1
|
Scholaske L, Spallek J, Entringer S. Perceived stress and depressive symptoms during pregnancy and postpartum in Turkish-origin women living in Germany. J Psychosom Res 2024; 177:111570. [PMID: 38141526 DOI: 10.1016/j.jpsychores.2023.111570] [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: 07/04/2023] [Revised: 12/01/2023] [Accepted: 12/17/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVE People of Turkish origin (also referred to as "with a Turkish migrant background") are one of the largest migrant groups in Germany and show disparities across different stress-related health outcomes. Specifically, women of Turkish origin in Germany have a greater risk for some mental health issues and adverse pregnancy and birth outcomes compared to women without migrant background. We tested differences between women of Turkish origin and women without migrant background in self-reported pregnancy and postpartum stress experiences and depressive symptoms. METHODS 32 women of Turkish origin (mean age 29.7 years) and 77 women without migrant background (mean age 32 years) participated in a multi-site prospective cohort study with two study visits during pregnancy and one month postpartum. Women provided sociodemographic data and completed the Perceived Stress Scale (PSS) and the Center for Epidemiology - Depression (CESD) scale at each study visit. RESULTS Using hierarchical linear models, we found that women of Turkish origin (both first and second generation) reported more perceived stress (b = 0.57, CI: 0.29-0.84, p < 0.001) and depressive symptoms (b = 0.32, CI = 0.14-0.49, p < 0.001) compared to women without migrant background across gestation. A linear regression analysis showed that there was also a significant difference in depressive symptoms at one month postpartum (b = 0.35, CI = 0.03-0.66, p < 0.05). CONCLUSION Tailored psychosocial interventions are needed to address mental health needs of pregnant Turkish origin women and to intervene on the possible transmission of stress-related health disadvantages to their offspring.
Collapse
Affiliation(s)
- Laura Scholaske
- Faculty for Medicine, Department for Human Medicine, MSB Medical School Berlin, Berlin, Germany; German Center for Integration and Migration Research (DeZIM), Berlin, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany; Lausitz Center for Digital Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Sonja Entringer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Psychology, 10117 Berlin, Germany; Department of Pediatrics, and Development, Health and Disease Research Program University of California, Irvine, USA.
| |
Collapse
|
2
|
Dingoyan D, Metzner F, Kongur A, Arslan Ö, Pust GEA, Weierstall-Pust R. The Impact of Perceived Discrimination on Cultural Identification, Psychological Stress, Emotion Regulation and Aggressive Tendencies in Individuals With Turkish Migration Background in Germany. FRONTIERS IN SOCIOLOGY 2022; 7:705027. [PMID: 35782709 PMCID: PMC9244781 DOI: 10.3389/fsoc.2022.705027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
The following study considers correlates of the identification with the origin and host culture of German individuals with a Turkish migrant background. It examines how these two factors mediate the relationship between perceived discrimination, emotion regulation or psychological stress, and aggressive tendencies as the major dependent variable. For this purpose, the data of 229 people with Turkish migration background living in Germany was collected through an online survey. Findings depict that the identification with the Turkish (origin) and German (host) culture mediate the relationship between perceived discrimination and emotion regulation. The relationship between perceived discrimination and psychological stress is mediated by the identification with the German culture. The analysis shows that perceived discrimination is associated with a reduced identification with the German culture and with a high identification with the Turkish culture. Emotion regulation abilities are negatively related to perceived discrimination and identification with the Turkish culture. In contrary, the psychological stress level is positively related to perceived discrimination. The preparedness for aggressive behavior is also associated positively by psychological stress and negatively by emotion regulation abilities. The results are discussed against the background of the specific migration history and living conditions of Turkish immigrants in Germany.
Collapse
Affiliation(s)
- Demet Dingoyan
- Institute of Medical Sociology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Franka Metzner
- Institute of Medical Psychology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
- Educational Science With a Focus on Special Education (“Emotional and Social Development”), University of Siegen, Siegen, Germany
| | - Akin Kongur
- Department of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
| | - Örsan Arslan
- Department of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
| | | | - Roland Weierstall-Pust
- Department of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
- Oberberg Clinics Group, Berlin, Germany
| |
Collapse
|
3
|
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.
