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Eiroa-Orosa FJ, Evangelidou S, Qureshi A, Collazos F. Cross-Cultural Validation of the Barcelona Immigration Stress Scale. J Immigr Minor Health 2023; 25:1339-1353. [PMID: 37458981 PMCID: PMC10632226 DOI: 10.1007/s10903-023-01520-2] [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] [Accepted: 06/21/2023] [Indexed: 11/09/2023]
Abstract
The concept of acculturative stress has been the subject of debate, resulting in contradictory arguments regarding its measurement. Many of the existing acculturative stress instruments have been developed for use with specific migrant groups. The objective of the current study is to revisit the psychometric properties of the Barcelona Immigration Stress Scale, an instrument aimed at measuring stress levels associated with the migration trajectory in any migrant group. Using a sample of 915 migrants who consulted in primary care, we carried out principal component and confirmatory factor analyses as well as item response theory analyses applied both to the entire sample and to different migratory groups separately. The new reduced version of the scale has very good psychometric properties both in general and applied to the Latino migratory group, the largest in the area where the study was carried out. Results were acceptable among sub-Saharan, North African, and Asian groups but not among Eastern Europeans. These results are discussed through the specificities of each migratory group and the limitations of psychometrics to capture the complexity of immigration-related and acculturative stress.
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Affiliation(s)
- Francisco José Eiroa-Orosa
- Section of Personality, Assessment and Psychological Treatment, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Institute of Neurosciences, University of Barcelona, Passeig Vall d'Hebron, 171, 08035, Barcelona, Catalonia, Spain.
| | - Stella Evangelidou
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain
| | - Adil Qureshi
- Department of Psychiatry, University Hospital Vall d'Hebron, CIBERSAM, Autonomous University of Barcelona, Barcelona, Catalonia, Spain
| | - Francisco Collazos
- Department of Psychiatry, University Hospital Vall d'Hebron, CIBERSAM, Autonomous University of Barcelona, Barcelona, Catalonia, Spain
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Amiri S. Global prevalence of anxiety and PTSD in immigrants: a systematic review and meta-analysis. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2022; 36:69-88. [PMID: 35147917 DOI: 10.1007/s40211-022-00411-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 01/09/2022] [Indexed: 05/27/2023]
Abstract
BACKGROUND A systematic and meta-analysis of the prevalence of anxiety and posttraumatic stress disorder (PTSD) in immigrants was conducted. METHODS Based on the keywords, scientific databases were systematically searched to identify articles. The search included the three databases PubMed, Google Scholar and Research Gate until June 2020. The analysis was performed to assess the prevalence of anxiety and PTSD; subgroups were examined based on anxiety disorders. RESULTS The prevalence of agoraphobia, PTSD, generalized anxiety disorder (GAD), panic disorder, obsessive-compulsive disorder (OCD), social phobia and specific phobia were 4, 25, 9, 4, 3, 5 and 8%, respectively. CONCLUSIONS Considering the findings of the present study regarding the significant prevalence of anxiety and PTSD in the immigrant population, it is necessary to pay special attention to the mental health of this population.
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Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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Epidemiology of depression among displaced people: A systematic review and meta-analysis. Psychiatry Res 2022; 311:114493. [PMID: 35316692 DOI: 10.1016/j.psychres.2022.114493] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 02/28/2022] [Accepted: 03/05/2022] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Displaced people are prone to develop mental health problems due to resettlement in new environments, traumatic events and forced migration. Depression is a mental health problem repeatedly observed among displaced people such as refugees, migrants, asylum seekers and internally displaced persons (IDPs). Therefore, estimating the global pooled prevalence of depression as well as pinpointing its determinants may support policymakers and health care workers to mitigate the disease burden and improve the psychological well-being of displaced people. METHODS PubMed, EMBASE, CINAHIL, Psych-INFO, and SCOPUS databases were searched for English written relevant observational studies conducted between 1984 and 2020. The methodological quality of studies was assessed using the Newcastle Ottawa Scale (NOS). Heterogeneity across studies was checked using the Q- and I2 test. Publication bias was checked by observing Funnel plot symmetry and using Egger's regression test. STATA 16 was used to combine studies using a random effect model. RESULTS Of the 4102 studies identified, 81 studies with an overall sample size of 53,458 were included in the current systematic review and meta-analysis. The pooled prevalence estimate of depression among displaced people was 26.4% (95% CI; 22.2-31.1). Also, three in five IDPs, one in three refugees and asylum seekers and one in four migrants suffer from depression globally. Being female migrant [AOR: 2.46 95% CI: 1.79-3.13, I2=34.5%), non-partnered marital status [AOR: 2.29, 95% CI: 1.29-3.30, I2= 0.00%], and perceived low social support [AOR: 1.76, 95% CI: 1.00-2.52, I2=34.6%] were significant determinants of depression among displaced people. CONCLUSION Overall, around 1 in 4 displaced people suffer from depression and exceed the prevalence of depression reported by community samples in different nations and demonstrate a need for culturally fitting and targeted responses from migrant/refugee host nations and their serving clinicians.
