaires as a part of the Oslo Health Study 2000-2001. 13581 Norwegian born (attendance rate 46%) and 339 ethnic Pakistanis (attendance rate 38%) in the selected age groups participated. A 10-item version of Hopkins Symptom Checklist (HSCL) was used as a measure of psychological distress. RESULTS Pakistanis reported less education and lower employment rate than Norwegians (p < 0.005). The Pakistani immigrants also reported higher distress, mean HSCL score 1.53(1.48-1.59), compared to the ethnic Norwegians, HSCL score 1.30(1.29-1.30). The groups differed significantly (p < 0.005) with respect to social support and feeling of powerlessness, the Pakistanis reporting less support and more powerlessness. The expected difference in mean distress was reduced from 0.23 (0.19-0.29) to 0.07 (0.01-0.12) and 0.12 (0.07-0.18) when adjusted for socioeconomic and social support variables respectively. Adjusting for all these variables simultaneously, the difference in the distress level between the two groups was eliminated CONCLUSION Poor social support and economic conditions are important mediators of mental health among immigrants. The public health recommendations/interventions should deal with both the economic conditions and social support system of immigrant communities simultaneously.
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Affiliation(s)
- Hammad Raza Syed
- Department of International Health, Institute of General Practice and Community Medicine, University of Oslo, Norway
- National Centre for Minority Health Research, (NAKMI), Ullevaal University Hospital, Oslo, Norway
| | - Odd Steffen Dalgard
- Department of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Ingvild Dalen
- Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Bjørgulf Claussen
- Department of International Health, Institute of General Practice and Community Medicine, University of Oslo, Norway
| | - Akthar Hussain
- Department of International Health, Institute of General Practice and Community Medicine, University of Oslo, Norway
| | - Randi Selmer
- Department of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Nora Ahlberg
- National Centre for Minority Health Research, (NAKMI), Ullevaal University Hospital, Oslo, Norway
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van der Wurff FB, Beekman ATF, Dijkshoorn H, Spijker JA, Smits CHM, Stek ML, Verhoeff A. Prevalence and risk-factors for depression in elderly Turkish and Moroccan migrants in the Netherlands. J Affect Disord 2004; 83:33-41. [PMID: 15546643 DOI: 10.1016/j.jad.2004.04.009] [Citation(s) in RCA: 133] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2003] [Revised: 04/26/2004] [Accepted: 04/26/2004] [Indexed: 10/26/2022]
Abstract
BACKGROUND Western societies host increasing number of elderly labour migrants from Turkey and Morocco. The article studied the prevalence of clinically significant depressive symptoms among elderly Turkish and Moroccan migrants compared with native Dutch elderly and if differences in prevalence rates were explained by known risk factors for depression and/or ethnic, migration-related factors. METHODS 330 Turkish, 299 Moroccan, and 304 Dutch elderly (55-74 years) were interviewed (cross-sectionally) using the Center for Epidemiologic Depression Scale (CES-D). Potential risk factors included sex, income level, marital status, ethnic origin, chronic physical illnesses, limitations in daily functioning, migration and acculturation questions. RESULTS The prevalence of self-reported depressive symptoms (CES-D>or=16) was very high in elderly migrants, 33.6% for Moroccan and 61.5% for Turkish elderly. The prevalence of depressive symptoms in the native Dutch sample was similar to earlier studies in the Netherlands and abroad: 14.5%. Among migrants education and income level was very low and they had a high number of physical limitations and chronic medical illnesses. This only explained part of the ethnic differences found. In all three samples, depressive symptoms were associated with sex, chronic physical illness and physical limitations. In multivariate analysis, ethnic origin was uniquely associated with the presence of clinically significant depressive symptoms. Only a small number of remigration and acculturation items were associated with depressive symptoms in bivariate analysis. CONCLUSIONS The prevalence of clinically significant depressive symptoms among elderly migrants from Turkey and Morocco in the Netherlands is very high. Ethnicity was a strong independent risk factor.
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Affiliation(s)
- F B van der Wurff
- Department of Psychiatry, Vrije Universiteit-VUmc and GGZ-Buitenamstel, Valeriusplein 9, 1075 BG Amsterdam, The Netherlands.
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Ahern J, Galea S, Fernandez WG, Koci B, Waldman R, Vlahov D. Gender, social support, and posttraumatic stress in postwar Kosovo. J Nerv Ment Dis 2004; 192:762-70. [PMID: 15505520 DOI: 10.1097/01.nmd.0000144695.02982.41] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The effects of social support and traumatic experiences on mental health in conflict situations may be different by gender. The Kosovo Emergency Department Study was conducted in July and August 2001 to assess mental health 2 years after the end of the war in Kosovo. Of 306 emergency department patients (87.7% response rate), all were ethnic Albanian, 97.4% had experienced traumatic events, and 89.5% had posttraumatic stress symptoms. Women and persons who experienced more traumatic events had higher posttraumatic stress scores. Persons with social support had lower posttraumatic stress scores. In a final model, social support had a greater protective effect for women, whereas traumatic events had a greater detrimental effect on men. Two years after the war in Kosovo, there remained a high prevalence of posttraumatic stress symptoms, particularly among women with low social support. Interventions targeting social support may be important public health efforts in the postwar context.
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Affiliation(s)
- Jennifer Ahern
- Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, New York 10029, USA
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Fountoulakis KN, O'Hara R, Iacovides A, Camilleri CP, Kaprinis S, Kaprinis G, Yesavage J. Unipolar late-onset depression: A comprehensive review. ANNALS OF GENERAL HOSPITAL PSYCHIATRY 2003; 2:11. [PMID: 14675492 PMCID: PMC317342 DOI: 10.1186/1475-2832-2-11] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2003] [Accepted: 12/16/2003] [Indexed: 11/10/2022]
Abstract
Background The older population increases all over the world and so also does the number of older psychiatric patients, which manifest certain specific and unique characteristics. The aim of this article is to provide a comprehensive review of the international literature on unipolar depression with onset at old age. Methods The authors reviewed several pages and books relevent to the subject but did not search the entire literature because of it's overwhelming size. They chose to review those considered most significant. Results The prevalence of major depression is estimated to be 2% in the general population over 65 years of age. The clinical picture of geriatric depression differs in many aspects from depression in younger patients. It is not yet clear whether it also varies across cultures and different socio-economic backgrounds. Biological data suggest that it is associated with an increased severity of subcortical vascular disease and greater impairment of cognitive performance. Many authors consider the existence of a somatic disorder to be related to the presence of depression in late life, even constituting a negative prognostic factor for the outcome of depression. Most studies support the opinion that geriatric depression carries a poorer prognosis than depression in younger patients. The therapeutic intervention includes pharmacotherapy, mainly with antidepressants, which is of established value and psychotherapy which is not equally validated. Conclusion A significant number of questions regarding the assessment and treatment of geriatric depression remain unanswered, empirical data are limited, and further research is necessary.
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Affiliation(s)
| | - Ruth O'Hara
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford California U.S.A
| | | | - Christopher P Camilleri
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford California U.S.A
| | - Stergios Kaprinis
- 3Department of Psychiatry, Aristotle University of Thessaloniki, Greece
| | - George Kaprinis
- 3Department of Psychiatry, Aristotle University of Thessaloniki, Greece
| | - Jerome Yesavage
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford California U.S.A
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