Collapse
Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
4
|
Feldhege JM, Gulec H, Moessner M, Stieler C, van Stipelen J, Bauer S. Stigmatization and attitudes toward eating disorders: a comparison between native German adolescents, Turkish immigrant adolescents in Germany, and native Turkish adolescents. J Ment Health 2021; 31:99-108. [PMID: 34569396 DOI: 10.1080/09638237.2021.1979484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS The purpose of this study was to investigate the attitudes toward eating disorders in native German adolescents (Germans), adolescents with Turkish migration background in Germany (Immigrants), and native Turkish adolescents (Turks). METHOD A total of 507 adolescents (N = 139 Germans; N = 126 Immigrants; N = 242 Turks) read a vignette describing a 16-year-old female with bulimic symptoms. Participants completed questionnaires on mental health literacy, stigmatization, desirability of eating disorder-related behaviors and acquaintance with bulimic symptoms. RESULTS Adolescents living in Germany were more likely to recognize the vignette as an eating disorder than Turks. Immigrants were more similar to Germans in mental health literacy of eating disorders than Turks. However, in terms of stigmatizing attitudes, immigrants blamed more than Germans, Turks being intermediate on this variable. In Turks, higher desirability of eating disorder-related behaviors was associated with an increased acquaintance with bulimic symptoms and decreased evaluations of impairment. Higher mental health literacy was associated with less blame in Germans. CONCLUSIONS Migration background was associated with increased mental health literacy of eating disorders but did not result in reduced stigma. Differences in attitudes toward eating disorders indicate the need for differential interventions across the groups.
Collapse
Affiliation(s)
| | - Hayriye Gulec
- Department of Psychology, Bursa Uludag University, Bursa, Turkey
| | - Markus Moessner
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Christiane Stieler
- Klinik für Suchttherapie und Entwöhnung, Psychiatrisches Zentrum Nordbaden, Wiesloch, Germany
| | - Jhana van Stipelen
- Refugio Villingen-Schwenningen e. V., Psychosoziales Zentrum für traumatisierte Flüchtlinge, Villingen-Schwenningen, Germany
| | - Stephanie Bauer
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
| |
Collapse
|
5
|
Ekeberg KA, Abebe DS. Mental disorders among young adults of immigrant background: a nationwide register study in Norway. Soc Psychiatry Psychiatr Epidemiol 2021; 56:953-962. [PMID: 33156357 PMCID: PMC8192316 DOI: 10.1007/s00127-020-01980-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 10/24/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE Previous research indicates increased risk of various mental disorders in immigrant populations, particularly for schizophrenia and PTSD. However, findings are inconclusive due to variations in contextual factors, characteristics of immigrant groups and study design. Our study aims to investigate prevalence differences of receiving an ICD-10 psychiatric diagnosis between 2008 and 2016 among four first-generation immigrant groups and one second-generation immigrant group compared to ethnic Norwegians. METHODS Linked register data from the Norwegian Patient Registry and Statistics Norway were utilised. The sample (age 18-35) comprises 758,774 ethnic Norwegians, 61,124 immigrants originating from Poland, Somalia, Iran and Pakistan and 4630 s-generation Pakistani immigrants. Age- and gender-adjusted binary logistic regression models were applied. RESULTS The odds of schizophrenia were significantly elevated for all groups except for Poles. The highest odds were observed for second-generation Pakistani immigrants (adjusted OR 2.72, 95% CI 2.21-3.35). For PTSD, the odds were significantly increased for Somalis (aOR 1.31, 95% CI 1.11-1.54), second-generation Pakistani immigrants (aOR 1.37, 95% CI 1.11-1.70), and in particular for Iranians (aOR 3.99, 95% CI 3.51-4.54). While Iranians showed similar or higher odds of receiving the vast majority of psychiatric diagnoses, the remaining groups showed lower or similar odds compared to ethnic Norwegians. CONCLUSION Our findings suggest considerable prevalence differences in receiving a psychiatric diagnosis according to country of origin and generational status compared to ethnic Norwegian controls. The general pattern was lower prevalence of most ICD-10 mental disorders for the majority of immigrant groups compared to ethnic Norwegians, except for schizophrenia and PTSD.