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Higher prevalence of depressed mood in immigrants' offspring reflects their social conditions in the host country: The HELIUS study. PLoS One 2020; 15:e0234006. [PMID: 32497057 PMCID: PMC7272005 DOI: 10.1371/journal.pone.0234006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 05/15/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Immigrants from low- and middle-income countries who have settled in high-income countries show higher risks of depression in comparison with host populations. The risks are associated with adverse social conditions. Indecisive results have been reported on the depression risks of the offspring of immigrant populations. OBJECTIVE To assess the prevalence of depressed mood in immigrant offspring relative to the host population and to analyse whether that risk is explained by social conditions. METHODS Cross-sectional data from the Dutch HELIUS study were analysed, involving 19,904 men and women of Dutch, South-Asian Surinamese, African Surinamese, Turkish or Moroccan ethnic descent aged 18 to 70. Depressive symptomatology was assessed using the Patient Health Questionnaire-9 (PHQ-9). Indicators of social conditions were socioeconomic position (educational level, occupational level, employment status), perceived ethnic discrimination and sociocultural integration (ethnic identity, cultural orientation, social network). We used logistic regression to assess the risk of depressed mood (PHQ-9 sum score ≥10) in immigrants' offspring, as well as in first generation immigrants, relative to the risk in the host population. Social indicators were stepwise added to the model. RESULTS The prevalence of depressed mood was 13% to 20% among immigrant offspring, with the lowest level for those of African Surinamese descent; prevalence in the Dutch origin population was 7%. Relative risk of depressed mood, expressed as average marginal effects (AMEs), decreased substantially in all offspring groups after adjustment for socioeconomic indicators and discrimination. E.g. the AME of Turkish vs. Dutch decreased from 0.11 (0.08-0.13) to 0.05 (0.03-0.08). Patterns resembled those in first generation immigrants. CONCLUSIONS Results suggest that the observed higher prevalence of depressed mood in immigrants' offspring will decline to the level of the host population as the various populations grow closer in terms of socioeconomic position and as immigrant offspring cease to experience discrimination.
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Bretones FD, Jain A, Leka S, García-López PA. Psychosocial Working Conditions and Well-Being of Migrant Workers in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2547. [PMID: 32276385 PMCID: PMC7178116 DOI: 10.3390/ijerph17072547] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 03/30/2020] [Accepted: 04/06/2020] [Indexed: 11/23/2022]
Abstract
This study examines the relationship beween employment and psychosocial working conditions and well-being of native and migrant workers in the working population of Spain. Data from the 7th Spanish Survey of Working Conditions was used to conduct a confirmatory factor analysis (n = 8508) to identify the main latent variables that influenced well-being. Using structural equation modeling and multivariate analysis, we found different patterns and perceptions of well-being and working conditions in these two groups. We discuss the reasons for these differences and suggest directions for further research in this area.
