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Causevic S, Ekström AM, Orsini N, Kagesten A, Strömdahl S, Salazar M. Prevalence and associated factors for poor mental health among young migrants in Sweden: a cross-sectional study. Glob Health Action 2024; 17:2294592. [PMID: 38180014 PMCID: PMC10773640 DOI: 10.1080/16549716.2023.2294592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 12/05/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Young migrants face multiple challenges that can affect their mental, sexual and reproductive health. OBJECTIVE To assess the prevalence of self-reported poor mental health and its associated demographic, post-migration and sexual risk behaviour factors among young migrants (aged 15-25) in Sweden. METHODS Data were drawn from a cross-sectional survey conducted with migrants aged 15-65 years old in Sweden between December 2018 and November 2019 (n = 6449). Among these, 990 participants aged 15-25 were eligible for the study. Mental health was measured using the Refugee Health Screener-13. Missing data indicator analysis and multivariable logistic regression models were conducted to estimate the association between mental health, sexual risk behaviour, demographic and migration-related variables. RESULTS Of the 990 participants, 59% reported poor mental health. Participants reporting poor mental health were more likely to be female (AOR:1.63, 95% CI:1.18-2.25), to have lived in Sweden more than three years (AOR:2.16, 95% CI:1.17-3.97), to engage in any sexual risk behaviour (AOR:1.99, 95% CI:1.25-3.17), and to live alone (AOR:1.95, 95% CI:1.25-3.03) or with friends they already knew (AOR:1.60, 95% CI:1.37-4.91). People arriving from the Americas (AOR:0.54, 95% CI:0.33-0.88), Asia (AOR:0.44, 95% CI:0.22-0.86), Europe (AOR:0.30, 95% CI:0.14-0.61) and Africa (AOR 0.37, 95% CI: 0.23-0.60) had lower odds of poor mental health than those arriving from Syria. CONCLUSION The prevalence of poor mental health among young migrants in Sweden was high, with specific subgroups (women, asylum seekers, people arriving from Syria, and those residing longer in Sweden) being particularly vulnerable. Our results indicate the interconnectedness between poor mental health and sexual risk behaviour in this population. Thus, policies targeting young migrants should ensure that healthcare services screen for both poor sexual and mental health at the same time.
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Affiliation(s)
- Sara Causevic
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Anna Mia Ekström
- Global and Sexual Health (GloSH) Research Group, Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Stockholm, Sweden
- Department of Infectious Diseases, South Central Hospital, Stockholm, Sweden
| | - Nicola Orsini
- Global and Sexual Health (GloSH) Research Group, Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Stockholm, Sweden
| | - Anna Kagesten
- Global and Sexual Health (GloSH) Research Group, Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Stockholm, Sweden
| | - Susanne Strömdahl
- Global and Sexual Health (GloSH) Research Group, Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Stockholm, Sweden
- Department of Medical Sciences, Infectious Medicine, Uppsala University, Uppsala, Sweden
- Swedish Public Health Agency, Stockholm, Sweden
| | - Mariano Salazar
- Global and Sexual Health (GloSH) Research Group, Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Stockholm, Sweden
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Oliveira J, Nienaber B, Bissinger J, Gilodi A, Richard C, Albert I. Double transition of young migrants in Luxembourg: vulnerable, resilient and empowering integration trajectories in the period of youth. FRONTIERS IN SOCIOLOGY 2024; 9:1230567. [PMID: 38799208 PMCID: PMC11119283 DOI: 10.3389/fsoc.2024.1230567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 04/19/2024] [Indexed: 05/29/2024]
Abstract
Migrant integration trajectories have become more complex, open, uncertain, and continuously changing, over time. For young migrants, their integration endeavour intersects with their process of transition to adulthood, a double transition that poses additional challenges. Recent theoretical perspectives such as "liquid integration" aim at focusing on the dynamic, processual, and temporal nature of migrant integration. The present article focuses on the dynamic interplay of obstacles and enablers that, over time, interact to construct complex, often non-linear, and open-ended integration and coming of age trajectories of young migrants (aged from 18 to 30 years) coming from outside the European Union (EU) to EU countries. Empirical results from the H2020 MIMY (Empowerment through liquid Integration of Migrant Youth in vulnerable conditions) research project in Luxembourg will be presented. In order to address the goal of the research, qualitative data were gathered by means of N = 38 interviews with young migrants with different migratory paths, characteristics and experiences, and specifically included: young migrants from non-EU Portuguese-speaking countries (N = 16), refugees living in reception centres (N = 15), migrants who since arriving in Luxembourg have become publicly visible (N = 7). Content analysis of the interviews allowed a twofold purpose: (1) capturing the unfolding of intersectional integration obstacles that over time play a decisive role in the building of conditions of vulnerability of the double transition under analysis; (2) capturing the multidimensional resources that interactively build up to give rise to resilient and empowering integration and coming of age experiences. The identification of decisive multidimensional obstacles and resources present in the integration endeavour during the process of coming of age allowed us to capture differentiated routes of vulnerability, on the one hand, and resilience/ empowerment on the other. Key ingredients of both vulnerable and more resilient and empowering integration and coming of age trajectories are identified as well as their relational dynamics, enabling to address key challenges for the resilience and empowerment of young migrants in the process of negotiating their transition to adulthood amidst their integration challenges in the Luxembourgish society.