Collapse
Affiliation(s)
| | - Dawit Shawel Abebe
- grid.412414.60000 0000 9151 4445Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway ,grid.412929.50000 0004 0627 386XNorwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
| |
Collapse
|
6
|
Stawinska-Witoszynska B, Czechowska K, Moryson W, Wieckowska B. The Prevalence of Generalised Anxiety Disorder Among Prisoners of the Penitentiary Institution in North-Eastern Poland. Front Psychiatry 2021; 12:671019. [PMID: 34194348 PMCID: PMC8236604 DOI: 10.3389/fpsyt.2021.671019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/18/2021] [Indexed: 02/03/2023] Open
Abstract
Introduction: Generalised anxiety disorder (GAD) is one of the most common mental disorders. The psychosocial factors that may lead to generalised anxiety disorders include stress, traumatic events, conscious and unconscious internal conflicts, and low social and economic status. Imprisonment and forced isolation may favour the development of depression or anxiety disorders in inmates. Thus, this study aimed to analyse the prevalence of generalised anxiety disorder (GAD) in the population of inmates detained in one of the largest penitentiary units in north-eastern Poland. Materials and Methods: The data comes from 2017 and includes information on 635 male inmates incarcerated at the Czerwony Bór Prison. The information comes from the health records of individual inmates, kept by the prison outpatient clinician, and documented consultations with doctors of units outside the prison. The classification of generalised anxiety disorders (F41.1) was made in accordance with the 10th Revision of the International Statistical Classification of Diseases and Health Problems and the clinical diagnosis made by a psychiatrist. The Mann-Whitney test was used to compare quantitative data without normal distribution, chi-squared test or Fisher exact test for comparing qualitative data. A one-dimensional and multi-dimensional logistic regression model was used to examine the impact of the prison type on the prevalence of generalised anxiety disorder. Results: Generalised anxiety disorder was observed among 44 prisoners (6.9%), most often in the age range 30-39 years and among men younger than 30 years, respectively 40.9 and 31.8% of all diagnosed. The average age of patients was 34.6 years. The least number of prisoners with GAD was in the age group 50-59 (2.3%). Nearly 66% of patients were prisoners detained in a closed type prison; the chance of generalised anxiety disorder was three times higher than among the prisoners in a half-open and open type facility. Generalised anxiety disorder was diagnosed significantly more often with those currently serving a prison sentence than those before incarceration. Conclusions: In Polish conditions, the importance of the problem associated with GAD is evidenced by a significant increase in its prevalence in the prison environment and a three times higher chance of developing generalised anxiety disorder among prisoners in a closed type institution, which calls for highly organised psychiatric care and increased availability of psychological assistance for prisoners.
Collapse
Affiliation(s)
- Barbara Stawinska-Witoszynska
- Department of Epidemiology and Hygiene, Chair of Social Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Czechowska
- Department of Epidemiology and Hygiene, Chair of Social Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Waclaw Moryson
- Department of Epidemiology and Hygiene, Chair of Social Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Barbara Wieckowska
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| |
Collapse
|
7
|
Diop S, Turmes L, Juckel G, Mavrogiorgou P. [Postpartum depression and migration]. DER NERVENARZT 2020; 91:822-831. [PMID: 31720700 DOI: 10.1007/s00115-019-00828-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Psychiatric research and care increasingly explore the connection between mental health and migration; however, it is striking that only a small number of analyses exist on the effect of migration on mental ailments specific to women. For example, even though postpartum depression regularly occurs among women with a migration background, in Germany and internationally there is a lack of knowledge on the epidemiology, particularly with respect to factors causing or contributing to postpartum depression among women with a migration background. Prospectively, culturally specific treatment options for women with a migration background are necessary to prevent chronification and subsequent harm to the mother and other family members. With this aim in mind, psychologists, psychiatrists and gynecologists should be aware of the specific factors contributing to the development of postpartum depression among women with a migration background. This overview article focuses on key aspects of postpartum depression, such as epidemiology, symptoms, risk factors and treatment concepts, while contextualizing them with respect to women's experience of migration.
Collapse
Affiliation(s)
- Shirin Diop
- Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum der Ruhr-Universität Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Deutschland
| | - Luc Turmes
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, LWL-Klinik Herten, Im Schloßpark 20, 45699, Herten, Deutschland
| | - Georg Juckel
- Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum der Ruhr-Universität Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Deutschland.
| | - Paraskevi Mavrogiorgou
- Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum der Ruhr-Universität Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Deutschland
| |
Collapse
|
8
|
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.