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Affiliation(s)
- Francisco Díaz Bretones
- School of Labour Relations and Human Resource, Universidad de Granada, 18071 Granada, Spain;
| | - Aditya Jain
- Nottingham University Business School, University of Nottingham, Nottingham NG8 1BB, UK;
| | - Stavroula Leka
- Cork University Business School, University College Cork, T12 K8AF Cork, Ireland;
- Centre for Organizational Health and Development, School of Medicine, University of Nottingham, Nottingham NG8 1BB, UK
| | - Pedro A. García-López
- School of Labour Relations and Human Resource, Universidad de Granada, 18071 Granada, Spain;
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Abstract
BACKGROUND The aim of this study was to compare the prevalence of depressive symptoms among migrants and non-migrants living in Qatar and identify variables associated with depressive symptomology in these groups, including culture of origin, time living in country and perceived quality of life. In addition, we tested if the latter two variables moderated the effect of culture of origin on depressive symptomology in the migrant groups. SUBJECT AND METHODS A telephone survey of a probability-based sample of 2,520 participants was conducted in February 2016. The sample was divided into three groups based on nationality and income: labour migrants (LMs), white-collar migrants (WCMs) and non-migrants or Qatari nationals (QNs). Participants completed the Whooley two-question test for depression. RESULTS The odds of depression were significantly increased in LMs (OR = 3.31, 95% CI = 2.36-4.65) and WCMs (OR = 1.40, 95% CI = 1.04-1.90) compared with non-migrants. Among LMs, having a problem with current employer in the last 3 months was also associated with depressive symptoms (OR = 2.10, 95% CI = 1.14-3.84). Culture of origin was significantly associated with depressive symptoms including South Asians (OR = 3.12, p < .001), East Asians (OR = 0.52, p = .013) and Westerners (OR = 0.45, p = .044) relative to Arabs. LM status remained strongly associated with depressive symptoms independent of culture of origin (OR = 2.02, p < .001). CONCLUSION Perceived quality of life, but not length of stay, appears to be an important variable in explaining differences in symptoms between some cultural groups. Findings from this study highlight the importance of the context of migration and culture of origin as potential determinants of depressive symptomology in the host country.
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Affiliation(s)
- Salma M Khaled
- Social and Economic Survey Research Institute, Qatar University, Doha, Qatar
- Salma M Khaled, Social and Economic Survey Research Institute, Qatar University, P.O. Box: 2713, Doha, Qatar.
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Foo SQ, Tam WW, Ho CS, Tran BX, Nguyen LH, McIntyre RS, Ho RC. Prevalence of Depression among Migrants: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1986. [PMID: 30213071 PMCID: PMC6163821 DOI: 10.3390/ijerph15091986] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 09/08/2018] [Accepted: 09/10/2018] [Indexed: 11/16/2022]
Abstract
As the number of migrants worldwide increases, it is worthwhile to examine the extent to which depression has affected this group of often vulnerable individuals. The purpose of this systematic review and meta-analysis is to examine the aggregate prevalence of depression among international migrants and to explore the variations in prevalence with demographic and educational factors. A search was conducted on the online databases PubMed and ScienceDirect whole using the terms "depression", "depressive disorder", "immigration", "immigrant", "migration", and "migrant". A total of 25 studies met our inclusion criteria. A random-effects model meta-analysis calculated an aggregate prevalence of 15.6% among migrants. Heterogeneity was identified by meta-regression and subgroup analyses, and the level of educational attainment, employment status, and length of residency spent in country of migration were found to be significant moderators contributing to depression prevalence. In conclusion, newly arrived migrants appear to be susceptible to developing depression and it is imperative that more in the form of preventive strategies and increased assistance be incorporated to ensure their psychological wellbeing and improve their mental health outcomes. Further research should be conducted to better understand the risk of psychiatric disorders among members of this subpopulation.
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Affiliation(s)
- Shea Q Foo
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Wilson W Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore.
| | - Cyrus S Ho
- Department of Psychological Medicine, National University Health System, Singapore 119228, Singapore.
| | - Bach X Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Long H Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam.
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON M5T 1R8, Canada.
| | - Roger C Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
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Markkula N, Lehti V, Gissler M, Suvisaari J. Incidence and prevalence of mental disorders among immigrants and native Finns: a register-based study. Soc Psychiatry Psychiatr Epidemiol 2017; 52:1523-1540. [PMID: 28856385 DOI: 10.1007/s00127-017-1432-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 08/16/2017] [Indexed: 01/08/2023]
Abstract
PURPOSE Migrants appear to have a higher risk of mental disorders, but findings vary across country settings and migrant groups. We aimed to assess incidence and prevalence of mental disorders among immigrants and Finnish-born controls in a register-based cohort study. METHODS A register-based cohort study of 184.806 immigrants and 185.184 Finnish-born controls (1.412.117 person-years) was conducted. Information on mental disorders according to ICD-10 was retrieved from the Hospital Discharge Register, which covers all public health care use. RESULTS The incidence of any mental disorder was lower among male (adjusted HR 0.82, 95% CI 0.77-0.87) and female (aHR 0.76, 95% CI 0.72-0.81) immigrants, being lowest among Asian and highest among North African and Middle Eastern immigrants. The incidence of bipolar, depressive and alcohol use disorders was lower among immigrants. Incidence of psychotic disorders was lower among female and not higher among male immigrants, compared with native Finns. Incidence of PTSD was higher among male immigrants (aHR 4.88, 95% CI 3.38-7.05). CONCLUSIONS The risk of mental disorders varies significantly across migrant groups and disorders and is generally lower among immigrants than native Finns.