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Affiliation(s)
- José Oliveira
- Department DGEO, University of Luxembourg, Luxembourg, Luxembourg
| | - Birte Nienaber
- Department DGEO, University of Luxembourg, Luxembourg, Luxembourg
| | - Jutta Bissinger
- Department DGEO, University of Luxembourg, Luxembourg, Luxembourg
| | - Amalia Gilodi
- Department DBCS, University of Luxembourg, Luxembourg, Luxembourg
| | | | - Isabelle Albert
- Department DBCS, University of Luxembourg, Luxembourg, Luxembourg
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Yamashita T, Quy PN, Yamada C, Nogami E, Seto-Suh E, Iwamoto S, Kato K. A cross-sectional survey of material deprivation and suicide-related ideation among Vietnamese technical interns in Japan. Front Psychol 2024; 14:1241837. [PMID: 38250095 PMCID: PMC10797745 DOI: 10.3389/fpsyg.2023.1241837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/06/2023] [Indexed: 01/23/2024] Open
Abstract
Background The economic struggles faced by many technical intern trainees in Japan include the necessity to remit money to their home country, debts owed to intermediaries facilitating their arrival, and reduced working hours due to the COVID-19 pandemic. Furthermore, there is concern that the pandemic may contribute to mental instability resulting from the significant life changes experienced by the trainees. This study examined the experience of material deprivation among Vietnamese intern trainees in Japan and explored the correlation between material deprivation and suicidal ideation. Methods A cross-sectional study was conducted between September and October 2021, involving 310 Vietnamese technical intern trainees. Data from 200 participants were analyzed. The questionnaire included gender, age, duration of residence in Japan, proficiency in the Japanese language, income changes due to the COVID-19 pandemic, material deprivation status, and suicidal ideation. Suicidal ideation was assessed using the ninth item of the Patient Health Questionnaire-9. Logistic regression analysis was performed to investigate the relationship between material deprivation items and suicidal ideation. Results The mean age of the respondents was 26.0 ± 5.1 years, with 62.0% (n = 124) being male. Among the material deprivation items, 74.0% (n = 148) reported food deprivation, 59.0% (n = 118) reported cellphone bill deprivation, and 55.0% (n = 110) reported medical expense deprivation. Suicidal ideation was reported by 23.0% (n = 46) of the respondents. The prevalence of suicidal ideation was associated with age (p = 0.031, odds ratio [OR] = 0.889, 95% confidence interval [CI] = 0.799-0.990), deprivation of food expenses (p = 0.003, OR = 3.897, 95% CI = 1.597-9.511), and deprivation of cellphone usage (p = 0.021, OR = 3.671, 95% CI = 1.217-11.075). Conclusion Vietnamese technical intern trainees in Japan faced various forms of material deprivation, which correlated with a high prevalence of significant psychological issues. Suicidal ideation was influenced by factors such as age, deprivation of food expenses, and inability to pay cellphone bills. The experience of material deprivation could have intensified the mental health challenges faced by Vietnamese trainees, particularly in the demanding circumstances of the COVID-19 pandemic.
