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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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Lee H, Kim J, Zrínyi M. Mental health effects of adult children's outmigration on older parents in Central and Eastern Europe. Aging Ment Health 2024; 28:353-359. [PMID: 37811709 DOI: 10.1080/13607863.2023.2260327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE To examine the association between adult children's migration and depression among older parents in Central and Eastern Europe (CEE) and explore the role of intergenerational support in contributing to their depression. METHODS Data are from the eighth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE), pooling a study sample of 11 CEE countries, with a cross-sectional design. Analysis of covariance (ANCOVA) and hierarchical linear regression were conducted using a study sample of 9133 respondents. RESULTS Older adults whose children migrated over 500 km were more likely to experience depression compared to those with no migrant child or all children within 500 km. Among intergenerational support, frequent parent-child contact mitigated the effects of migration on depression in older parents with all their children who migrated over 500 km. CONCLUSION This study suggests that older parents with migrant children over 500 km away should be considered a vulnerable population at risk for mental health in CEE countries. It is crucial for local governments and policymakers to address these challenges through improving integrated mental health and social programs for better mental health outcomes among older adults in CEE countries.
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Affiliation(s)
- Hayoung Lee
- Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Jaeshin Kim
- Dankook Center for Dispute Resolution, Dankook University, Yongin, South Korea
| | - Miklós Zrínyi
- Faculty of Health Sciences, University of Pécs, Pécs, Hungary
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Jang SY, Oksuzyan A, Myrskylä M, van Lenthe FJ, Loi S. Healthy immigrants, unhealthy ageing? Analysis of health decline among older migrants and natives across European countries. SSM Popul Health 2023; 23:101478. [PMID: 37635989 PMCID: PMC10448331 DOI: 10.1016/j.ssmph.2023.101478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/29/2023] Open
Abstract
The probability of having multiple chronic conditions simultaneously, or multimorbidity, tends to increase with age. Immigrants face a particularly high risk of unhealthy ageing. This study investigates the immigrant-native disparities in the speed of age-related chronic disease accumulation, focusing on the number of chronic health conditions; and considers the heterogeneity of this trajectory within immigrant populations by origin and receiving country. We use data from the Survey of Health, Ageing and Retirement in Europe from 2004 to 2020 on adults aged 50 to 79 from 28 European countries and employ both cross-sectional and longitudinal analyses. For longitudinal panel analyses, we use fixed-effects regression models to account for the unobserved heterogeneity related to individual characteristics including migration background. Our results indicate that immigrants report a higher number of chronic conditions at all ages relative to their native-born peers, but also that the immigrant-native differential in the number of chronic conditions decreases from age 65 onwards. When considering differences by origin country, we find that the speed of chronic disease accumulation is slower among immigrants from the Americas and the Asia and Oceania country groups than it is among natives. When looking at differences by receiving country group, we observe that the speed of accumulating chronic diseases is slower among immigrants in Eastern Europe than among natives, particularly at older ages. Our findings suggest that age-related trajectories of health vary substantially among immigrant populations by origin and destination country, which underscore that individual migration histories play a persistent role in shaping the health of ageing immigrant populations throughout the life course.
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Affiliation(s)
- Su Yeon Jang
- Max Planck Institute for Demographic Research, Rostock, Germany
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Anna Oksuzyan
- Max Planck Institute for Demographic Research, Rostock, Germany
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Mikko Myrskylä
- Max Planck Institute for Demographic Research, Rostock, Germany
- Centre for Social Data Science and Population Research Unit, University of Helsinki, Helsinki, Finland
- Max Planck – University of Helsinki Center for Social Inequalities in Population Health, Rostock, Germany and Helsinki, Finland
| | - Frank J. van Lenthe
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Silvia Loi
- Max Planck Institute for Demographic Research, Rostock, Germany
- Max Planck – University of Helsinki Center for Social Inequalities in Population Health, Rostock, Germany and Helsinki, Finland
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Vo TT, Phu-Duyen TT. Mental health around retirement: evidence of Ashenfelter's dip. Glob Health Res Policy 2023; 8:35. [PMID: 37620953 PMCID: PMC10464218 DOI: 10.1186/s41256-023-00320-3] [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: 10/03/2022] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Mental health issues among retirees have become increasingly concerning because the aging population presents a significant challenge globally, particularly in Western countries. Previous studies on this issue are plagued with bias owing to lacking panel data and estimation strategies. This study investigated the depression levels of European adults around the time of retirement. METHODS We used data obtained from Waves 1-7 of the Survey of Health, Ageing, and Retirement in Europe (SHARE) to create panel data covering the 2004-2017 period. Wave 3 (SHARELIFE) was excluded from the sample because it provided mismatched information. Fixed-effects (FE) and fixed-effects instrumental variables (FE-IV) models with multiple imputations were employed to examine the impacts of retirement on mental health before and after retirement, where being over pension age (normal and early) was used as the instrument variable. RESULTS Our results indicated that retirement based on aspirational motivations (β = - 0.115, p < 0.001) and positive circumstances (β = - 0.038, p < 0.001) significantly reduced depression, whereas retiring under negative circumstances could deteriorate one's mental health (β = 0.087, p < 0.001). FE and FE-IV models indicated that overall, retiring reduced retirees' depression (β = - 0.096, p < 0.001 and β = - 0.261, p < 0.001, respectively). The results of FE-IV models showed that adults planning to retire in the next two years experienced less depression compared with others in the workforce (λ = - 0.313, p < 0.01). These adults must have adjusted their lifestyles in response to their impending retirement, thereby evincing Ashenfelter's dip. Two years after retirement, when the "honeymoon" phase was over, retirees may have completely adapted to their new lives and the effect of retirement was no longer important. CONCLUSIONS Retirement improves mental health before it happens, but not after. Increasing the pension eligibility age may postpone the beneficial effects of retirement on health. However, policy implications should be tailored according to the unique situations of each country, job sector, and population. Providing flexible schemes regarding retirement timing decisions would be better than a generalized retirement policy.
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Affiliation(s)
- Thang T Vo
- Health and Agricultural Policy Research Institute, 279 Nguyen Tri Phuong, District 10, 72406, Ho Chi Minh City, Vietnam.
- School of Economics, University of Economics HCMC, 279 Nguyen Tri Phuong, District 10, 72406, Ho Chi Minh City, Vietnam.
| | - Tran T Phu-Duyen
- Health and Agricultural Policy Research Institute, 279 Nguyen Tri Phuong, District 10, 72406, Ho Chi Minh City, Vietnam
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Vonneilich N, Becher H, Bohn B, Brandes B, Castell S, Deckert A, Dragano N, Franzke CW, Führer A, Gastell S, Greiser H, Keil T, Klett-Tammen C, Koch-Gallenkamp L, Krist L, Leitzmann M, Meinke-Franze C, Mikolajczyk R, Moreno Velasquez I, Obi N, Peters A, Pischon T, Reuter M, Schikowski T, Schmidt B, Schulze M, Sergeev D, Stang A, Völzke H, Wiessner C, Zeeb H, Lüdecke D, von dem Knesebeck O. Associations of Migration, Socioeconomic Position and Social Relations With Depressive Symptoms - Analyses of the German National Cohort Baseline Data. Int J Public Health 2023; 68:1606097. [PMID: 37533684 PMCID: PMC10391163 DOI: 10.3389/ijph.2023.1606097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/05/2023] [Indexed: 08/04/2023] Open
Abstract
Objectives: We analyze whether the prevalence of depressive symptoms differs among various migrant and non-migrant populations in Germany and to what extent these differences can be attributed to socioeconomic position (SEP) and social relations. Methods: The German National Cohort health study (NAKO) is a prospective multicenter cohort study (N = 204,878). Migration background (assessed based on citizenship and country of birth of both participant and parents) was used as independent variable, age, sex, Social Network Index, the availability of emotional support, SEP (relative income position and educational status) and employment status were introduced as covariates and depressive symptoms (PHQ-9) as dependent variable in logistic regression models. Results: Increased odds ratios of depressive symptoms were found in all migrant subgroups compared to non-migrants and varied regarding regions of origins. Elevated odds ratios decreased when SEP and social relations were included. Attenuations varied across migrant subgroups. Conclusion: The gap in depressive symptoms can partly be attributed to SEP and social relations, with variations between migrant subgroups. The integration paradox is likely to contribute to the explanation of the results. Future studies need to consider heterogeneity among migrant subgroups whenever possible.
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Affiliation(s)
- Nico Vonneilich
- Institute of Medical Sociology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Heiko Becher
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Barbara Bohn
- NAKO e.V., Heidelberg University, Heidelberg, Baden-Württemberg, Germany
| | - Berit Brandes
- Leibniz Institute for Prevention Research and Epidemiology (LG), Bremen, Germany
| | - Stefanie Castell
- Department of Epidemiology, Helmholtz Center for Infection Research, Helmholtz Association of German Research Centers (HZ), Braunschweig, Niedersachsen, Germany
| | - Andreas Deckert
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Nico Dragano
- Institute for Medical Sociology, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - Claus-Werner Franzke
- Institute for Prevention and Cancer Epidemiology, University of Freiburg Medical Center, Freiburg, Baden-Württemberg, Germany
| | - Amand Führer
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), University Hospital in Halle, Halle, Saxony-Anhalt, Germany
| | - Sylvia Gastell
- NAKO Study Center, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Potsdam, Brandenburg, Germany
| | - Halina Greiser
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Baden-Württemberg, Germany
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medicine Berlin, Berlin, Germany
- Institute of Clinical Epidemiology and Biometry, Faculty of Medicine, University of Würzburg, Würzburg, Bavaria, Germany
- State Institute of Health I, Bavarian Health and Food Safety Authority, Erlangen, Germany
| | - Carolina Klett-Tammen
- Department of Epidemiology, Helmholtz Center for Infection Research, Helmholtz Association of German Research Centers (HZ), Braunschweig, Niedersachsen, Germany
| | - Lena Koch-Gallenkamp
- Department of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Baden-Württemberg, Germany
| | - Lilian Krist
- Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medicine Berlin, Berlin, Germany
| | - Michael Leitzmann
- Deptartment of Epidemiology and Preventive Medicine, University Medical Center Regensburg, Regensburg, Bavaria, Germany
| | - Claudia Meinke-Franze
- Institute for Community Medicine, University Medical Center Greifswald, Greifswald, Mecklenburg-Vorpommern, Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), University Hospital in Halle, Halle, Saxony-Anhalt, Germany
| | - Ilais Moreno Velasquez
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine, Helmholtz Association of German Research Centers (HZ), Berlin, Baden-Wurttemberg, Germany
| | - Nadia Obi
- Institute for Occupational and Maritime Medicine Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Hamburg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Center München, Helmholtz Association of German Research Centres (HZ), Neuherberg, Germany
| | - Tobias Pischon
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine, Helmholtz Association of German Research Centers (HZ), Berlin, Baden-Wurttemberg, Germany
- Berlin Institute of Health (BIH), Charité University Medicine Berlin, Berlin, Germany
| | - Marvin Reuter
- Subject Sociology, University of Bamberg, Bamberg, Bavaria, Germany
| | - Tamara Schikowski
- Leibniz-Institut für Umweltmedizinische Forschung (IUF), Dusseldorf, Germany
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, Essen University Hospital, Essen, North Rhine-Westphalia, Germany
| | - Matthias Schulze
- German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Potsdam, Brandenburg, Germany
- Institute of Nutrition Science, Faculty of Mathematics and Natural Sciences, University of Potsdam, Potsdam, Brandenburg, Germany
| | - Dmitry Sergeev
- Department of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Baden-Württemberg, Germany
| | - Andreas Stang
- Institute for Medical Informatics, Biometry and Epidemiology, Essen University Hospital, Essen, North Rhine-Westphalia, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medical Center Greifswald, Greifswald, Mecklenburg-Vorpommern, Germany
| | - Christian Wiessner
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Hamburg, Germany
| | - Hajo Zeeb
- Leibniz Institute for Prevention Research and Epidemiology (LG), Bremen, Germany
| | - Daniel Lüdecke
- Institute of Medical Sociology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Olaf von dem Knesebeck
- Institute of Medical Sociology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Moran JK, Jesuthasan J, Schalinski I, Kurmeyer C, Oertelt-Prigione S, Abels I, Stangier U, Starck A, Gutermann J, Zier U, Wollny A, Richter K, Krüger A, Schouler-Ocak M. Traumatic Life Events and Association With Depression, Anxiety, and Somatization Symptoms in Female Refugees. JAMA Netw Open 2023; 6:e2324511. [PMID: 37471088 PMCID: PMC10359962 DOI: 10.1001/jamanetworkopen.2023.24511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/04/2023] [Indexed: 07/21/2023] Open
Abstract
Importance Different types of traumatic life events have varying impacts on symptoms of depression, anxiety, and somatization. For women from areas of the world experiencing war and humanitarian crises, who have experienced cumulative trauma exposure during war and forced migration, it is not known whether cumulative trauma or particular events have the greatest impact on symptoms. Objective To examine which traumatic life events are associated with depression, anxiety, and somatization symptoms, compared with the cumulative amount, in a sample of female refugees. Design, Setting, and Participants For this cross-sectional study, data were collected in 2016 as a part of The Study on Female Refugees. The current analysis was conducted in 2022 to 2023. This multicenter study covered 5 provinces in Germany. Participants were recruited at reception centers for refugees. Women volunteered to participate and to be interviewed after information seminars at the different centers. Exposure Traumatic life events experienced by refugees from areas of the world experiencing war and humanitarian crises. Main Outcomes and Measures Demographic variables (age, country of origin, religion, education, relationship status, and children), traumatic and adverse life events, and self-reported depression, anxiety, and somatization symptoms were measured. Random forest regressions simultaneously examined the importance of these variables on symptom scores. Follow-up exploratory mediation models tested potential associative pathways between the identified variables of importance. Results For the final sample of 620 refugee women (mean [SD] age, 32.34 [10.35] years), family violence was most associated with depression (mean [SD] variable of importance [VIM], 2.93 [0.09]), anxiety (mean [SD] VIM, 4.15 [0.11]), and somatization (mean [SD] VIM, 3.99 [0.15]), even though it was less common than other traumatic experiences, including war, accidents, hunger, or lack of housing. Other factors, such as childhood sexual abuse, injury, near-death experiences, and lack of access to health care, were also important. Follow-up analyses showed partial mediation effects between these factors in their association with symptoms, supporting the unique importance of family violence in understanding mental health. Conclusions and Relevance The findings of this cross-sectional study of refugee women who experienced multiple severe traumas related to war in their home countries and danger encountered during their migration suggest that family violence was key to their current mental health problems. Culturally sensitive assessment and treatment need to place special emphasis on these family dynamics.