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Affiliation(s)
- Niina Markkula
- Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Av. Las Condes 12 438, Las Condes, Santiago, Chile. .,Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland.
| | - Venla Lehti
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Centre for Child Psychiatry, University of Turku, Turku, Finland
| | - Mika Gissler
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland.,Information Services Department, National Institute for Health and Welfare, Helsinki, Finland.,Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Jaana Suvisaari
- Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland
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García-Campayo J, Demarzo M, Shonin E, Van Gordon W. How Do Cultural Factors Influence the Teaching and Practice of Mindfulness and Compassion in Latin Countries? Front Psychol 2017; 8:1161. [PMID: 28744247 PMCID: PMC5504142 DOI: 10.3389/fpsyg.2017.01161] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 06/26/2017] [Indexed: 12/02/2022] Open
Affiliation(s)
- Javier García-Campayo
- Department of Psychiatry, Aragon Institute of Health Sciences, Miguel Servet HospitalZaragoza, Spain
| | - Marcelo Demarzo
- Department of Preventive Medicine, Universida de Federal de Sao PauloSao Paulo, Brazil.,Preventive Medicine, Hospital Israelita Albert EinsteinSao Paulo, Brazil
| | - Edo Shonin
- Awake to Wisdom Centre for Meditation and Mindfulness ResearchRagusa, Italy
| | - William Van Gordon
- Centre for Psychological Research, University of DerbyDerby, United Kingdom
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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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Jurado D, Alarcón RD, Martínez-Ortega JM, Mendieta-Marichal Y, Gutiérrez-Rojas L, Gurpegui M. Factors associated with psychological distress or common mental disorders in migrant populations across the world. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.rpsmen.2017.02.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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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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Bergero-Miguel T, García-Encinas MA, Villena-Jimena A, Pérez-Costillas L, Sánchez-Álvarez N, de Diego-Otero Y, Guzman-Parra J. Gender Dysphoria and Social Anxiety: An Exploratory Study in Spain. J Sex Med 2016; 13:1270-8. [DOI: 10.1016/j.jsxm.2016.05.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 05/19/2016] [Accepted: 05/22/2016] [Indexed: 11/26/2022]
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Factors associated with psychological distress or common mental disorders in migrant populations across the world. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2016; 10:45-58. [PMID: 27291831 DOI: 10.1016/j.rpsm.2016.04.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 03/07/2016] [Accepted: 04/21/2016] [Indexed: 11/21/2022]
Abstract
We systematically review factors associated with the presence of psychological distress or common mental disorders in migrant populations. Articles published between January 2000 and December 2014 were reviewed and 85 applying multivariate statistical analysis were selected. Common mental disorders were significantly associated with socio-demographic and psychological characteristics, as observed in large epidemiological studies on general populations. The probability of common mental disorders occurrence differs significantly among migrant groups according to their region of origin. Moreover, traumatic events prior to migration, forced, unplanned, poorly planned or illegal migration, low level of acculturation, living alone or separated from family in the host country, lack of social support, perceived discrimination, and the length of migrants' residence in the host country all increase the likelihood of CMD. In contrast, language proficiency, family reunification, and perceived social support reduce such probability. Factors related with the risk of psychiatric morbidity among migrants should be taken into account to design preventive strategies.