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Affiliation(s)
| | - Pham Nguyen Quy
- Department of Medical Oncology, Kyoto Miniren Central Hospital, Kyoto, Japan
| | - Chika Yamada
- Department of Environmental Coexistence, Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Emi Nogami
- Department of Social Welfare, School of Psychology and Social Welfare, Mukogawa Women’s University, Nishinomiya, Japan
| | - Erina Seto-Suh
- Human Rights Research Institute, Kindai University, Higashi osaka, Japan
| | - Saori Iwamoto
- Faculty of Nursing, Kobe City College of Nursing, Kobe, Japan
| | - Kenji Kato
- Faculty of Nursing, Kobe Women’s University, Kobe, Japan
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Nam B, Kim J, Kim JY, Lee Y. Depression, Alcohol Misuse, and Suicide Attempt Among North Korean Refugee Women Exposed to Gender-Based Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2023:8862605231161290. [PMID: 36942848 DOI: 10.1177/08862605231161290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
North Korean (NK) refugee women report a disproportionately high rate of suicide compared to the general South Korean (SK) population. NK refugee women's exposure to gender-based violence (GBV) is a risk factor for adverse mental health symptoms. However, the association between GBV exposure and mental health has received less scholarly attention. This study examined NK refugee women's exposure to GBV (i.e., sexual violence, human trafficking, and forced sex work) and explored whether it is associated with an increased risk of depression, alcohol misuse, and suicide attempts. A three-way interaction between depression, alcohol misuse, and suicide attempts among GBV-exposed NK refugee women was examined. Data from a snowball sample of 180NK refugee women were analyzed for this study. Findings show that 47.8% experienced GBV in either NK or intermediary countries. Multivariate analyses revealed that depression (OR = 1.13, p < .05) and alcohol misuse (OR = 3.01, p < .01) was significantly associated with suicide attempts in GBV-exposed groups. Results from the three-way interaction (GBV victimization × Depression × Alcohol misuse) suggest that GBV exposure and higher levels of depression were significantly associated with suicide attempts among NK refugee women with greater severity of alcohol misuse (OR = 1.75, p < .05). The findings indicate that NK refugee women with GBV exposure, depression, and alcohol misuse are at increased risk for suicide attempts. Study limitations included the use of snowball sampling and cross-sectional data. This study discusses implications for future research and targeted, trauma-informed treatments focused on GBV and mental health symptoms among NK refugee women.
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Affiliation(s)
- Boyoung Nam
- School of Social Welfare, Yonsei University, Seoul, Republic of Korea
| | - Joonbeom Kim
- Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, Seoul, Republic of Korea
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Yop Kim
- School of Social Welfare, Yonsei University, Seoul, Republic of Korea
| | - Yujin Lee
- School of Social Welfare, Yonsei University, Seoul, Republic of Korea
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Abstract
OBJECTIVE In recent years, there has been an increase in immigrant populations worldwide. This study aims to present the global prevalence of suicide between immigrants and refugees as well as to report the prevalence of suicide ideation, suicide mortality, suicide attempts, and plan of suicide. METHOD Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA's) rules were used as a guide in the current research path. PubMed and EMBASE were targeted for the study until December 2019. After collecting the data, the number of events and sample size extracted for each study and also pooled odds ratio and confidence interval (CI) were used to investigate the suicide ratio among immigrants and refugees compared to the native population. RESULTS Fifty-one studies were included in the meta-analysis to investigate suicide prevalence or suicide odds ratio. The prevalence of suicidal ideation was 16% (CI: 0.12-0.20, I2 = 99.4%), for attempted suicide was 6% (CI: 0.05-0.08, I2 = 98.0%), and for suicide plan prevalence was 4% (CI: 0.00-0.08, I2 = 96.8%). The prevalence of suicidal ideation was 10% (CI: 0.04-0.17, I2 = 0.0%) in men and 17% (CI: 0.10-0.24, I2 = 96.8%) in women. The prevalence of attempted suicide was 1% (CI: 0.01-0.02, I2 = 0.0%) in men and 7% (CI: 0.03-0.10, I2 = 94.4%) in women. The odds ratio of suicide mortality among immigrants was 0.91 (CI: 0.90-0.93, p < 0.001; I2 = 97.6%) and for attempted suicide was 1.15 (CI: 1.10-1.20, p < 0.001; I2 = 92.0%). Begg's test (p = 0.933) (Egger test; p = 0.936) rejected publication bias. CONCLUSION Given the high prevalence of suicide, especially suicide ideation and suicide attempts in immigrants, increased attention needs to be paid to the mental health of this population.