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Affiliation(s)
- James Kenneth Moran
- Department of Psychiatry and Psychotherapy, Multisensory Integration Lab, Charité Universitätsmedizin, St Hedwig Hospital, Berlin, Germany
| | - Jenny Jesuthasan
- Psychiatric University Clinic Charité, St Hedwig Hospital, Berlin, Germany
| | - Inga Schalinski
- Universität der Bundeswehr München, Department of Human Sciences, Institute of Psychology, Munich, Germany
| | - Christine Kurmeyer
- Office of the Equal Opportunities Officer, Charité–Universitätsmedizin, Berlin, Germany
| | - Sabine Oertelt-Prigione
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- AG 10 Sex- and Gender-Sensitive Medicine, Medical Faculty OWL, University of Bielefeld, Bielefeld, Germany
| | - Ingar Abels
- Office of the Equal Opportunities Officer, Charité–Universitätsmedizin, Berlin, Germany
| | - Ulrich Stangier
- Clinical Psychology and Psychotherapy, Department of Psychology, Goethe-University Frankfurt, Frankfurt, Germany
| | - Annabelle Starck
- Clinical Psychology and Psychotherapy, Department of Psychology, Goethe-University Frankfurt, Frankfurt, Germany
| | - Jana Gutermann
- Clinical Psychology and Psychotherapy, Department of Psychology, Goethe-University Frankfurt, Frankfurt, Germany
| | - Ulrike Zier
- Institute of Occupational, Social, and Environmental Medicine, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
- Now with Ministry of Science and Health of Rhineland-Palatinate, Mainz, Germany
| | - Anja Wollny
- Institute of General Practice, University Medical Center Rostock, Rostock, Germany
| | - Knejinja Richter
- CuraMed Tagesklinik Nürnberg, Nuremberg, Germany
- Technische Hochschule Nürnberg, Nuremberg, Germany
| | - Antje Krüger
- Institute of General Practice, University Medical Center Rostock, Rostock, Germany
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7
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Calvey B, Maguire R, de Andrade Moral R, McHugh Power J. Health asymmetry as a predictor of depressive symptomatology over time among older European adults: A growth curve analysis. J Psychosom Res 2023; 166:111158. [PMID: 36731198 DOI: 10.1016/j.jpsychores.2023.111158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 01/10/2023] [Accepted: 01/16/2023] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Subjective (SH) and objective health (OH) measures are associated with depressive symptomatology in older adults. We explored whether the discrepancy between SH and OH (operationalised as 'health asymmetry' with four categories: 'health optimistic', 'health pessimistic' and 'good health realistic' and 'poor health realistic') may also relate to depressive symptomatology 1) cross-sectionally, and 2) longitudinally, among older European adults. METHODS Adults (n = 26,520), aged 50+, from 11 European countries, were assessed over six waves of data collection (2006-2020) in the SHARE study. A hierarchical multi-level growth curve model explored whether health asymmetry was associated with depressive symptomology at baseline, and with depressive symptom trajectories across time, accounting for country of origin. RESULTS At baseline, 11.8% of older adults were classified as health pessimistic, with 15.5% being health optimistic, 42.9% being poor health realistic and 29.8% being good health realistic. A positive linear trend in depressive symptomatology was noted across 14 years of SHARE data (β = 0.11, p < .001). Health pessimists displayed higher levels of depressive symptoms than both health realistic groups and health optimists. However, health pessimists experienced a less steep increase in depressive symptoms across time (β = -0.10, p < .001), relative to good health realists. CONCLUSION Health pessimists experience elevated levels of depressive symptoms, but show less growth in depressive symptomatology than expected. Further research is required to understand the underlying causes of the varying depressive symptom trajectories among these groups.
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Affiliation(s)
- Bill Calvey
- Hamilton Institute, Maynooth University, Maynooth, Co. Kildare, Ireland.
| | - Rebecca Maguire
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland
| | - Rafael de Andrade Moral
- Hamilton Institute, Maynooth University, Maynooth, Co. Kildare, Ireland; Department of Mathematics and Statistics, Maynooth University, Co. Kildare, Ireland
| | - Joanna McHugh Power
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland
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8
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Wang W, Song J, Fan C, Li Q, Ma D, Yin W. Cross-sectional study of factors affecting the receipt of mental health education in older migrants in China. BMC Public Health 2023; 23:376. [PMID: 36814209 PMCID: PMC9945688 DOI: 10.1186/s12889-023-15287-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Population migration in China has increasingly included middle-aged and older populations. Relatedly, the lack of mental health education among China's older migrants is still an important but neglected problem. This study aimed to understand the current situation of mental health education received by the older migrant population in China and to explore related influencing factors. METHODS This cross-sectional study included 5729 older migrants who participated in the 2017 China Migrants Dynamic Survey. The independent variables included four components: demographic and socioeconomic characteristics, migration factors, public health service utilization, and social integration factors. Data were analyzed using the chi-square test for single factors and a binary logistic regression model for multiple factors. RESULTS A total of 1749 older migrants received mental health education, for a receipt rate of 30.53%. Regression analysis showed that older migrant individuals who had an average monthly household income > 3000 CNY, self-rated their health as healthy, had chronic diseases, had heard of National Basic Public Health Services, had established health records, received ≥2 types of health education were willing to integrate into the local population, and were highly involved in the community were more likely to receive mental health education. Older migrants who were ≥ 70 years old, had an elementary school education or below, had difficulties in the local community, had migrated ≥11 years prior, moved for their offspring, and moved across provinces were less likely to receive mental health education. CONCLUSIONS The older migrant population does not receive sufficient mental health education. Mental health interventions should be tailored to the characteristics of older migrants to increase their mental health literacy and meet their psychological needs.
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Affiliation(s)
- Wanchen Wang
- grid.268079.20000 0004 1790 6079School of Public Health, Weifang Medical University, NO.7166, Baotong West Street, Weifang, Shandong China
| | - Jia Song
- grid.268079.20000 0004 1790 6079School of Management, Weifang Medical University, NO.7166, Baotong West Street, Weifang, Shandong China
| | - Chengxin Fan
- grid.268079.20000 0004 1790 6079School of Management, Weifang Medical University, NO.7166, Baotong West Street, Weifang, Shandong China
| | - Qiusha Li
- grid.268079.20000 0004 1790 6079School of Public Health, Weifang Medical University, NO.7166, Baotong West Street, Weifang, Shandong China
| | - Dongping Ma
- grid.268079.20000 0004 1790 6079School of Management, Weifang Medical University, NO.7166, Baotong West Street, Weifang, Shandong China
| | - Wenqiang Yin
- School of Management, Weifang Medical University, NO.7166, Baotong West Street, Weifang, Shandong, China.
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9
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Marin IB, Fernández D, Ayuso-Mateos JL, Leonardi M, Tobiasz-Adamczyk B, Koskinen S, Sanchez-Niubo A, Cristóbal-Narváez P. Healthy aging and late-life depression in Europe: Does migration matter? Front Med (Lausanne) 2022; 9:866524. [PMID: 36425106 PMCID: PMC9680089 DOI: 10.3389/fmed.2022.866524] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 09/22/2022] [Indexed: 11/03/2023] Open
Abstract
Background There is limited research examining the impact of risk and protective factors on late-life depression using large population-based datasets, particularly those examining differences among older migrants and non-migrants in Europe countries. Thus, the first aim was to analyze differences between migrants and non-migrants regarding socioeconomic status, depression, multimorbidity, healthy aging, and lifestyle behaviors. The second aim was to examine the impact of healthy aging on late-life depression in older migrants compared to their counterparts without a history of international migration in extensive and harmonized data from different population-based cohort studies. Materials and methods We analyzed cross-sectional, predominantly nationally representative, community-based data from European participants in the Aging Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) cohort. The descriptive analyses included sociodemographic variables, somatic comorbidities, multimorbidity, healthy aging, and lifestyle behaviors according to migration status. The effects of these variables on late-life depression were examined in a multivariate logistic regression model, including migration status and years since migration as predictors. Results Data of 122,571 individuals aged ≥ 50 years were analyzed, of which 11,799 (9.60%) were migrants. The descriptive analyses indicated that compared to non-migrants, migrants showed a higher prevalence of diabetes (25.6%), hypertension (38.0%), coronary artery disease (49.4%), stroke (4.9%), and depression (31.1%). Healthy aging was also better in non-migrants (51.7; SD = 9.7) than in migrants (39.6; SD = 18.2). The results of the logistic regression showed that migration status [OR = 1.231 (CIs: 0.914-1.547)] and increased number of years since migration in the host country [OR = 0.003 (CIs: 0.001-0.005)] were associated with greater levels of depressive symptoms. Concerning health variables, multimorbidity was associated with higher levels of depressive symptoms [OR = 0.244 (CIs: 0.211-0.278)], whereas better healthy aging was associated with fewer depressive symptoms [OR = -0.100 (CIs: -0.102 to -0.098)]. The interaction between migration and healthy aging status was also significant [OR. = -0.019 (CIs: -0.025 to -0.014)]. Conclusion Migrants reported higher risks for worse health outcomes compared to non-migrants. Significantly, worse healthy aging was associated with a greater risk of depressive symptoms in migrants than in non-migrants. Shedding light on migration and aging processes is essential for promoting a cross-cultural understanding of late-life depression in Europe.