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Gimeno-Feliu LA, Calderón-Larrañaga A, Prados-Torres A, Revilla-López C, Diaz E. Patterns of pharmaceutical use for immigrants to Spain and Norway: a comparative study of prescription databases in two European countries. Int J Equity Health 2016; 15:32. [PMID: 26912255 PMCID: PMC4765128 DOI: 10.1186/s12939-016-0317-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 02/11/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although equity in health care is theoretically a cornerstone in Western societies, several studies show that services do not always provide equitable care for immigrants. Differences in pharmaceutical consumption between immigrants and natives are explained by variances in predisposing factors, enabling factors and needs across populations, and can be used as a proxy of disparities in health care use. By comparing the relative differences in pharmacological use between natives and immigrants from the same four countries of origin living in Spain and Norway respectively, this article presents a new approach to the study of inequity in health care. METHODS All purchased drug prescriptions classified according to the Anatomical Therapeutic Chemical (ATC) system in Aragon (Spain) and Norway for a total of 5 million natives and nearly 100,000 immigrants for one calendar year were included in this cross-sectional study. Age and gender adjusted relative purchase rates for immigrants from Poland, China, Colombia and Morocco compared to native populations in each of the host countries were calculated. Direct standardisation was performed based on the 2009 population structure of the OECD countries. RESULTS Overall, a significantly lower proportion of immigrants in Aragon (Spain) and Norway purchased pharmacological drugs compared to natives. Patterns of use across the different immigrant groups were consistent in both host countries, despite potential disparities between the Spanish and Norwegian health care systems. Immigrants from Morocco showed the highest drug use rates in relation to natives, especially for antidepressants, "pain killers" and drugs for peptic ulcer. Immigrants from China and Poland showed the lowest use rates, while Colombians where more similar to host countries. CONCLUSIONS The similarities found between the two European countries in relation to immigrants' pharmaceutical use disregarding their host country emphasises the need to consider specific immigrant-related features when planning and providing healthcare services to this part of the population. These results somehow remove the focus on inequity as the main reason to explain differences in purchase between immigrants and natives.
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Affiliation(s)
- Luis Andres Gimeno-Feliu
- EpiChron Research Group on Chronic Diseases, Aragon Health Sciences Institute (IACS), IIS Aragon, Miguel Servet University Hospital, Paseo Isabel La Católica 1-3, 50009, Zaragoza, Spain. .,San Pablo Health Centre, C/Aguadores 7, 50003, Zaragoza, Spain. .,Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, C/Domingo Miral s/n, 50009, Zaragoza, Spain. .,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, C/Sinesio Delgado 4, 28029, Madrid, Spain.
| | - Amaia Calderón-Larrañaga
- EpiChron Research Group on Chronic Diseases, Aragon Health Sciences Institute (IACS), IIS Aragon, Miguel Servet University Hospital, Paseo Isabel La Católica 1-3, 50009, Zaragoza, Spain. .,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, C/Sinesio Delgado 4, 28029, Madrid, Spain.
| | - Alexandra Prados-Torres
- EpiChron Research Group on Chronic Diseases, Aragon Health Sciences Institute (IACS), IIS Aragon, Miguel Servet University Hospital, Paseo Isabel La Católica 1-3, 50009, Zaragoza, Spain. .,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, C/Sinesio Delgado 4, 28029, Madrid, Spain. .,Department of Microbiology, Preventive Medicine and Public Health, University of Zaragoza, C/Domingo Miral s/n, 50009, Zaragoza, Spain.
| | - Concha Revilla-López
- Teaching Unit of Preventive Medicine and Public Health, Aragon Health Sciences Institute (IACS), Avda. San Juan Bosco 13, 50009, Zaragoza, Spain.
| | - Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, 5018, Bergen, Norway. .,Norwegian Centre for Minority Health Research, Gullhaugveien 1-3, 0484, Oslo, Norway.
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Roura M, Domingo A, Leyva-Moral JM, Pool R. Hispano-Americans in Europe: what do we know about their health status and determinants? A scoping review. BMC Public Health 2015; 15:472. [PMID: 25948239 PMCID: PMC4430018 DOI: 10.1186/s12889-015-1799-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 04/24/2015] [Indexed: 12/19/2022] Open
Abstract
Background Policy makers and health practitioners are in need of guidance to respond to the growing geographic mobility of Hispano-American migrants in Europe. Drawing from contributions from epidemiology, social sciences, demography, psychology, psychiatry and economy, this scoping review provides an up-to-date and comprehensive synthesis of studies addressing the health status and determinants of this population. We describe major research gaps and suggest specific avenues of further inquiry. Methods We identified systematically papers that addressed the concepts “health” and “Hispano Americans” indexed in five data bases from Jan 1990 to May 2014 with no language restrictions. We screened the 4,464 citations retrieved against exclusion criteria and classified 193 selected references in 12 thematic folders with the aid of the reference management software ENDNOTE X6. After reviewing the full text of all papers we extracted relevant data systematically into a table template to facilitate the synthesising process. Results Most studies focused on a particular disease, leaving unexplored the interlinkages between different health conditions and how these relate to legislative, health services, environmental, occupational, and other health determinants. We elucidated some consistent results but there were many heterogeneous findings and several popular beliefs were not fully supported by empirical evidence. Few studies adopted a trans-national perspective and many consisted of cross-sectional descriptions that considered “Hispano-Americans” as a homogeneous category, limiting our analysis. Our results are also constrained by the availability and varying quality of studies reviewed. Conclusions Burgeoning research has produced some consistent findings but there are huge gaps in knowledge. To prevent unhelpful generalisations we need a more holistic and nuanced understanding of how mobility, ethnicity, income, gender, legislative status, employment status, working conditions, neighbourhood characteristics and social status intersect with demographic variables and policy contexts to influence the health of the diverse Hispano-American populations present in Europe. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1799-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maria Roura
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB) Hospital Clínic, Universitat de Barcelona, Rosselló 132, 4th floor, 08036, Barcelona, Spain.