Collapse
|
9
|
Brandl EJ, Dietrich N, Mell N, Winkler JG, Gutwinski S, Bretz HJ, Schouler-Ocak M. Attitudes towards psychopharmacology and psychotherapy in psychiatric patients with and without migration background. BMC Psychiatry 2020; 20:176. [PMID: 32303265 PMCID: PMC7164188 DOI: 10.1186/s12888-020-02585-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 04/05/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Sociodemographic factors, attitude towards treatment and acculturation may be important factors influencing the decision of immigrants to seek and maintain psychiatric treatment. A better understanding of these factors may significantly improve treatment adherence and outcome in these patients. Therefore, we investigated factors associated the attitude towards psychotherapy and medication in a sample of psychiatric outpatients with and without migration background. METHODS N = 381 patients in a psychiatric outpatient unit offering specialized treatment for migrants were included in this study. Attitude towards psychotherapy was assessed using the Questionnaire on Attitudes Toward Psychotherapeutic Treatment, attitude towards medication with the Drug Attitude Inventory-10. Acculturation, symptom load and sociodemographic variables were assessed in a general questionnaire. Statistical analyses included analyses of covariance and hierarchical regression. RESULTS Patients of Turkish and Eastern European origin reported a significantly more positive attitude towards medication than patients without migration background. When controlling for sociodemographic and clinical variables, we did not observe any significant differences in attitude towards psychotherapy. Acculturation neither influenced the attitude towards psychotherapy nor towards medication. CONCLUSION Our study indicates that sociodemographic and clinical factors may be more relevant for patients´ attitudes towards treatment than acculturation. Considering these factors in psychiatric treatment of patients with migration background may improve treatment outcome and adherence.
Collapse
Affiliation(s)
- Eva J. Brandl
- grid.6363.00000 0001 2218 4662Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany Charité Universitätsmedizin Berlin, Berlin, Germany ,grid.488294.bPsychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115 Berlin, Germany
| | - Nora Dietrich
- grid.6363.00000 0001 2218 4662Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany Charité Universitätsmedizin Berlin, Berlin, Germany ,grid.488294.bPsychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115 Berlin, Germany
| | - Nicoleta Mell
- grid.6363.00000 0001 2218 4662Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany Charité Universitätsmedizin Berlin, Berlin, Germany ,grid.488294.bPsychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115 Berlin, Germany
| | - Johanna G. Winkler
- grid.6363.00000 0001 2218 4662Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany Charité Universitätsmedizin Berlin, Berlin, Germany ,grid.488294.bPsychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115 Berlin, Germany
| | - Stefan Gutwinski
- grid.6363.00000 0001 2218 4662Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany Charité Universitätsmedizin Berlin, Berlin, Germany ,grid.488294.bPsychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115 Berlin, Germany
| | - H. Joachim Bretz
- grid.6363.00000 0001 2218 4662Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany Charité Universitätsmedizin Berlin, Berlin, Germany ,grid.488294.bPsychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115 Berlin, Germany
| | - Meryam Schouler-Ocak
- grid.6363.00000 0001 2218 4662Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany Charité Universitätsmedizin Berlin, Berlin, Germany ,grid.488294.bPsychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115 Berlin, Germany
| |
Collapse
|
10
|
Haller J, Hillebrecht J, Bengel J. [The Culturally Sensitive Therapy Relationship: A Concept for the Training and Further Education of Psychotherapists]. Psychother Psychosom Med Psychol 2020; 70:441-448. [PMID: 32252117 DOI: 10.1055/a-1120-9004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Already in 2002, the Sonnenberger Leitlinien called for the development of further training programs for psychotherapists in the context of the intercultural opening of the psychosocial health care system [1]. However, so far, there has been a lack of evaluated, accessible (published) training concepts to enhance the intercultural and transcultural competences of psychotherapists in German-speaking countries. This article presents a training concept for medical and psychological psychotherapists as well as for psychologists in training based on the guidelines for trainings in inter-/transcultural competence for psychotherapists [2]. The concept focusses especially on the reflection of one's own culturally influenced values as well as on knowledge and skills that facilitate the development of a therapeutic relationship in an intercultural setting. Implementation tips are presented to help readers to apply the concept.