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Affiliation(s)
- Ivet Bayes Marin
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut–Campus Clínic, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Daniel Fernández
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Serra Húnter fellow, Department of Statistics and Operations Research (DEIO), Universitat Politècnica de Catalunya BarcelonaTech, Barcelona, Spain
- Institute of Mathematics of UPC–BarcelonaTech, Barcelona, Spain
| | - Jose Luis Ayuso-Mateos
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit–IRCCS Neurology Institute Besta, Milan, Italy
| | - Beata Tobiasz-Adamczyk
- Department of Medical Sociology, Jagiellonian University Medical College, Kraków, Poland
| | - Seppo Koskinen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Albert Sanchez-Niubo
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
| | - Paula Cristóbal-Narváez
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
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10
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Goudsmit M, van de Vorst I, van Campen J, Parlevliet J, Schmand B. Clinical characteristics and presenting symptoms of dementia - a case-control study of older ethnic minority patients in a Dutch urban memory clinic. Aging Ment Health 2022; 26:2277-2284. [PMID: 34459695 DOI: 10.1080/13607863.2021.1963416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Despite the suspected higher prevalence of dementia in first generation ethnic minority populations, little is known about their pathway to geriatric diagnostic facilities. This study describes presenting symptoms, demographic and clinical characteristics of a large cohort of patients from ethnic minority populations at their first visit to a geriatric day clinic and compares them with those of native majority (Dutch) patients. METHOD Retrospective case control study in an urban geriatric day clinic setting. Participants were 415 minority patients (cases) from 47 different countries and 428 native Dutch control patients. Measurements were demographic characteristics, cognitive screening results, informant questionnaires, neuropsychiatric and depressive symptoms and somatic comorbidity. RESULTS Ethnic minority patients presented with a different profile of psychiatric and somatic comorbidity. They were younger, had longer duration of symptoms and possibly presented somewhat later in the course of the dementia than the controls. Minority patients had more neuropsychiatric and depressive symptoms than native Dutch patients. They also had more often somatic comorbidities than controls, especially diabetes mellitus. CONCLUSIONS Clinicians in geriatric diagnostic facilities should be aware of the younger age at presentation and the high prevalence of some specific risk factors for dementia in ethnic minority patients.
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Affiliation(s)
- Miriam Goudsmit
- Department of Psychiatry and Medical Psychology, OLVG Hospital, Amsterdam, the Netherlands
| | | | - Jos van Campen
- Department of Geriatrics, OLVG Hospital, Amsterdam, the Netherlands
| | - Juliette Parlevliet
- Department of Geriatrics, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam, the Netherlands
| | - Ben Schmand
- Department of Medical Psychology, Amsterdam University Medical Center, location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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Skogberg N, Castaneda AE, Agyemang C, Koponen P, Lilja E, Laatikainen T. The association of depressive and anxiety symptoms with the metabolic syndrome and its components among Russian, Somali, and Kurdish origin adults in Finland: A population-based study. J Psychosom Res 2022; 159:110944. [PMID: 35605441 DOI: 10.1016/j.jpsychores.2022.110944] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/30/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Positive association of depressive and anxiety symptoms with the metabolic syndrome (MetS) have been reported, however there is little information on these among migrant origin populations. The aim of this study was to examine these associations among diverse migrant origin populations in Finland. METHODS Data of 318 Russian, 212 Somali, and 321 Kurdish origin participants in the cross-sectional Finnish Migrant Health and Wellbeing Study (Maamu) aged 30-64 years was used. The general population reference group constituted of 786 Health 2011 Survey participants. Depressive and anxiety symptoms were measured with HSCL-25 subscales. Harmonized definition of MetS was used. RESULTS Depressive symptoms were associated with elevated blood pressure in Kurdish origin (30.1%, 95% CI 22.7-38.8 vs. 19.9%, 95%CI 15.4-25.4 for those with and without symptoms respectively); and elevated waist circumference (72.1%, 95%CI 56.9-83.5 vs. 55.0%, 95%CI 50.6-59.4) and triglycerides (30.8%, 95%CI 16.0-51.0 vs. 11.9%, 95%CI 9.3-15.0) in general population. Anxiety symptoms were associated with MetS (47.0%, 95%CI 37.6-56.7 vs. 31.9%, 95%CI 26.7-37.6) and elevated blood pressure (37.2%, 95%CI 28.3-46.9 vs. 18.8%, 95%CI 14.7-23.6), and with elevated triglycerides in Somali origin (33.0%, 95%CI 14.5-59.0 vs. 5.7%, 95%CI 3.3-9.6) and general population (30.2%, 95%CI 16.4-48.8, 12.8%, 95%CI 9.9-16.2). No associations between low HDL-cholesterol and depressive or anxiety symptoms were observed. CONCLUSION Cardiometabolic health should be taken into account in mental health services. Future studies should explore the underlying pathways to the observed differences in strengths of associations of depressive and anxiety symptoms with MetS and its components across diverse migrant origin populations.
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Affiliation(s)
- Natalia Skogberg
- Department of Public Health and Welfare, Finnish institute for Health and Welfare, Helsinki, Finland.
| | - Anu E Castaneda
- Department of Public Health and Welfare, Finnish institute for Health and Welfare, Helsinki, Finland
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Päivikki Koponen
- Department of Public Health and Welfare, Finnish institute for Health and Welfare, Helsinki, Finland
| | - Eero Lilja
- Department of Public Health and Welfare, Finnish institute for Health and Welfare, Helsinki, Finland
| | - Tiina Laatikainen
- Department of Public Health and Welfare, Finnish institute for Health and Welfare, Helsinki, Finland; Institute of Public Health and Clinical Nutrition, Kuopio, Finland; Joint municipal authority for social and health services (Siun sote), Joensuu, Finland
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12
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Jagroep W, Cramm JM, Denktaș S, Nieboer AP. Behaviour change interventions to promote health and well-being among older migrants: A systematic review. PLoS One 2022; 17:e0269778. [PMID: 35709205 PMCID: PMC9202883 DOI: 10.1371/journal.pone.0269778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 05/27/2022] [Indexed: 11/25/2022] Open
Abstract
Background Whether behaviour change interventions are effective for the maintenance of older migrants’ health and well-being is uncertain. A systematic review was conducted to assess evidence for the capacity of behaviour change techniques (BCTs) to promote the health and well-being of older migrants. Methods Electronic databases (Cochrane CENTRAL, Embase, Ovid MEDLINE and Web of Science) were searched systematically to identify relevant randomised controlled trials, pre–post studies and quasi-experimental studies published before March 2021. Additional articles were identified through citation tracking. Studies examining BCTs used to promote the health and/or well-being of older migrants were eligible. Two independent reviewers used the Behaviour Change Technique Taxonomy version 1 to extract data on BCTs. Data on intervention functions (IFs) and cultural adaption strategies were also extracted. Intervention contents (BCTs, IFs, culture adaption strategies) were compared across effective and ineffective interventions according to health and well-being outcome clusters (anthropometrics, health behaviour, physical functioning, mental health and cognitive functioning, social functioning and generic health and well-being). Results Forty-three studies (23 randomised controlled trials, 13 pre–post studies and 7 quasi-experimental studies) reporting on 39 interventions met the inclusion criteria. Thirteen BCTs were identified as promising for at least one outcome cluster: goal-setting (behaviour), problem-solving, behavioural contract, self-monitoring of behaviour, social support (unspecified), instruction on how to perform the behaviour, information about health consequences, information about social and environmental consequences, demonstration of the behaviour, social comparison, behavioural practice/rehearsal, generalisation of a target behaviour and addition of objects to the environment. Three BCTs (instruction on how to perform the behaviour, demonstration of the behaviour, and social comparison) and two IFs (modelling and training) were identified as promising for all outcome clusters. Conclusions Thirteen distinct BCTs are promising for use in future interventions to optimise health and well-being among older migrants. Future research should focus on the effectiveness of these BCTs (combinations) in various contexts and among different subgroups of older migrants, as well as the mechanisms through which they act. Given the scarcity of interventions in which cultural adaption has been taken into account, future behavioural change interventions should consider cultural appropriateness for various older migrant (sub)groups. Trial registration PROSPERO CRD42018112859.
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Affiliation(s)
- Warsha Jagroep
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
- * E-mail:
| | - Jane M. Cramm
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Semiha Denktaș
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Anna P. Nieboer
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Prevalence, progress, and subgroup disparities in pharmacological antidepressant treatment of those who screen positive for depressive symptoms: A repetitive cross-sectional study in 19 European countries. Lancet Reg Health Eur 2022; 17:100368. [PMID: 35373171 PMCID: PMC8969158 DOI: 10.1016/j.lanepe.2022.100368] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background The European Mental Health Action Plan (EMHAP) 2013–2020 promoted community-based mental health services. One potential success indicator is the provision of antidepressant medication to those needing it. Methods Public data from two surveys (Health Survey for England, UK; Survey of Health, Ageing and Retirement in Europe) covered 19 European countries across EMHAP phases one (2011–2015) and two (2015–2018). People screening positive for depressive symptoms by self-report were included. The primary outcome was antidepressant use: using country-specific weighted regression models, we estimated temporal trends and subgroup disparities in antidepressant receipt, with secondary analysis by country-level measures including healthcare expenditure. Findings Across 37,250 participants, after controlling for age, sex, wealth, and physical disability, antidepressant use (amongst those screening positive) increased significantly in 14/19 countries, with the smallest increase being in Slovenia (adjusted OR[AOR] for trend=1.68[1.20–2.36]) and the highest increase being in Germany (AOR for trend=10.07[7.54–13.46]) and Austria (AOR for trend=10.07[7.32–13.74]). The overall proportion using antidepressants was positively associated with national health expenditure (coefficient=5.43[1.62–9.25]), but not with gross national income per capita or the number of psychiatrists, general practitioners, or psychiatric hospital beds. In 15/19 countries, antidepressants were used less by ≥65-year-olds than 50–64-year-olds, with the smallest differential reported in Luxembourg (AOR=0.70[0.49, 0.98]) and the highest in Germany (AOR=0.28[0.21, 0.37]); this disparity widened in 12/15 countries. Men used antidepressants less than women in 8/19 countries, across phases. In 13/19 countries, people with physical disability were more likely to receive antidepressants, with the smallest gap in Italy (AOR=1.42[1.12–1.80]) and the largest in Israel (AOR=2.34[1.46–3.74]); this disparity narrowed in 5/13 countries. Disparity by wealth was found in 8/19 countries, but its temporal trend varied. Interpretation Usage of antidepressants by those with depressive symptoms has increased, with wide variation between countries and subgroups. Disparities across age, sex, and disability should prompt further research. Funding Medical Research Council (grants MC_PC_17213 and MR/W014386/1), UK National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) East of England, NIHR Cambridge Biomedical Research Centre (BRC-1215-20014).
