[Diagnosis of depression in Sub-Saharan immigrants]

Risk for Complicated Immigration Transition: New Diagnosis for NANDA-International

OBJECTIVE

The objective of this article is to describe the developmental processes for the creation of the new diagnosis risk for complicated immigration transition for the NANDA-I.

METHODS

The study followed the recommended steps of developmental processes for NANDA-I. The identification of risk factors,which cause those who have migrated to feel vulnerable, is the result of two different research studies aimed at identifying nursing diagnosis related to the immigration process.

RESULTS

A proposal of label, definition and risk factors of risk for complicated immigration transition.

CONCLUSIONS

This new nursing diagnosis will reinforce the strategies for nursing interventions directed to empower immigrant people to acquire and/or develop the resources needed to cope with the immigration process.

[Outpatient psychiatric care in the immigrant population of Segovia (2001-2008): descriptive study]

INTRODUCTION

Immigration is a phenomenon with a significant impact on mental health. The aims of this study were to describe health care characteristics, time trends, differences among Immigrant, and diagnoses associated with new outpatient psychiatric consultation Immigrant in Segovia.

METHODS

A descriptive study of new consultations with sociodemographic, health care and clinical variables computerized records from the «Antonio Machado» Mental Health Center for 2001-2002 and 2008 comparing immigrant and Spanish population. Population incidences were calculated by sex, geographic regions and countries of origin. By multivariate logistic regression assessed the relationship between ICD-10 diagnoses and immigration.

RESULTS

Immigrants had an average age 10 years younger than the Spanish. Incidence rate of new consultation was always higher in women, decreased in immigrants and increased in the Spanish between 2001 and 2008. South Central Americans and Eastern Europeans had the highest and lowest rates of new visits, respectively. Bulgaria, Morocco, Romania and Poland were the countries most representative in 2008, with low incidences. Neurotic and somatoform disorders were the most common regardless of the origin of the patient. Psychotic and personality disorders were positively associated with immigration in the multivariate analysis.

CONCLUSIONS

The attention of mental health immigrants in Segovia is characterized by young age, lower incidence of new queries with important variations between regions, and diagnostic association with processes more severe, which may reflect underdiagnosis and underutilization phenomena.

Comparison of the consumption of antidepressants in the immigrant and native populations in a Spanish health region: an observational study

Background

Health professionals and organizations in developed countries adapt slowly to the increase of ethnically diverse populations attending health care centres. Several studies report that attention to immigrant mental health comes up with barriers in access, diagnosis and therapeutics, threatening equity. This study analyzes differences in exposure to antidepressant drugs between the immigrant and the native population of a Spanish health region.

Methods

Cross-sectional study of the dispensation of antidepressant drugs to the population aged 15 years or older attending the public primary health centres of a health region, 232,717 autochthonous and 33,361 immigrants, during 2008. Data were obtained from computerized medical records and pharmaceutical records of medications dispensed in pharmacies. Age, sex, country of origin, visits, date of entry in the regional health system, generic drugs and active ingredients were considered. Statistical analysis expressed the percentage of persons exposed to antidepressants stratified by age, gender, and country of origin and prevalence ratios of antidepressant exposition were calculated.

Results

Antidepressants were dispensed to 11% of native population and 2.6% of immigrants. Depending on age, native women were prescribed antidepressants between 1.9 and 2.7 times more than immigrant women, and native men 2.5 and 3.1 times more than their immigrant counterparts. Among immigrant females, the highest rate was found in the Latin Americans (6.6%) and the lowest in the sub-Saharans (1.4%). Among males, the highest use was also found in the Latin Americans (1.6%) and the lowest in the sub-Saharans (0.7%). The percentage of immigrants prescribed antidepressants increased significantly in relation to the number of years registered with the local health system. Significant differences were found for the new antidepressants, prescribed 8% more in the native population than in immigrants, both in men and in women.

Conclusions

All the immigrants, regardless of the country of origin, had lower antidepressant consumption than the native population of the same age and sex. Latin American women presented the highest levels of consumption, and the sub-Saharan men the lowest. The prescription profiles also differed, since immigrants consumed more generics and fewer recently commercialized active ingredients.

[Prevalence of diagnosed chronic disorders in the immigrant and native population]

OBJECTIVE

To estimate the prevalence rates of chronic disorders in immigrants and to compare them with those in the native population, based on electronic clinical records in primary care (ECRPC).

METHODS

We performed a descriptive cross-sectional study in patients aged 16 and over included in the Madrid Regional Public Health System. Age-adjusted prevalence rates for each sex and region were estimated on the basis of medically examined cases registered in the ECRPC with any new data entry made in 2005 or 2006.

RESULTS

After age-adjustment, a total of 36.8% immigrants had some chronic health problem (vs. 55.3% natives). These disorders were more frequent among women and among the population from Africa and Latin America. The highest overall prevalence rates in the foreign population were allergy (10.2% crude rate), low-back pain (9.1%), chronic skin problems (6.8%) and mental disorders (6.4%).

CONCLUSIONS

The prevalence rate of chronic disease is lower in the foreign population and differs according to sex and country of origin.