Collapse
Affiliation(s)
- Julia Haller
- Institut für Psychologie, Albert-Ludwigs-Universität Freiburg, Freiburg im Breisgau
| | - Jennifer Hillebrecht
- Institut für Psychologie, Albert-Ludwigs-Universität Freiburg, Freiburg im Breisgau
| | - Jürgen Bengel
- Institut für Psychologie, Albert-Ludwigs-Universität Freiburg, Freiburg im Breisgau
| |
Collapse
|
11
|
Wolf S, Hahn E, Wingenfeld K, Nguyen MH, von Poser A, Nguyen TH, Hanewald B, Böge K, Bajbouj M, Dettling M, Nguyen VT, Ta TMT. Mental Health Determinants Among a Psychiatric Outpatient Sample of Vietnamese Migrants in Germany. Front Psychiatry 2020; 11:580103. [PMID: 33424659 PMCID: PMC7785831 DOI: 10.3389/fpsyt.2020.580103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 10/20/2020] [Indexed: 12/19/2022] Open
Abstract
Background: Mental health risk-factors for Asian migrants have been studied almost exclusively in the US, Canada, and Australia but not in European countries. Therefore, we aimed to identify sociodemographic, clinical, and migration-surrounding factors associated with experienced mental distress among Vietnamese migrants in Germany. Method: 305 Vietnamese migrants utilizing Germany's first Vietnamese psychiatric outpatient clinic filled out at admission the Brief-Symptom-Inventory 18 (BSI-18) as well as a questionnaire on 22 potential mental health determinants. Using a multiple linear regression model, we identified those sociodemographic, clinical, and migration-surrounding factors that were significantly related to the Global Severity Index (GSI) of the BSI-18. Results: The factors unemployment (B = -6.32, p = 0.014), financial problems (B = -10.71, p < 0.001), no or only little religious involvement (B = -3.23, p = 0.002), no psychiatric precontact (B = -7.35, p = 0.004), previous migration experiences (B = 8.76, p = 0.002), and perceived discrimination (B = 6.58, p = 0.011) were found to significantly increase the level of mental distress according to the BSI-GSI. Conclusion: Based on these results, we were able to construct a mental health risk-profile for Vietnamese migrants in Germany, which aims to detect candidates for psychiatric problems earlier and supply them with customized prevention and therapy options.
Collapse
Affiliation(s)
- Simon Wolf
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Eric Hahn
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Katja Wingenfeld
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Main Huong Nguyen
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Anita von Poser
- Institute of Social and Cultural Anthropology, Freie Universität Berlin, Berlin, Germany
| | - Thi Hoa Nguyen
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Department of Psychiatry, Hanoi Medical University, Hanoi, Vietnam
| | - Bernd Hanewald
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Gießen and Marburg, Gießen, Germany
| | - Kerem Böge
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Malek Bajbouj
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Michael Dettling
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Van Tuan Nguyen
- Department of Psychiatry, Hanoi Medical University, Hanoi, Vietnam
| | - Thi Minh Tam Ta
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| |
Collapse
|
12
|
Morawa E, Brand T, Dragano N, Jöckel KH, Moebus S, Erim Y. Associations Between Acculturation, Depressive Symptoms, and Life Satisfaction Among Migrants of Turkish Origin in Germany: Gender- and Generation-Related Aspects. Front Psychiatry 2020; 11:715. [PMID: 32848908 PMCID: PMC7406783 DOI: 10.3389/fpsyt.2020.00715] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 07/07/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of the present study was to investigate the degree of depressive symptoms and life satisfaction (LS) as well as the association between acculturation and depressive symptoms among a large sample of persons with Turkish migration background in Germany, taking into account gender- and migration-related differences. METHODS This study was part of a pretest for a large national epidemiological cohort study in Germany. Acculturation was measured using the Frankfurt Acculturation Scale (FRACC). Based on the median split of the two subscales, four acculturative styles according to Berry (integration, assimilation, separation and marginalization) were determined. Depressive symptoms were assessed with the depression module (PHQ-9) from the Patient Health Questionnaire. LS was assessed with a single item on a scale from 1 = bad to 5 = excellent. Differences in levels of depressive symptoms and LS in relation to gender and generation of migration were tested with analysis of covariance, controlling for age. Gender-stratified multiple linear regression analyses were also conducted for depressive symptoms as criterion variable. RESULTS 328 Turkish migrants participated (61.3% women). The cut-off-value of ≥10 for the PHQ-9 was achieved by 33.2% of the women and 26.4% of the men (p=0.209, φ=0.071). In female migrants, the age-adjusted mean score for depressive symptoms was 7.81 (SD=6.42), in males 6.70 (SD=6.41) (p=0.137, η2=0.007). After controlling for unemployment status, women showed a trend for being more frequently depressed than men (p=0.055, φ=0.117) and also demonstrated a trend for higher levels of depressive symptoms (p=0.072, η2=0.012). No significant gender-specific difference was found concerning age-adjusted mean score for LS (p=0.547, η2=0.001), also when controlled for unemployment status (p=0.322, η2=0.004). In both sexes, the second generation demonstrated a significantly higher age-adjusted mean score for LS of small/medium effect size than the first generation. In women, separation as acculturation style (linear regression coefficient (B=4.42, 95% CI=1.68, 7.17, p=0.002; reference: integration), having no partnership (B=2.56, 95% CI=0.26, 4.86, p=0.03) and lower education (B=-2.28, 95% CI=-4.54, -0.02, p=0.048) were associated with higher severity of depressive symptoms; in men, separation as acculturation style (B=4.01, 95% CI=0.70, 7.31, p=0.018; reference: integration) and employment status (B=-3.32, 95% CI=-5.71, -0.92, p=0.007) were related to depression levels. CONCLUSIONS Separation as acculturation style is associated with higher levels of depressive symptoms (for both genders). Gender-sensitive health promotion programs should target separated migrants to improve their integration into the German society.