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Bramajo ON. An Age-Period-Cohort Approach to Analyse Late-Life Depression Prevalence in Six European Countries, 2004-2016. EUROPEAN JOURNAL OF POPULATION = REVUE EUROPEENNE DE DEMOGRAPHIE 2022; 38:223-245. [PMID: 35228766 PMCID: PMC8865500 DOI: 10.1007/s10680-022-09610-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/24/2022] [Indexed: 12/20/2022]
Abstract
Late-life depression is a condition that affects an ever-growing share of the population in ageing societies. While depression prevalence varies across countries for a myriad of reasons, generational factors, expressed in the shared experience of birth cohorts, may also play a part in such differentials. This paper describes the presence of age, period, and cohort (APC) effects in late-life depression prevalence trends (for adults aged 50 and above) for selected countries in Europe, using the Survey of Health and Ageing and Retirement of Europe (SHARE). We analysed six countries during the 2004-2016 period: Denmark, Sweden, and Germany, with a lower baseline prevalence, and Italy, Spain, and France, with a higher baseline prevalence. By applying a set of APC statistical models to visualise linear and nonlinear effects, we found that all countries followed a J-shaped curve when describing the transversal and longitudinal age trajectories of late-life depression. We also found a combination of nonlinear effects present in Germany, France and Sweden in males, indicating that younger male cohorts had a higher relative risk of depression. In females, we found nonlinear cohort effects, indicating that younger and older cohorts presented a higher risk of depression in Sweden and Germany and a lower risk in Spain. The presence of an increased risk for younger male cohorts may be indicative of a new trend in some countries, which may reduce the sex gap in prevalence. Future analysis should focus on the causes and mechanisms that lead to differential risks across cohorts.
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Reich H, Zürn D, Mewes R. Engaging Turkish Immigrants in Psychotherapy: Development and Proof-of-Concept Study of a Culture-Tailored, Web-Based Intervention. CLINICAL PSYCHOLOGY IN EUROPE 2021; 3:e5583. [PMID: 36398285 PMCID: PMC9667227 DOI: 10.32872/cpe.5583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 08/25/2021] [Indexed: 11/25/2022] Open
Abstract
Background Culturally tailored interventions can increase the engagement and the success rate of psychotherapy in immigrant and ethnic minority patients. In this regard, the integration of the patients' illness beliefs is a key element. Applying principles of Motivational and Ethnographic Interviewing, we developed a culture-tailored, web-based intervention to facilitate engagement of Turkish immigrant inpatients in psychotherapy. Method The different aspects of the engagement intervention development are described and its acceptance and usefulness were tested in a proof-of-concept trial with an experimental control group design (active control condition: progressive muscle relaxation) in a sample of Turkish immigrant inpatients in Germany (N = 26). Illness perception, illness-related locus of control, and self-efficacy were assessed pre and post intervention. Results The engagement intervention was rated better than the control condition (p = .002) and in particular, participants felt better prepared for therapy after working with it (p = .013). By working with the engagement intervention, self-efficacy increased (p = .034) and external-fatalistic control beliefs diminished (p = .021). However, half of the participants needed assistance in using the computer and web-based interventions. Conclusion The developed intervention provides a first step towards feasible culture-tailored psychotherapeutic elements that can be integrated into routine clinical care. The first results regarding acceptance and usefulness are promising.
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Affiliation(s)
- Hanna Reich
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University of Marburg, Marburg, Germany
- Depression Research Centre of the German Depression Foundation, Department for Psychiatry, Psychosomatics and Psychotherapy, Goethe University, Frankfurt, Germany
| | - Daniela Zürn
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University of Marburg, Marburg, Germany
| | - Ricarda Mewes
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University of Marburg, Marburg, Germany
- Outpatient Unit for Research, Teaching and Practice, Faculty of Psychology, University of Vienna, Vienna, Austria
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Health Patterns among Migrant and Non-Migrant Middle- and Older-Aged Individuals in Europe-Analyses Based on Share 2004-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212047. [PMID: 34831800 PMCID: PMC8622058 DOI: 10.3390/ijerph182212047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/11/2021] [Accepted: 11/15/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION European populations are becoming older and more diverse. Little is known about the health differences between the migrant and non-migrant elderly in Europe. The aim of this paper was to analyse changes in the health patterns of middle- and older-aged migrant and non-migrant populations in Europe from 2004 to 2017, with a specific focus on differences in age and gender. We analysed changes in the health patterns of older migrants and non-migrants in European countries from 2004 to 2017. METHOD Based on data from the Survey of Health, Ageing and Retirement in Europe (6 waves; 2004-2017; n = 233,117) we analysed three health indicators (physical functioning, depressive symptoms, and self-rated health). Logistic regression models for complex samples were calculated. Interaction terms (wave * migrant * gender * age) were used to analyse gender and age differences and the change over time. RESULTS Middle- and older-aged migrants in Europe showed significantly higher rates of depressive symptoms, lower self-rated health, and a higher proportion of limitations on general activities compared to non-migrants. However, different time trends were observed. An increasing health gap was identified in the physical functioning of older males. Narrowing health gaps over time were observed in women. DISCUSSION An increasing health gap in physical functioning in men is evidence of cumulative disadvantage. In women, evidence points towards the hypothesis of aging-as-leveler. These different results highlight the need for specific interventions focused on healthy ageing in elderly migrant men.
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Hedna K, Hensing G, Skoog I, Fastbom J, Waern M. Sociodemographic and gender determinants of late-life suicide in users and non-users of antidepressants. Eur J Public Health 2021; 30:958-964. [PMID: 32653913 PMCID: PMC7536256 DOI: 10.1093/eurpub/ckaa114] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background The treatment of depression is a main strategy for suicide prevention in older adults. Our aim was to examine factors related to suicide in older adults (75+) with and without antidepressant (AD) therapy. Methods A national population-based register study, including all Swedish residents aged ≥75 years between 2006 and 2014 (N = 1 413 806). A nested case–control design was used to investigate sociodemographic factors associated with suicide among users and non-users of ADs. Risk estimates were calculated in adjusted conditional logistic regression models for the entire cohort and by gender. Results In all, 1305 individuals died by suicide (70% men). The suicide rate in men who used ADs was over four times higher than women with such treatment. Being unmarried was a risk factor for suicide in men but not in women. Being born outside of Nordic countries was associated with increased suicide risk; a 3-fold risk increase was observed in non-Nordic women without AD treatment. Lower suicide risk was observed in blue-collar women who used ADs, whereas a higher risk was found in blue-collar men who did not. Conclusions Our differential findings on factors associated with suicide can offer clues for gender-specific preventive strategies that go beyond the healthcare sphere.
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Affiliation(s)
- Khedidja Hedna
- Department of Psychiatry and Neurochemistry, AgeCap Center, Gothenburg University, Gothenburg, Sweden.,Statistikkonsulterna Jostat & Mr Sample AB, Gothenburg, Sweden
| | - Gunnel Hensing
- Section of Epidemiology and Social Medicine, Department of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, AgeCap Center, Gothenburg University, Gothenburg, Sweden.,Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Västra Götaland, Gothenburg, Sweden
| | - Johan Fastbom
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Margda Waern
- Department of Psychiatry and Neurochemistry, AgeCap Center, Gothenburg University, Gothenburg, Sweden.,Psychosis Clinic, Sahlgrenska University Hospital, Gothenburg, Västra Götaland, Sweden
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Kieseppä V, Holm M, Jokela M, Suvisaari J, Gissler M, Lehti V. Depression and anxiety disorders among immigrants living in Finland: Comorbidity and mental health service use. J Affect Disord 2021; 287:334-340. [PMID: 33813253 DOI: 10.1016/j.jad.2021.03.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The aims of this study were to (1) compare differences in psychiatric comorbidity of depression and anxiety disorders between immigrants and native Finns and to (2) compare differences in the intensity of psychiatric care received by different immigrant groups and Finnish-born controls with depression and/or anxiety disorders. METHODS The study uses registered-based data, which includes all immigrants living in Finland at the end of 2010 and matched Finnish-born controls. For this study, we selected individuals who had received a diagnosis of depression and/or an anxiety disorder during the follow-up (2011-2015) (immigrants n = 6542, Finnish-born controls n = 9281). We compared differences in comorbidity between the immigrants and the Finnish-born controls using chi-squared tests. Multinomial logistic regression was used to predict psychiatric treatment intensity by immigrant status, region of origin, and other background factors. RESULTS In both diagnosis groups, Finnish-born participants exhibited greater comorbidity of other psychiatric disorders. Immigrants more often received lower intensity treatment and less often higher intensity treatment. These differences were most striking among those from Eastern Europe, the Middle East, and Africa. LIMITATIONS We did not have the information on the perceived need for the services, which limits us from drawing further conclusions about the mechanisms behind the observed patterns. CONCLUSIONS Immigrants in Finland receive less intensive treatment for depression and anxiety disorders compared to the Finnish-born population. Since lower symptom levels can unlikely alone explain these differences, they could reflect a need for improvement in the psychiatric services for immigrants.
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Affiliation(s)
- Valentina Kieseppä
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.
| | - Minna Holm
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Markus Jokela
- Department of Psychology and Logopedics, Medicum, University of Helsinki, Helsinki, Finland
| | - Jaana Suvisaari
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mika Gissler
- Information Services Department, Finnish Institute for Health and Welfare, Helsinki, Finland; Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Solna, Sweden
| | - Venla Lehti
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Moran JK, Bretz J, Winkler J, Gutwinski S, Brandl EJ, Schouler-Ocak M. The Differential Impact of Lockdown Measures Upon Migrant and Female Psychiatric Patients - A Cross-Sectional Survey in a Psychiatric Hospital in Berlin, Germany. Front Psychiatry 2021; 12:642784. [PMID: 34122174 PMCID: PMC8192805 DOI: 10.3389/fpsyt.2021.642784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/28/2021] [Indexed: 01/07/2023] Open
Abstract
The COVID-19 pandemic could have major effects on already vulnerable individuals with psychiatric disorders. It is important to assess how different patient groups respond to stress related to the pandemic, and what additional factors influence it, including family-related stress, migration background, and sex. We conducted a survey in a sample of 294 psychiatric patients in a large outpatient clinic in Berlin, measuring level of distress in relation to COVID-19 lockdown as well as family-related distress. We also measured potential influencing factors such as media consumption and medical support. In the migration background group, we found that women had more lockdown related psychological distress than men. This was not apparent in those patients with a German background. We found that females were more strongly affected by family-related distress, particularly those with a migration background. People with PTSD were most strongly affected by family-related distress, whereas people with psychotic disorders and addiction reported the least distress. There were no effects of media consumption. There were no differences in ability to abide by the lockdown related restrictions across diagnoses. Our results support earlier findings on differential vulnerability of diagnostic groups to these stressors. Thus, clinicians can optimize treatment by taking family-related stressors into account particularly for females and people with a migrant background.
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Affiliation(s)
- James K Moran
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Joachim Bretz
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Johanna Winkler
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan Gutwinski
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Eva J Brandl
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Meryam Schouler-Ocak
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Rapp MA, Tschorn M, Supprian T, Thomas C, Kreisel S, Benninghoff J, Schumann G, Heinz A. [Potentials and limits of aging cohort studies for geriatric psychiatry]. DER NERVENARZT 2020; 92:219-227. [PMID: 33242121 DOI: 10.1007/s00115-020-01035-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/30/2020] [Indexed: 11/29/2022]
Abstract
The sizeable number of population-based cohort studies of aging in Germany have provided highly valuable contributions for the specification of risk factors and predictors for frequent mental disorders in old age, especially dementia and depression. The results from these cohort studies enable the specification of mechanisms for the development of and preventative interventions for common mental disorders in old age. On the other hand, there is a significant paucity of clinical cohort studies investigating disease trajectories and possible markers for specific individualized interventions of frequent mental disorders in old age. In this article, we report selected key findings from cohort studies of aging and discuss novel approaches for the integration and harmonization of population-based and clinical cohort studies.