| | - Andreu Domingo
- Centre for Demographic Studies, Autonomous University of Barcelona, Carrer de Ca n'Altayó. Edifici E2, Bellaterra, Barcelona, 08193, Spain.
| | - Juan M Leyva-Moral
- Escola Superior d'Infemeria del Mar, University Pompeu Fabra, Doctor Aiguader, 80, Barcelona, Spain.
| | - Robert Pool
- Social Science and Global Health, Centre for Social Science and Global Health, University of Amsterdam, Postbus 15718, 1001, NE, Amsterdam, The Netherlands.
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Reneses B, Garrido S, Navalón A, Martín O, Ramos I, Fuentes M, Moreno J, López-Ibor JJ. Psychiatric morbidity and predisposing factors in a primary care population in Madrid. Int J Soc Psychiatry 2015; 61:275-86. [PMID: 25063751 DOI: 10.1177/0020764014542815] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this article is to estimate the prevalence of mental disorders in patients in primary care centers in an urban area of Madrid and to study possible associated risk factors. METHODS Cross-sectional month prevalence was evaluated in two phases in an urban area of Madrid. The sample for the first phase included 635 individuals (aged 18-65 years), and the second phase included 320 individuals. Socio-demographic variables (age, sex, educational level, living conditions and country of origin) and clinical variables (psychiatric diagnosis and level of psychosocial stress) were studied. The instruments used for screening were the General Health Questionnaire (GHQ)-28 item questionnaire and the MULTICAGE-CAD 4test. The Mini International Neuropsychiatric Interview (M.I.N.I.) was used in the second phase (in 'possible cases' and 20% of the 'non-cases'). Prevalence was calculated using weighted logistic regression with the observed sampling fractions of the patients in study phase 2 as sample weights. RESULTS AND CONCLUSIONS The month prevalence of mental disorders was 31.3% (95% confidence interval (CI) = [27.6, 35.2]). Anxiety disorders were the most frequent diagnoses with a prevalence of 22.4% (95% CI = [17.8, 27.1]), followed by depressive disorders (16.6%; 95% CI = [12.9, 20.3]), substance abuse or dependence disorders (5.6%; 95% CI = [3.2, 6.9]) and posttraumatic stress disorder (PTSD; 4.4%; 95% CI = [2.0, 2.8]). Factors associated with mental disorders were the presence of stressful life events in the previous 12 months, Latin American region of origin, being woman aged 25 and 34 years and having a low education level.