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Clark KA, Björkenstam C, Kosidou K, Björkenstam E. Psychological Distress, Suicidal Ideation, and Suicide Attempt Among Lesbian, Gay, and Bisexual Immigrants: Population-Based Findings from the Stockholm Public Health Cohort. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:3563-3574. [PMID: 34725752 PMCID: PMC9308978 DOI: 10.1007/s10508-021-01997-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/25/2021] [Accepted: 03/27/2021] [Indexed: 06/13/2023]
Abstract
In a large, population-based sample in Sweden, we sought to examine mental health disparities between lesbian, gay and bisexual (LGB) and heterosexual individuals with different immigration statuses. We conducted a population-based study including 1799 LGB and 69,324 heterosexual individuals, recruited in 2010 and 2014 as part of the Stockholm Public Health Cohort. Data were obtained from self-administered surveys that were linked to nationwide registers. We examined associations between mental health outcomes (i.e., psychological distress, suicidal ideation, and suicide attempt) and sexual orientation (LGB versus heterosexual), immigration status (immigrant versus Nordic-born), and their interaction. Sex-stratified weighted multivariable logistic regression analyses were used to calculate adjusted odds ratios with 95% confidence intervals. LGB individuals demonstrated substantially elevated odds of all mental health outcomes compared to heterosexuals; immigrants reported moderately elevated odds of psychological distress and suicide attempt, but not suicidal ideation, compared to Nordic-born individuals. Interaction terms between sexual orientation and immigration status were significant at p < 0.05 for psychological distress for both sexes and for suicidal ideation and attempt among women. Unexpectedly, models probing interactions generally demonstrated that Nordic-born LGB individuals demonstrated greater risk of psychological distress, suicidal ideation, and suicide attempt than did immigrant LGB individuals, especially among women. Supplemental analyses showed that Nordic-born bisexual women demonstrated the highest risk of all studied outcomes. Being LGB in Sweden is generally a stronger risk factor for poor mental health among Nordic-born than immigrant populations. These findings call for future intersectionality-focused research to delineate the unique cultural, social, and psychological factors associated with mental health and resilience among LGB immigrants.
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Affiliation(s)
- Kirsty A Clark
- Department of Medicine, Health, and Society, Vanderbilt University, Nashville, TN, 37235, USA.
| | | | - Kyriaki Kosidou
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Center for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
| | - Emma Björkenstam
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Community Health Sciences, Fielding School of Public Health and California Center for Population Research, University of California Los Angeles, Los Angeles, CA, USA
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Nam B, Kim JY, DeVylder J, Kim J. Suicidal Ideation and Attempt among North Korean Refugee Women in South Korea: Factors that Distinguish Suicide Attempt from Suicidal Ideation. Suicide Life Threat Behav 2021; 51:564-571. [PMID: 33890688 DOI: 10.1111/sltb.12742] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/01/2020] [Accepted: 10/02/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND North Korean Refugee Women (NKRW) are at a high risk for suicide. However, few studies have examined risk factors for suicide among NKRW in South Korea. This study aimed to examine factors increasing risk for suicidal ideation and to identify factors differentiating suicide attempt from ideation among NKRW in South Korea. METHODS A sample of 140 NKRW was analyzed; multinomial logistic regression was conducted to identify factors distinguishing respondents with (1) no suicidal ideation, (2) isolated suicidal ideation (without attempts), and (3) ideation with attempts. RESULTS About 46% of the sample reported suicidal ideation, and about 18% attempted suicide during the past year. NKRW without any suicidal risk had significantly lower levels of social isolation (OR = 0.86, p = 0.02) and less exposure to traumatic events (OR = 0.89, p = 0.02) than those with suicidal ideation. NKRW who attempted suicide were more likely to have higher levels of stress than those with only suicidal ideation (OR = 1.40, p = 0.03). CONCLUSION This study provides insights into suicide prevention among refugees and emphasized that post-migration life stress significantly differentiates suicidal ideation from attempt among NKRW. Intervening to address current life stress, traumatic experiences, and social isolation may help prevent refugee suicidal ideation and further attempt.