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Affiliation(s)
- M A Rapp
- Sozial- und Präventivmedizin, Department Sport- und Gesundheitswissenschaften, Strukturbereich Kognitionswissenschaften, Universität Potsdam, Am Neuen Palais 10, 14469, Potsdam, Deutschland.
| | - M Tschorn
- Sozial- und Präventivmedizin, Department Sport- und Gesundheitswissenschaften, Strukturbereich Kognitionswissenschaften, Universität Potsdam, Am Neuen Palais 10, 14469, Potsdam, Deutschland
| | - T Supprian
- Abteilung Gerontopsychiatrie, LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Deutschland
| | - C Thomas
- Klinik für Psychiatrie und Psychotherapie für Ältere, Klinikum Stuttgart, Stuttgart, Deutschland
| | - S Kreisel
- Abteilung Gerontopsychiatrie, Campus Bielefeld-Bethel, Universitätsklinikum Ostwestfalen-Lippe, Bielefeld, Deutschland
| | - J Benninghoff
- Zentrum für Altersmedizin und Entwicklungsstörungen, kbo-Isar-Amper-Klinikum München-Ost, Haar, Deutschland
| | - G Schumann
- Klinik für Psychiatrie und Psychotherapie, PONS Zentrum, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - A Heinz
- Klinik für Psychiatrie und Psychotherapie, PONS Zentrum, Charité Universitätsmedizin Berlin, Berlin, Deutschland
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21
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EPA guidance on cultural competence training. Eur Psychiatry 2020; 30:431-40. [DOI: 10.1016/j.eurpsy.2015.01.012] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 01/30/2015] [Accepted: 01/30/2015] [Indexed: 11/22/2022] Open
Abstract
AbstractThe stress of migration as well as social factors and changes related to the receiving society may lead to the manifestation of psychiatric disorders in vulnerable individuals after migration. The diversity of cultures, ethnicities, races and reasons for migration poses a challenge for those seeking to understand how illness is experienced by immigrants whose backgrounds differ significantly from their clinicians. Cultural competence represents good clinical practice and can be defined as such that a clinician regards each patient in the context of the patient's own culture as well as from the perspective of the clinician's cultural values and prejudices. The EPA Guidance on cultural competence training outlines some of the key issues related to cultural competence and how to deal with these. It points out that cultural competence represents a comprehensive response to the mental health care needs of immigrant patients and requires knowledge, skills and attitudes which can improve the effectiveness of psychiatric treatment. To reach these aims, both individual and organizational competence are needed, as well as teaching competence in terms of educational leadership. The WPA Guidance on Mental Health and Mental Health Care for Migrants and the EPA Guidance on Mental Health Care for Migrants list a series of recommendations for policy makers, service providers and clinicians; these are aimed at improving mental health care for immigrants. The authors of this paper would like to underline these recommendations and, focusing on cultural competency and training, believe that they will be of positive value.
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22
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Zhao L, Liang C, Gu D. Mobile Social Media Use and Trailing Parents' Life Satisfaction: Social Capital and Social Integration Perspective. Int J Aging Hum Dev 2020; 92:383-405. [PMID: 32098476 DOI: 10.1177/0091415020905549] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In recent years, a special group of elderly migrants emerged in some developing countries, namely "trailing parents," who migrated with adult children in their later years. Lots of developing countries such as China have an increasing number of old people using mobile social media for social interaction, information, and entertainment. Based on social capital theory, we developed a research model and investigated the relationship between mobile social media use (MSMU) and social capital, social integration, and life satisfaction of trailing parents. We completed an empirical study by collecting 244 valid samples. The results show that MSMU has a positive impact on trailing parents' life satisfaction, and bonding social capital, bridging social capital and social integration are all important predictors of trailing parents' life satisfaction. Furthermore, social capital and social integration play an important chain mediation role in the relationship between MSMU and trailing parents' life satisfaction.
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Affiliation(s)
- Lei Zhao
- 12513 School of Management, Hefei University of Technology, Hefei, Anhui, China.,Wendian College, Anhui University, Hefei, Anhui, China
| | - Changyong Liang
- 12513 School of Management, Hefei University of Technology, Hefei, Anhui, China
| | - Dongxiao Gu
- 12513 School of Management, Hefei University of Technology, Hefei, Anhui, China
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23
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Affiliation(s)
- Laia Bécares
- School of Education and Social Work, University of Sussex, Falmer, UK
| | - Dharmi Kapadia
- School of Social Sciences, University of Manchester, Manchester, UK
| | - James Nazroo
- School of Social Sciences, University of Manchester, Manchester, UK
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24
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Huang Z, Kohler IV, Kämpfen F. A Single-Item Visual Analogue Scale (VAS) Measure for Assessing Depression Among College Students. Community Ment Health J 2020; 56:355-367. [PMID: 31531784 DOI: 10.1007/s10597-019-00469-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 09/12/2019] [Indexed: 02/04/2023]
Abstract
There is an increased need for efficient, low-cost methods to collect information on a range of widely prevalent mental health outcomes in the general population that can be administered outside of clinical settings. We evaluate the validity of a single-item Visual Analogue Scale (VAS) for assessing the presence and severity of depression and compare its performance with the Patient Health Questionnaire (PHQ-9) depression scale using a large non-clinical sample (N = 1816) of college students from Switzerland. The VAS scale is strongly correlated with the PHQ-9 total score (0.61) and its 9 individual items (ranging from 0.19 to 0.67). ROC analysis shows that the VAS scale has high accuracy for detecting the presence and different levels (mild to severe) of depression corresponding to PHQ-9 cutoffs. The VAS depression scale represents a simple, easily implementable instrument that is suitable for mental health research in common settings and larger population-based studies.
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Affiliation(s)
- Zhiyong Huang
- Southwestern University of Finance and Economics, Chengdu, China
| | - Iliana V Kohler
- Department of Sociology, University of Pennsylvania, Philadelphia, USA.,Population Studies Center, University of Pennsylvania, Philadelphia, USA
| | - Fabrice Kämpfen
- Population Studies Center, University of Pennsylvania, Philadelphia, USA. .,Department of Economics, HEC, University of Lausanne, Lausanne, Switzerland.
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25
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Guo M, Stensland M, Li M, Dong X, Tiwari A. Is Migration at Older Age Associated With Poorer Psychological Well-Being? Evidence from Chinese Older Immigrants in the United States. THE GERONTOLOGIST 2019; 59:865-876. [PMID: 29931059 PMCID: PMC6857695 DOI: 10.1093/geront/gny066] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The migrating age of an individual has far-reaching implications for their acculturation experience, social integration, and well-being. This study addressed two questions: Is migrating at older age associated with poorer psychological well-being? If so, what factors account for such differences? RESEARCH DESIGN AND METHODS Using data of 3,138 Chinese elderly people in Chicago, we compared the levels of depression and quality of life among individuals who migrated in young adulthood (before 35), adulthood (35-49), midlife (50-64), and later life (65+). Negative binominal and logistic regressions were performed to examine the associations between age at migration and the two outcomes, controlling for demographics and four sets of explanatory variables (socioeconomic status, health status, acculturation level, and family/social relations). RESULTS The findings revealed mixed results. Migrating in later life was associated with more depressive symptoms, but also a higher chance of reporting good quality of life. Late-life immigrants' greater depression was partially contributed to their low income, lack of access to health care, poor physical health, and weak social relations. In contrast, regardless of the explanatory variables, migrating at middle age was associated with lower quality of life. DISCUSSION AND IMPLICATIONS Acknowledging that the older immigrant population is segmented with unique susceptibilities improves understanding of heterogeneity among the older immigrant populations and allows for targeted intervention. Gerontological practitioners should include migration history during their intakes and more actively screen for depression with socially isolated Chinese older immigrants who migrated at a later age.
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Affiliation(s)
- Man Guo
- School of Social Work, University of Iowa
| | | | - Mengting Li
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
| | - Xinqi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey
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26
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Yang FJ. Is childhood migration a mental health risk? Exploring health behaviors and psychosocial resources as pathways using the cross-sectional Canadian Community Health Survey. SOCIAL SCIENCE RESEARCH 2019; 83:102303. [PMID: 31422841 DOI: 10.1016/j.ssresearch.2019.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 04/07/2019] [Accepted: 04/18/2019] [Indexed: 06/10/2023]
Abstract
Drawing on the Stress Process Model, this study investigates the effect of early migration on health behaviors and psychosocial resources. Further, I consider whether health behaviors and psychosocial processes lead to higher psychological distress for childhood immigrants in adulthood. Cross-sectional data from the Canadian Community Health Survey-Mental Health 2012 (N = 4282) reveal that compared to adult immigrants, childhood immigrants are not only four times more likely to use drugs, but also experience greater interpersonal strain. However, health behaviors such as these contribute less to psychological distress than do psychosocial resources. Additionally, longer duration of migration is found to reduce psychological distress when controlling for age at migration, thus suggesting the migrant health literature should examine age-salient life challenges at the time of migration, instead of continuing to use duration of migration as a proxy for negative acculturation.
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Qiao YM, Lu YK, Yan Z, Yao W, Pei JJ, Wang HX. Reciprocal associations between job strain and depression: A 2-year follow-up study from the Survey of Health, Ageing and Retirement in Europe. Brain Behav 2019; 9:e01381. [PMID: 31448560 PMCID: PMC6749471 DOI: 10.1002/brb3.1381] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/23/2019] [Accepted: 07/18/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND A growing number of people suffered from depression. This study examined the depression prevalence in workers across 10 European countries plus Israel and the reciprocal associations between job strain and depression. METHODS The study population consisted of 7,879 workers aged 50-63 years at baseline (2004) from the Survey of Health, Ageing, and Retirement in Europe (SHARE). Job demands (physical or psychosocial) and job control variables were derived from the Job Content Questionnaire (JCQ). Two 4-category job strains (physical and psychosocial) were obtained based on the cross-tabulation of these dichotomized demands and control variables. There were 4,284 depression-free, 3,259 high physical strain-free and 3,195 high psychosocial strain-free participants at baseline who were followed up for 2 years to detect incident depression, high physical job strain, or high psychosocial strain, respectively. The reciprocal associations between job strain and depression were analyzed by multivariate logistic regression and multivariate multilevel logistic regression adjusting for potential confounders. RESULTS The prevalence of depression varied from the lowest 12.5% in Germany to the highest 27.2% in France. Compared to individuals with low strain, a significantly higher risk of depression were found in individuals with high physical strain (OR = 1.39) and high psychosocial strain (OR = 1.55), after adjusting for potential confounders. Depression at baseline was not significantly associated with subsequent high job strain. Similar results were observed from multilevel models that took into consideration of the potential country-level influences. CONCLUSIONS The prevalence of depression varies across countries in Europe. Avoiding high job strain may be an effective preventive strategy to prevent depression epidemic.