Collapse
Affiliation(s)
- Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Tilman Brand
- Department for Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Nico Dragano
- Institute for Medical Sociology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen, Essen, Germany
| | - Susanne Moebus
- Institute for Urban Public Health, University Hospital Essen, Essen, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| |
Collapse
|
13
|
Igde E, Heinz A, Schouler-Ocak M, Rössler W. [Depressive and somatoform disorders in persons with a Turkish migration background in Germany]. DER NERVENARZT 2019; 90:25-34. [PMID: 30187080 DOI: 10.1007/s00115-018-0602-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Migration is a risk factor for the onset of mental disorders. Epidemiologic studies indicate that there is an increased prevalence of depressive and somatoform disorders in individuals with a Turkish migration background in Germany. OBJECTIVES The aim of this review article is to determine the impact of sociocultural factors on depressive and somatoform disorders in individuals with a Turkish migration background in Germany. MATERIALS AND METHODS The systematic review is based on 23 studies identified in PubMed and PsycINFO. RESULTS Acculturation, perceived discrimination and the socioeconomic status affect the severity of mental disorders, and impair the access to the health care system as well as to psychotherapy. Women with a Turkish migration background represent a particularly vulnerable group in this context. CONCLUSION Multiple factors influence the increased prevalence of depressive and somatoform disorders in individuals with a Turkish migration background in Germany. Most of the identified studies suffer from significant methodological restrictions and as such do not allow generalization to the whole population of individuals with a Turkish migration background in Germany. There is a lack of national surveys and a need for longitudinal studies in representative population samples.
Collapse
Affiliation(s)
- E Igde
- Klinik für Psychiatrie und Psychotherapie, Campus Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
| | - A Heinz
- Klinik für Psychiatrie und Psychotherapie, Campus Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - M Schouler-Ocak
- St. Hedwig-Krankenhaus, Tagesklinik Wedding, Psychiatrische Universitätsklinik, Charité, Berlin, Deutschland
| | - W Rössler
- Klinik für Psychiatrie und Psychotherapie, Campus Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
- Psychiatrische Universitätsklinik Zürich, Zürich, Schweiz
| |
Collapse
|
14
|
The Role of the Social Network in Access to Psychosocial Services for Migrant Elderly-A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101215. [PMID: 29019961 PMCID: PMC5664716 DOI: 10.3390/ijerph14101215] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 09/27/2017] [Accepted: 10/05/2017] [Indexed: 11/17/2022]
Abstract
Background: Despite high prevalence of mental problems among elderly migrants in The Netherlands, the use of psychosocial care services by this group is low. Scientific evidence points at the crucial role of social support for mental health and the use of psychosocial services. We therefore explored the role of social networks in the access to psychosocial care among elderly migrants in The Netherlands. Methods: A qualitative study was conducted using semi-structured group interviews and individual interviews. The eight group and eleven individual interviews (respectively n = 58 and n = 11) were conducted in The Netherlands with Turkish, Moroccan, Surinamese, and Dutch elderly. The data were analysed through coding and comparing fragments and recognizing patterns. Results: Support of the social network is important to navigate to psychosocial care and is most frequently provided by children. However, the social network of elderly migrants is generally not able to meet the needs of the elderly. This is mostly due to poor mental health literacy of the social network, taboo, and stigma around mental illness and the busy lives of the social network members. Conclusions: Strategies to address help-seeking barriers should consider mental health literacy in elderly migrants as well as their social networks, and counteract taboos and stigma of mental health problems.
Collapse
|