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Affiliation(s)
- Banca Reneses
- Instituto de Psiquiatría y Salud Mental. Hospital Clínico San Carlos, Madrid, Spain Departamento de Psiquiatría y Psicología Médica, Facultad de Medicina, Universidad Complutense, Madrid, Spain Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Sofía Garrido
- Gerencia de Atención Primaria, Consejería de Sanidad, Madrid, Spain
| | - Aida Navalón
- Instituto de Psiquiatría y Salud Mental. Hospital Clínico San Carlos, Madrid, Spain
| | - Olga Martín
- Instituto de Psiquiatría y Salud Mental. Hospital Clínico San Carlos, Madrid, Spain
| | - Isabel Ramos
- Instituto de Psiquiatría y Salud Mental. Hospital Clínico San Carlos, Madrid, Spain Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Manuel Fuentes
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Jorge Moreno
- Servicios de Atención Primaria, Dirección Asistencial Centro, Madrid, Spain
| | - Juan José López-Ibor
- Departamento de Psiquiatría y Psicología Médica, Facultad de Medicina, Universidad Complutense, Madrid, Spain Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Comparative Epidemiologic Study of Skin Diseases in Foreign Children and Children of Spanish Origin in Alicante, Spain. ACTAS DERMO-SIFILIOGRAFICAS 2014. [DOI: 10.1016/j.adengl.2013.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Pérez-Crespo M, Ramos-Rincón JM, Albares-Tendero MP, Betlloch-Mas I. Comparative epidemiologic study of skin diseases in foreign children and children of Spanish origin in Alicante, Spain. ACTAS DERMO-SIFILIOGRAFICAS 2014; 105:394-400. [PMID: 24480098 DOI: 10.1016/j.ad.2013.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 12/03/2013] [Accepted: 12/11/2013] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Previous studies in Spain have shown that the foreign and immigrant populations can have different diseases to Spanish-born individuals. However, no comparative study has specifically investigated foreign children in Spain. MATERIAL AND METHODS The objective of the study was to compare skin diseases in foreign children with those in children born in Spain of Spanish parents. We included all patients under 15 years of age who were seen in our dermatology department between January 2007 and December 2007. RESULTS During the study period, 3108 pediatric patients were seen in the dermatology department. Of these, 2661 (85.6%) were Spanish and 447 (14.3%) were foreigners. Foreign children sought medical care more often (11.4%) than Spanish children (6%) (P<.001) and made less use of the specialist outpatient clinic (59.6% vs 68.8% [P<.001]) and more use of emergency care. Complaints observed more frequently in the foreign children were scabies (adjusted odds ratio [aOR], 10.6; 95% CI, 4.71-24.10), arthropod bites (aOR, 2.80; 95% CI, 1.14-6.87), hypopigmentation (aOR, 2.61; 95% CI, 1.06-6.44), and atopic dermatitis (aOR, 1.65; 95% CI, 1.19-2.31). Melanocytic nevus was observed more frequently in Spanish children (aOR, .50; 95% CI, .30-.83). CONCLUSIONS Differences between children born in Spain of Spanish parents and foreign children were found for type of visit and frequency of skin diseases.
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Affiliation(s)
- M Pérez-Crespo
- Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España; Unidad de Dermatología, Hospital Marina Baixa, Villajoyosa, Alicante, España.
| | - J M Ramos-Rincón
- Servicio de Medicina Interna, Hospital General Universitario de Alicante, Alicante, España; Departamento de Medicina Clínica, Facultad de Medicina, Universidad Miguel Hernández, Campus de San Juan, Alicante, España
| | - M P Albares-Tendero
- Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España
| | - I Betlloch-Mas
- Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España; Departamento de Medicina Clínica, Facultad de Medicina, Universidad Miguel Hernández, Campus de San Juan, Alicante, España
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Qureshi A, Garcia Campayo J, Eiroa-Orosa FJ, Sobradiel N, Collazos F, Febrel Bordejé M, Roncero C, Andrés E, Casas M. Epidemiology of substance abuse among migrants compared to native born population in primary care. Am J Addict 2013; 23:337-42. [DOI: 10.1111/j.1521-0391.2013.12103.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 06/12/2013] [Accepted: 07/14/2013] [Indexed: 11/27/2022] Open
Affiliation(s)
- Adil Qureshi
- Department of Psychiatry; University Hospital Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona; Barcelona Spain
| | - Javier Garcia Campayo
- Department of Psychiatry; University Hospital Miguel Servet, Zaragoza University; Barcelona Spain
| | | | - Natalia Sobradiel
- Department of Psychiatry; University Hospital Miguel Servet, Zaragoza University; Barcelona Spain
| | - Francisco Collazos
- Department of Psychiatry; University Hospital Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona; Barcelona Spain
- Department of Psychiatry and Legal Medicine; Universitat Autónoma de Barcelona; Barcelona Spain
| | - Mercedes Febrel Bordejé
- Department of Psychiatry; University Hospital Miguel Servet, Zaragoza University; Barcelona Spain
| | - Carlos Roncero
- Department of Psychiatry; University Hospital Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona; Barcelona Spain
- Department of Psychiatry and Legal Medicine; Universitat Autónoma de Barcelona; Barcelona Spain
| | - Eva Andrés
- Department of Psychiatry; University Hospital Miguel Servet, Zaragoza University; Barcelona Spain
| | - Miguel Casas
- Department of Psychiatry; University Hospital Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona; Barcelona Spain
- Department of Psychiatry and Legal Medicine; Universitat Autónoma de Barcelona; Barcelona Spain
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