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Affiliation(s)
- Ya-Mei Qiao
- Department of Occupational and Environmental Health Sciences, College of Public health, Zhengzhou University, Zhengzhou, China
| | - Ya-Ke Lu
- Department of Occupational and Environmental Health Sciences, College of Public health, Zhengzhou University, Zhengzhou, China
| | - Zhen Yan
- Department of Occupational and Environmental Health Sciences, School of Public Health, Hainan Medical University, Haikou, China
| | - Wu Yao
- Department of Occupational and Environmental Health Sciences, College of Public health, Zhengzhou University, Zhengzhou, China
| | - Jin-Jing Pei
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Hui-Xin Wang
- Department of Occupational and Environmental Health Sciences, College of Public health, Zhengzhou University, Zhengzhou, China.,Stress Research Institute, Stockholm University, Stockholm, Sweden.,Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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28
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Health of migrant care-givers across Europe: what is the role of origin and welfare state context? AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18001599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractAcross Europe a rising number of migrants are reaching higher ages. As old age is related to care dependency, care-giving within migrant families is becoming more important. To date, little research has focused on health outcomes for migrant care-givers. Theories and empirical evidence suggest differences in the relationship of care-giving and health between migrants and non-migrants due to differences in support, income, norms and values. Furthermore, across Europe the degree of formal care supply and the obligation to provide informal care vary considerably and presumably lead to different health outcomes of care-giving in different countries. Based on data from the Survey of Health, Ageing and Retirement in Europe (Waves 1, 2, 4, 5 and 6) and the English Longitudinal Study of Ageing (Waves 2–6), this paper studies the relationship between informal care-giving inside the household and health for migrant and non-migrant care-givers across Europe and analyses changes in health. In most countries migrant care-givers are in worse self-perceived and mental health compared to non-migrant care-givers. When controlling for important influences no differences in the relationship between health and care-giving for migrants and non-migrants can be found. Moreover, care-giving deteriorates mental health irrespective of origin. The country models showed that for non-migrants care-giving is most detrimental in Southern welfare states whereas for migrants care-giving is also burdening in Nordic welfare states.
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29
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Gruebner O, Rapp MA, Adli M, Kluge U, Galea S, Heinz A. Cities and Mental Health. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 114:121-127. [PMID: 28302261 DOI: 10.3238/arztebl.2017.0121] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 07/19/2016] [Accepted: 01/11/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND More than half of the global population currently lives in cities, with an increasing trend for further urbanization. Living in cities is associated with increased population density, traffic noise and pollution, but also with better access to health care and other commodities. METHODS This review is based on a selective literature search, providing an overview of the risk factors for mental illness in urban centers. RESULTS Studies have shown that the risk for serious mental illness is generally higher in cities compared to rural areas. Epidemiological studies have associated growing up and living in cities with a considerably higher risk for schizophrenia. However, correlation is not causation and living in poverty can both contribute to and result from impairments associated with poor mental health. Social isolation and discrimination as well as poverty in the neighborhood contribute to the mental health burden while little is known about specific interactions between such factors and the built environment. CONCLUSION Further insights on the interaction between spatial heterogeneity of neighborhood resources and socio-ecological factors is warranted and requires interdisciplinary research.
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Affiliation(s)
- Oliver Gruebner
- Department of Epidemiology and Health Monitoring of the Robert Koch Institute, Berlin; Social and Preventive Medicine, Universität Potsdam; Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin; School of Public Health, Boston University, MA, USA; Berlin Institute for Integration and Migration Research (BIM), Humboldt University of Berlin
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30
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Walkden G, Anderson E, Vink M, Tilling K, Howe L, Ben-Shlomo Y. Frailty in older-age European migrants: Cross-sectional and longitudinal analyses of the Survey of Health, Aging and Retirement in Europe (SHARE). Soc Sci Med 2018; 213:1-11. [DOI: 10.1016/j.socscimed.2018.07.033] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 04/01/2018] [Accepted: 07/19/2018] [Indexed: 11/29/2022]
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31
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Reich H, Rief W, Brähler E, Mewes R. Cross-cultural validation of the German and Turkish versions of the PHQ-9: an IRT approach. BMC Psychol 2018; 6:26. [PMID: 29871664 PMCID: PMC5989477 DOI: 10.1186/s40359-018-0238-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 05/22/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Patient Health Questionnaire's depression module (PHQ-9) is a widely used screening tool to assess depressive disorders. However, cross-linguistic and cross-cultural validation of the PHQ-9 is mostly lacking. This study investigates whether scores on the German and Turkish versions of the PHQ-9 are comparable. METHODS Data from Germans without a migration background (German version, n = 1670) and Turkish immigrants in Germany (either German or Turkish version, n = 307) were used. Differential Item Functioning (DIF) was assessed using Item Response Theory (IRT) models. RESULTS Several items of the PHQ-9 were found to exhibit DIF related to language or ethnicity, e.g. 'sleep problems', 'appetite changes' and 'anhedonia'. However, PHQ-9 sum scores were found to be unbiased, i.e., DIF had no notable impact on scale levels. CONCLUSIONS PHQ-9 sum scores can be compared between Turkish immigrants and Germans without a migration background without any adjustments, regardless of whether they complete the German or the Turkish version.
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Affiliation(s)
- Hanna Reich
- Department of Psychology, University of Marburg, Marburg, Germany
- Institute of Medical Psychology, Justus-Liebig-University, Gießen, Germany
| | - Winfried Rief
- Department of Psychology, University of Marburg, Marburg, Germany
| | - Elmar Brähler
- Institute of Medical Psychology, Medical School, University of Leipzig, Leipzig, Germany
- Clinic and Policlinic for Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Ricarda Mewes
- Department of Psychology, University of Marburg, Marburg, Germany
- Outpatient Unit for Research, Teaching and Practice, Faculty of Psychology, University of Vienna, Renngasse 6-8, 1010 Vienna, Austria
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32
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Reus-Pons M, Mulder CH, Kibele EUB, Janssen F. Differences in the health transition patterns of migrants and non-migrants aged 50 and older in southern and western Europe (2004-2015). BMC Med 2018; 16:57. [PMID: 29681241 PMCID: PMC5911969 DOI: 10.1186/s12916-018-1044-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 03/26/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Most previous research on migrant health in Europe has taken a cross-sectional perspective, without a specific focus on the older population. Having knowledge about inequalities in health transitions over the life course between migrants and non-migrants, including at older ages, is crucial for the tailoring of policies to the demands of an ageing and culturally diverse society. We analyse differences in health transitions between migrants and non-migrants, specifically focusing on the older population in Europe. METHODS We used longitudinal data on migrants and non-migrants aged 50 and older in 10 southern and western European countries from the Survey of Health, Ageing and Retirement in Europe (2004-2015). We applied multinomial logistic regression models of experiencing health deterioration among individuals in good health at baseline, and of experiencing health improvement among individuals in poor health at baseline, separately by sex, in which migrant status (non-migrant, western migrant, non-western migrant) was the main explanatory variable. We considered three dimensions of health, namely self-rated health, depression and diabetes. RESULTS At older ages, migrants in Europe were at higher risk than non-migrants of experiencing a deterioration in health relative to remaining in a given state of self-rated health. Western migrants had a higher risk than non-migrants of becoming depressed, while non-western migrants had a higher risk of acquiring diabetes. Among females only, migrants also tended to be at lower risk than non-migrants of experiencing an improvement in both overall and mental health. Differences in the health transition patterns of older migrants and non-migrants remained robust to the inclusion of several covariates, including education, job status and health-related behaviours. CONCLUSIONS Our findings indicate that, in addition to having a health disadvantage at baseline, older migrants in Europe were more likely than older non-migrants to have experienced a deterioration in health over the study period. These results raise concerns about whether migrants in Europe are as likely as non-migrants to age in good health. We recommend that policies aiming to promote healthy ageing specifically address the health needs of the migrant population, thereby distinguishing migrants from different backgrounds.
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Affiliation(s)
- Matias Reus-Pons
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Clara H. Mulder
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
| | | | - Fanny Janssen
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
- Netherlands Interdisciplinary Demographic Institute, The Hague, The Netherlands
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Müller MJ, Koch E. Gender Differences in Stressors Related to Migration and Acculturation in Patients with Psychiatric Disorders and Turkish Migration Background. J Immigr Minor Health 2018; 19:623-630. [PMID: 27026345 DOI: 10.1007/s10903-016-0408-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Migration, acculturation, and psychiatric disorders may cause stress and adaptation processes differently in men and women, but empirical research is scarce. In a retrospective study n = 62 Turkish migrants and n = 62 native German inpatients with depressive or anxiety disorders, matched for age, gender, and diagnoses, were compared using a 10-item instrument for the assessment of migration- and acculturation related stressors (MIGSTR10). Gender differences in the prevalence of stressors and in the total sum of stressors were calculated and compared between migrants and indigenous patients. Results showed a higher global stress level in migrants and in women than in men with migration background. Regarding single stressors, the perceived loss of status was significantly more prevalent and more pronounced in men than in women (P < 0.05) whereas guilt feelings were more severe in women with Turkish migration background compared to men (P < 0.05). Gender differences of perceived stress should be taken into account in migration and acculturation research.
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Affiliation(s)
- Matthias Johannes Müller
- Faculty of Medicine, University of Giessen, Giessen, Germany.
- Vitos Clinical Centre for Psychiatry and Psychotherapy Giessen-Marburg, Licher Strasse 106, 35394, Giessen, Germany.
| | - Eckhardt Koch
- Vitos Clinical Centre for Psychiatry and Psychotherapy Giessen-Marburg, Licher Strasse 106, 35394, Giessen, Germany
- Institute of European Ethnology and Cultural Studies, University of Marburg, Marburg, Germany
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Abstract
As the migrant workers of the 1960s and 1970s age in place, many countries are facing caring for increasing numbers of older migrants, many of whom have complex health and social care needs. By applying a qualitative case study approach, of a grassroots disability resource center that works with older migrants, this article critically explores the social policy debates that are focused on older migrants in the Black and Minority Ethnic community. A number of themes have emerged, including the impact of changing family structure, difficulties with accessing services, and increased isolation. In addition, there are also examples of older migrants activtly engaged in building communities and supporting others, defying the stereotypes of vulnerable older migrants being a burden on the state. This article argues for politicians and social policy makers to refocus on the new challenges that are emerging in the older migrants of the Black and Minority Ethnic community.
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Affiliation(s)
- Younus Khan
- Pukar Disability Resource Centre, Preston, Lancashire, UK
| | - Elizabeth Caldwell
- School of Art, Design and Architecture, The University of Huddersfield, Queensgate, UK
| | - Jamie P. Halsall
- School of Human and Health Sciences, The University of Huddersfield, Queensgate, UK
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Acculturation and other risk factors of depressive disorders in individuals with Turkish migration backgrounds. BMC Psychiatry 2017; 17:264. [PMID: 28724369 PMCID: PMC5517803 DOI: 10.1186/s12888-017-1430-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 07/13/2017] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Acculturation is a long-term, multi-dimensional process occurring when subjects of different cultures stay in continuous contact. Previous studies have suggested that elevated rates of depression among different migrant groups might be due to patterns of acculturation and migration related risk factors. This paper focused on prevalence rates of depressive disorders and related risk factors among individuals with Turkish migration backgrounds. METHODS A population-based sample of 662 individuals with Turkish migration backgrounds were interviewed by bilingual interviewers using a standardised diagnostic interview for DSM-IV-TR and ICD-10 diagnoses (CIDI DIA-X Version 2.8). Associations between 12-month prevalence rates of depressive disorders with potential risk factors were assessed, including gender, age, socioeconomic status, acculturation status and migration status. RESULTS 12-month prevalence rates of any depressive disorder were 29.0%, 14.4% of major depressive disorder (MDD) and 14.7% of dysthymia. Older age and low socioeconomic status were most consistently related to higher risks of depressive disorders. Acculturation status showed associations with subtypes of depressive disorder. Associations differed between men and women. Symptom severity of MDD was linked to gender, with females being more affected by severe symptoms. CONCLUSION The prevalence of depressive disorders is high in individuals with Turkish migration backgrounds, which can be partly explained by older age, low socioeconomic status and acculturation pressures. Only a limited number of risk factors were assessed. Acculturation in particular is a complex process which might not be sufficiently represented by the applied measures. Further risk factors have to be identified in representative samples of this migrant group.
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Dingoyan D, Schulz H, Kluge U, Penka S, Vardar A, von Wolff A, Strehle J, Wittchen HU, Koch U, Heinz A, Mösko M. Lifetime prevalence of mental disorders among first and second generation individuals with Turkish migration backgrounds in Germany. BMC Psychiatry 2017; 17:177. [PMID: 28490323 PMCID: PMC5425978 DOI: 10.1186/s12888-017-1333-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 04/24/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This paper focuses on the lifetime prevalence of mental disorders in individuals with Turkish migration backgrounds in Germany, as there is a lack of reliable epidemiological data on this subject. METHODS In total, 662 adults with Turkish migration backgrounds were interviewed in Hamburg and Berlin by trained, bilingual interviewers using the computerized Composite International Diagnostic Interview (CIDI DIA-X Version 2.8) to assess diagnoses according to the DSM-IVTR. RESULTS The analyses showed a weighted lifetime prevalence of 78.8% for any mental disorder, 21.6% for more than one and 7.3% for five or more disorders. Any mood disorder (41.9%), any anxiety disorder (35.7%) and any somatoform disorder/syndrome (33.7%) had the highest prevalences. Despite the sociodemographic differences between the first and second generations, there were no significant differences in the lifetime prevalence between generations, with the exception of any bipolar disorder. Female gender, older age and no current partnership were significantly associated with the occurrence of any mood disorder. CONCLUSIONS Overall, the results indicate a high lifetime prevalence in individuals with Turkish migration backgrounds in Germany. These initial data are highly relevant to the German clinical and psychosocial healthcare system; however, the methodological limitations and potential biases should be considered when interpreting the results.
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Affiliation(s)
- Demet Dingoyan
- Department of Medical Psychology, Study group on Psychosocial Migration Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Building W(est)26, 20246, Hamburg, Germany.
| | - Holger Schulz
- 0000 0001 2180 3484grid.13648.38Department of Medical Psychology, Study group on Psychosocial Migration Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Building W(est)26, 20246 Hamburg, Germany
| | - Ulrike Kluge
- 0000 0001 2218 4662grid.6363.0Clinic for Psychiatry and Psychotherapy, Charité – University Medicine Berlin, Campus Mitte, Berlin, Germany ,0000 0001 2248 7639grid.7468.dBerlin Institute for Integration and Migration Research, Department Migration, Mental and Physical Health and Health Promotion, Faculty of Humanities and Social Sciences, Humboldt University Berlin, Berlin, Germany
| | - Simone Penka
- 0000 0001 2218 4662grid.6363.0Clinic for Psychiatry and Psychotherapy, Charité – University Medicine Berlin, Campus Mitte, Berlin, Germany
| | - Azra Vardar
- 0000 0001 2218 4662grid.6363.0Clinic for Psychiatry and Psychotherapy, Charité – University Medicine Berlin, Campus Mitte, Berlin, Germany
| | - Alessa von Wolff
- 0000 0001 2180 3484grid.13648.38Department of Medical Psychology, Study group on Psychosocial Migration Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Building W(est)26, 20246 Hamburg, Germany
| | - Jens Strehle
- 0000 0001 2111 7257grid.4488.0Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Hans-Ulrich Wittchen
- 0000 0001 2111 7257grid.4488.0Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Uwe Koch
- 0000 0001 2180 3484grid.13648.38Department of Medical Psychology, Study group on Psychosocial Migration Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Building W(est)26, 20246 Hamburg, Germany
| | - Andreas Heinz
- 0000 0001 2218 4662grid.6363.0Clinic for Psychiatry and Psychotherapy, Charité – University Medicine Berlin, Campus Mitte, Berlin, Germany ,0000 0001 2248 7639grid.7468.dBerlin Institute for Integration and Migration Research, Department Migration, Mental and Physical Health and Health Promotion, Faculty of Humanities and Social Sciences, Humboldt University Berlin, Berlin, Germany
| | - Mike Mösko
- 0000 0001 2180 3484grid.13648.38Department of Medical Psychology, Study group on Psychosocial Migration Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Building W(est)26, 20246 Hamburg, Germany
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Wang Y, Chen YC, Shen HW, Morrow-Howell N. Neighborhood and Depressive Symptoms: A Comparison of Rural and Urban Chinese Older Adults. THE GERONTOLOGIST 2017; 58:68-78. [DOI: 10.1093/geront/gnx063] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 04/17/2017] [Indexed: 01/08/2023] Open
Affiliation(s)
- Yi Wang
- School of Social Work, Washington University in St. Louis, Missouri
| | - Yu-Chih Chen
- School of Social Work, Washington University in St. Louis, Missouri
| | | | - Nancy Morrow-Howell
- Brown School of Social Work, Friedman Center for Aging, Washington University, St. Louis, Missouri
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Malmusi D, Palència L, Ikram UZ, Kunst AE, Borrell C. Inequalities by immigrant status in depressive symptoms in Europe: the role of integration policy regimes. Soc Psychiatry Psychiatr Epidemiol 2017; 52:391-398. [PMID: 28194503 DOI: 10.1007/s00127-017-1348-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 01/13/2017] [Indexed: 10/17/2022]
Abstract
PURPOSE We aimed to study whether country integration policy models were related to inequalities by immigrant status in depressive symptoms in Europe. METHODS This is a cross-sectional study using data from 17 countries in the sixth wave of the European Social Survey (2012), comparing subjects born either in the country of residence (non-immigrants, N = 28,333) or in a country not classified as "advanced economy" by the IMF (immigrants, N = 2041). Depressive symptoms were assessed with the eight-item version of the Center for Epidemiologic Studies Depression scale. Countries were grouped into three integration policy regimes (inclusive, assimilationist, and exclusionist). Linear regressions were fitted adjusting first by age, sex, and education level, then sequentially by citizenship, perceived discrimination, and socio-economic variables. RESULTS In all integration regimes, immigrants report significantly more depressive symptoms than non-immigrants. The gap is the largest in exclusionist countries (immigrants score 1.16, 95% CI 0.65-1.68, points higher than non-immigrants in the depression scale), followed by assimilationist countries (0.85 and 0.57-1.13) and inclusive countries (0.60 and 0.36-0.84). Financial strain explains all the associations in inclusive countries, most of it in assimilationist countries, but only a small part in exclusionist countries. CONCLUSIONS Across most European countries, immigrants seem to experience more depressive symptoms than the population born in the country, mostly reflecting their poorer socio-economic situation. Inequalities are larger in countries with more restrictive policies. Despite some limitations, this study adds new evidence to suggest that immigrants' health is shaped by integration policies in their host country.
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Affiliation(s)
- Davide Malmusi
- Agència de Salut Pública de Barcelona, IIB-Sant Pau, Plaça Lesseps, 1, 08023, Barcelona, Spain. .,Ciber de Epidemiología y Salud Pública, Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029, Madrid, Spain.
| | - Laia Palència
- Agència de Salut Pública de Barcelona, IIB-Sant Pau, Plaça Lesseps, 1, 08023, Barcelona, Spain.,Ciber de Epidemiología y Salud Pública, Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029, Madrid, Spain
| | - Umar Z Ikram
- Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands
| | - Anton E Kunst
- Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands
| | - Carme Borrell
- Agència de Salut Pública de Barcelona, IIB-Sant Pau, Plaça Lesseps, 1, 08023, Barcelona, Spain.,Ciber de Epidemiología y Salud Pública, Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029, Madrid, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader, 88, 08003, Barcelona, Spain
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Liu X, Cook G, Cattan M. Support networks for Chinese older immigrants accessing English health and social care services: the concept of Bridge People. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:667-677. [PMID: 27188976 DOI: 10.1111/hsc.12357] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/08/2016] [Indexed: 06/05/2023]
Abstract
As Chinese immigrants in the United Kingdom age, they experience an increasing need to access health and care services. It has, however, been reported that older Chinese immigrants have difficulties in accessing these services. This study explored the experiences of this population in using health and care services and the strategies that they adopted to address their difficulties. A grounded theory method with a two-staged research design was used. Stage 1 explored the participants' experiences of ageing and use of health and social care services through focus group interviews. Stage 2 investigated the strategies individuals used to support access to and use of services through individual interviews. Forty-four older Chinese people and 15 supporters participated in interviews during August 2011 and May 2013. These older Chinese immigrants were challenged in knowing about and in accessing services. Their difficulties were attributed to language barriers, lack of information and instrumental support, and emotional and cultural issues regarding use of health and care services. Their supporters facilitated access to services and acted as a bridge between the service and the user; therefore, they were given the title 'Bridge People'. Bridge People have different backgrounds: family and friends, public sector workers and staff from community-based Chinese organisations. The defining attributes of these supporters were: bilinguality, bicultural, multifunctionality and accessibility. There is no charge for this support; and the relationship between the Bridge Person and recipient involves trust and influence over decisions regarding use of health and care services. Bridge People should be recognised and identified by health, social care and housing services to promote engagement and use of services by older immigrant Chinese people.
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Affiliation(s)
- Xiayang Liu
- Shenzhen Institute of Standards and Technology, Shenzhen, China
| | - Glenda Cook
- Public Health and Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | - Mima Cattan
- Public Health and Wellbeing, Northumbria University, Newcastle upon Tyne, UK
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Mental Health in Immigrants Versus Native Population: A Systematic Review of the Literature. Arch Psychiatr Nurs 2017; 31:111-121. [PMID: 28104048 DOI: 10.1016/j.apnu.2016.07.014] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 07/25/2016] [Accepted: 07/29/2016] [Indexed: 11/22/2022]
Abstract
UNLABELLED The relationship between psychopathology and migration presents unresolved questions. OBJECTIVES To determine whether there is a higher incidence of mental illness among immigrants, to describe the nosologic differences between immigrant and native populations, and to identify the risk factors involved of immigration. METHODS A systematic review was conducted using the PubMed, Science Direct, ISI, Scopus, Psycinfo, Cochrane, and Cuiden databases. The search strategy was conducted using the MeSH thesaurus for the controlled terms "mental disorders," "mental health," "transients and migrants," "immigrants," and "epidemiology." The quality of the articles was analyzed by using the Equator Guidelines, following checklists according to the methodological design of the studies by two independent reviewers. RESULTS From a total of 817 studies found, 21 met the inclusion criteria. Out of the 21 studies selected, 13 showed a higher prevalence of mental illness. CONCLUSIONS Migration represents a major challenge, but it does not lead exclusively to mental distress. Immigrants experience more problems in depression, anxiety, and somatic disorders, pathologies related directly to the migration process and stress suffered. Resources should be oriented to primary and community care.
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Liddell BJ, Nickerson A, Sartor L, Ivancic L, Bryant RA. The generational gap: Mental disorder prevalence and disability amongst first and second generation immigrants in Australia. J Psychiatr Res 2016; 83:103-111. [PMID: 27585424 DOI: 10.1016/j.jpsychires.2016.08.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 08/18/2016] [Accepted: 08/18/2016] [Indexed: 11/18/2022]
Abstract
Despite unprecedented numbers of migrants internationally, little is known about the mental health needs of immigrant groups residing in common countries of resettlement. The majority of studies support the 'healthy migrant hypothesis', but few studies have examined: 1) shifts in prevalence patterns across generations; 2) how prevalence relates to disability in immigrant groups. Our study examined the prevalence of common mental disorders and disability in first and second generation migrants to Australia. Twelve-month and lifetime prevalence rates of affective, anxiety, and substance use disorders were obtained from the Australian National Survey of Mental Health and Wellbeing (N = 8841). First generation immigrants (born overseas) and second generation immigrants (both parents overseas) from non-English and English speaking backgrounds were compared to an Australian-born cohort. Disability was indexed by days out of role and the WHO Disability Assessment Schedule (WHODAS12). First generation immigrants with non-English speaking (1G-NE) backgrounds evidenced reduced prevalence of common mental disorders relative to the Australian-born population (adjusted odds ratio 0.5 [95% CI 0.38-0.66]). This lower prevalence was not observed in second generation immigrant cohorts. While overall levels of disability were equal between all groups (p > 0.05), mental health-related disability was elevated in the 1G-NE group relative to the Australian-born group (p = 0.012). The findings challenge the overarching notion of the "healthy migrant" and suggest a dissociation between reduced prevalence and elevated mental health-related disability amongst first generation immigrants with non-English speaking backgrounds. These findings highlight the heterogeneous psychiatric needs of first and second generation immigrants.
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Affiliation(s)
| | | | - Lauren Sartor
- School of Psychology, University of New South Wales, Australia
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43
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[Mental disorders of immigrants in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 58:527-32. [PMID: 25893739 DOI: 10.1007/s00103-015-2143-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Currently the majority of data regarding indicators of psychiatric morbidity of migrant and minority groups in Germany is derived from studies on help-seeking behavior, mental health service use, or data from population studies, which were not specifically aimed at including migrants. Such data are only available for certain groups, for example, population-based studies on psychiatric disorders and suicidal behavior among Turkish migrants have been conducted, while, comprehensive data on the psychiatric morbidity among major migrant groups in Germany are still rather limited. Barriers to recruiting migrants for health studies, difficulties in assessing psychiatric morbidity in multi-cultural samples, observed as feasibility problems, are among the factors that interfere with population-based studies.
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44
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Rommel A, Saß AC, Born S, Ellert U. [Health status of people with a migrant background and impact of socio-economic factors: First results of the German Health Interview and Examination Survey for Adults (DEGS1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 58:543-52. [PMID: 25824135 DOI: 10.1007/s00103-015-2145-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
People with a migrant background (PMB) have specific health-related risk factors and resources compared to the non-migrant population (NMP). The analysis focuses on the relationship between migrant background and health and health-related behavior. Moreover, the study analyses whether socio-economic status (SES) contributes to the explanation of differences between PMB and the NMP. The research is based on the German Health Interview and Examination Survey for Adults (DEGS1) (2008-2012, n = 8151). The population for cross-sectional analyses contains 1107 PMB (weighted 19.8 %). The research question is addressed on the basis of nine exemplary health outcomes. All analyses are gender specific and make a distinction between first and second generation PMB. Logistic regression is calculated adjusting for age and SES. The results reveal clear gender-specific patterns: For women, differences are statistically significant mainly for first generation PMB. Compared to the NMP their self-assessed health status is lower, they are less physically active, consume less alcohol, feel less informed about cancer screening programs and make less use of preventive health services. However, daily smoking is more prevalent in second generation women. For men, differences are statistically significant for first and second generation PMB. Men with a migrant background show more symptoms of depression, consume less alcohol and feel less informed about cancer screening programs. After adjusting for SES the impact of migrant background on health status and health-related behavior largely remains stable. The study shows that the DEGS1 data offers valuable results and new insights into the health status of people with a migrant background. The use of this data for further research requires a differentiated approach to the concept of migrant background and a careful interpretation of results.
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Affiliation(s)
- Alexander Rommel
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland,
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Kristiansen M, Razum O, Tezcan-Güntekin H, Krasnik A. Aging and health among migrants in a European perspective. Public Health Rev 2016; 37:20. [PMID: 29450062 PMCID: PMC5809957 DOI: 10.1186/s40985-016-0036-1] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 10/05/2016] [Indexed: 11/10/2022] Open
Abstract
Population aging and the associated changes in demographic structures and healthcare needs is a key challenge across Europe. Healthy aging strategies focus on ensuring the ability to maintain health, quality of life and independent living at old age. Concurrent to the process of population aging, the demographics of Europe are affected by increased migration resulting in substantial ethnic diversity. In this paper, we narratively review the health profile of the growing proportion of aging migrants in Europe, outline key factors shaping health among this diverse group and consider ways of addressing their healthcare needs. Although factors shaping aging processes are largely similar across populations, migrant-specific risk factors exist. These include exposure to health risks before and during migration; a more disadvantaged socioeconomic position; language barriers and low health literacy; cultural factors influencing health-seeking behaviours; and psychosocial vulnerability and discrimination affecting health and quality of life. Overall, migrants experience the same morbidity and mortality causes as the native populations, but with different relative importance, severity and age of onset and with substantial differences within and between migrant groups. Little is known regarding health behaviours among aging migrants, although differences in cancer screening behaviours have been identified. Indications of widening health differentials between migrants and native populations with age and informal barriers to quality healthcare for aging migrants are causes of concern. In conclusion, there is a need for attention to migration alongside other determinants of healthy aging. The diversity in individual characteristics, life course processes and contextual factors shaping aging processes among migrants point to the need for a sensitive and comprehensive approach to policies, practices and research within the field of healthy aging. This is important to accommodate for the needs of the growing number of aging migrants in Europe and counter inequities in health and well-being at old age.
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Affiliation(s)
- Maria Kristiansen
- 1Center for Healthy Aging (CEHA), Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Oliver Razum
- 2Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Hürrem Tezcan-Güntekin
- 2Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Allan Krasnik
- 1Center for Healthy Aging (CEHA), Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,3Danish Research Center for Migration, Ethnicity and Health (MESU), Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Parlevliet JL, Uysal-Bozkir Ö, Goudsmit M, van Campen JP, Kok RM, Ter Riet G, Schmand B, de Rooij SE. Prevalence of mild cognitive impairment and dementia in older non-western immigrants in the Netherlands: a cross-sectional study. Int J Geriatr Psychiatry 2016; 31:1040-9. [PMID: 26799690 DOI: 10.1002/gps.4417] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 11/23/2015] [Accepted: 12/03/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE In the Netherlands, persons of Turkish, Moroccan and Surinamese descent form the largest groups of non-western immigrants. A high prevalence of mild cognitive impairment (MCI) and dementia has been described in immigrant populations in the United States of America and the United Kingdom. We determined the prevalence of MCI and dementia in older community-dwelling adults from the largest non-western immigrant groups in the Netherlands. METHODS Participants, aged 55 years and older, of Turkish, Moroccan (Arabic or Berber), Surinamese (Creole or Hindustani) or Dutch descent were recruited via their general practitioners. Cognitive deficits were assessed using the Cross-Cultural Dementia screening instrument, which was validated in poorly educated people from different cultures. Differences in prevalence rates of MCI and dementia between the immigrant groups and a native Dutch group were analysed using chi-square tests. RESULTS We included 2254 participants. Their mean age was 65.0 years (standard deviation, 7.5), and 44.4% were male. The prevalence of MCI was 13.0% in Turkish, 10.1% in Moroccan-Arabic, 9.4% in Moroccan-Berber and 11.9% in Surinamese-Hindustani participants, compared to 5.9% in Surinamese-Creoles and 3.3% in native Dutch. The prevalence of dementia was 14.8% in Turkish, 12.2% in Moroccan Arabic, 11.3% in Moroccan Berber and 12.6% in Surinamese-Hindustani participants, compared to 4.0% in Surinamese-Creoles and 3.5% in native Dutch. CONCLUSIONS MCI and dementia were three to four times more prevalent in the majority of non-western immigrant groups when compared to the native Dutch population. These differences are important for planning and improving healthcare facilities. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- J L Parlevliet
- Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Ö Uysal-Bozkir
- Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - M Goudsmit
- Department of Medical Psychology/Hospital Psychiatry, Slotervaartziekenhuis, Amsterdam, The Netherlands
| | - J P van Campen
- Department of Geriatrics, Slotervaartziekenhuis, Amsterdam, The Netherlands
| | - R M Kok
- Department of Old Age Psychiatry Parnassia, The Hague, The Netherlands
| | - G Ter Riet
- Department of General Practice, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - B Schmand
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Faculty of Social and Behavioural Science, programme group Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - S E de Rooij
- Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,University Center of Geriatric Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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47
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Perceived Discrimination in Patients With Psychiatric Disorder and Turkish Migration Background in Germany. J Nerv Ment Dis 2016; 204:542-6. [PMID: 27218220 DOI: 10.1097/nmd.0000000000000535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Perceived discrimination (PD) has a negative impact on the course of psychiatric disorders. We have investigated PD in inpatients with affective or anxiety disorder and Turkish migration background (TP) or native Germans (GP). Migration-related, clinical, and sociodemographic data of n = 62 TP and n = 62 GP, matched for age, sex, and psychiatric diagnoses, were retrospectively analyzed. PD was assessed as one of 10 questions related to migration and acculturation (yes/no, severity 0-10). PD prevalence rates were compared between TP and GP; relationships of PD with other variables were analyzed using bivariate correlations and multiple regression analyses. A PD prevalence of 26% in TP and 1% in GP was found (odds ratio, 21.2 [2.7-165.8]). Migration background was the strongest predictor of PD in the total group. Within the TP sample, asylum-seeking status and migration-related distress were significantly predictive of PD. In patients with psychiatric disorder in Germany, PD seems to be strongly related to migration-related distress.
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49
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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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50
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Rohacek M, Nickel CH, Dietrich M, Bingisser R. Clinical intuition ratings are associated with morbidity and hospitalisation. Int J Clin Pract 2015; 69:710-7. [PMID: 25689155 PMCID: PMC5024066 DOI: 10.1111/ijcp.12606] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To evaluate how the rating of the severity of sickness - as performed by the physician, nurse and patient - is associated with hospitalisation and acute morbidity. METHODS Prospective observational study, performed in the emergency department of a tertiary hospital. Patients, physicians and nurses were interviewed separately after the first contact from 21 October through to 11 November 2013. RESULTS Of 2426 presenting patients, 1861 were screened, and 1196 were included. A total of 299 (25%) were hospitalised, 504 (42%) suffered acute morbidity. In the univariate analysis, the physician's, nurse's and patient's rating of severity of sickness, expressed on a scale from 0 to 10, was significantly associated with hospitalisation (physicians: OR 1.61, 95% CI 1.50-1.73; nurses: OR 1.52, 1.41-1.64; patients: OR 1.16, 1.10-1.22), and with acute morbidity (OR 1.49, 1.40-1.59; OR 1.39, 1.30-1.48 and OR 1.05, 1.003-1.09 respectively). The area under the curve of the receiver operating characteristic curves was 0.77, 0.72 and 0.61 for hospitalisation, and 0.72, 0.68 and 0.54 for acute morbidity. The interrater reliability was estimated by the intraclass correlation, which was 0.49 for physician/nurse, 0.17 for nurse/patient and 0.07 for physician/patient. In a multivariable analysis model consisting of age, male sex, ethnic origin, ratings of severity of sickness, symptoms, ability to go home and hospitalisation during the preceding 12 months, only age, and the physician's and nurses' rating of severity of sickness remained significantly associated with both outcomes. CONCLUSION The first impression of severity of sickness was associated with hospitalisation and morbidity.
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Affiliation(s)
- M Rohacek
- Department of Emergency Medicine, Basel University Hospital, Basel, Switzerland
| | - C H Nickel
- Department of Emergency Medicine, Basel University Hospital, Basel, Switzerland
| | - M Dietrich
- Department of Emergency Medicine, Basel University Hospital, Basel, Switzerland
| | - R Bingisser
- Department of Emergency Medicine, Basel University Hospital, Basel, Switzerland
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