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Affiliation(s)
- Boyoung Nam
- Department of Social Welfare, Yonsei University, Seoul, Korea
| | - Jae Yop Kim
- Department of Social Welfare, Yonsei University, Seoul, Korea
| | - Jordan DeVylder
- Graduate School of Social Service, Fordham University, New York, NY, USA
| | - JoonBeom Kim
- Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, Seoul, Korea
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AlShamlan NA, AlShamlan RA, AlShamlan AA, AlOmar RS, AlAmer NA, Darwish MA, Sebiany AM. Prevalence of depression and its associated factors among clinical-year medical students in Eastern Province, Saudi Arabia. Postgrad Med J 2020; 96:343-348. [PMID: 32303582 DOI: 10.1136/postgradmedj-2020-137578] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/23/2020] [Accepted: 03/28/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND To assess the prevalence of depression among medical students in their clinical years (fourth, fifth, and sixth years) in a government university in Eastern Province, Saudi Arabia, and its association with the students' sociodemographic characteristics, academic factors, perceived health problems and their perceived readiness to their future specialties. METHODS A cross-sectional study was conducted among 527 clinical-year medical students. The Patient Health Questionnaire (PHQ-9) and questionnaire designed by the researchers to collect data on sociodemographic and academic variables were used as research instruments. Statistical analyses were conducted using Stata Statistical Software V.15. Descriptive statistics, the χ test, and both an ordered logistic regression and a binary logistic regression analysis were performed. RESULTS The prevalence of depression was found to be 39.27%, according to the results of the PHQ-9. Both the ordered logistic regression and the binary logistic regression analyses revealed that the odds of severe depression were high among women, and students who perceived that they were not yet ready for their future specialties. The more senior the medical students were, the less likely it is that they have severe depression. A similar association was found for students who perceived that they did not have psychological problems. However, students' grade point average was not statistically significantly associated with depression. CONCLUSIONS The prevalence of depression was high among the medical students examined. Policy makers should establish screening programmes, provide counselling for students who need it and deliver early interventions in detected cases.
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Affiliation(s)
- Nouf A AlShamlan
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | | | - Reem S AlOmar
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Naheel A AlAmer
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Magdy A Darwish
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdulaziz M Sebiany
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Honkaniemi H, Juárez SP, Katikireddi SV, Rostila M. Psychological distress by age at migration and duration of residence in Sweden. Soc Sci Med 2020; 250:112869. [PMID: 32120203 PMCID: PMC8325349 DOI: 10.1016/j.socscimed.2020.112869] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 12/02/2019] [Accepted: 02/18/2020] [Indexed: 11/24/2022]
Abstract
Migrants suffer from worse psychological health than natives in many countries, yet the extent to which this varies by age at migration and duration of residence in the receiving context remains unexplored in Sweden. Drawing on a life course approach, we investigate differences in psychological distress by age at migration and duration of residence in working-age migrants to Sweden, and examine the role of various social determinants of health in explaining these differences relative to Swedish-born. Using pooled cross-sectional data from the 2011/2015 Health on Equal Terms survey in Västra Götaland Region, Sweden (n = 58,428), we applied logistic regression analysis to calculate predicted probabilities and average marginal effects (AME) of migrant status, by age at migration and duration of residence, on psychological distress. Analyses were stratified by sex and region of origin and controlled for indicators of socioeconomic status (SES), social cohesion, and discrimination to assess their potential contribution to differences in migrants' and natives' psychological distress. All migrants except men from OECD-predominant regions had a greater probability of psychological distress than Swedish-born (ranging from AME 0.031 [95% Confidence Interval or CI 0.000-0.062] for OECD women to AME 0.115 [95% CI 0.074-0.156] for non-OECD men). Marginal effects of migration status on psychological distress probabilities generally increased with age at migration and duration of residence. Differences between migrants and natives were largely attenuated after controlling for social determinants, the greatest contribution coming from inequalities in social cohesion, followed by inequalities in discrimination and SES. Our results suggest a relative health advantage of early-life compared to later-life migration, albeit with worse outcomes with longer residence in Sweden. The predominance of integration opportunities in childhood strengthens calls for supportive policies to assist older migrants' integration directly upon arrival, which may ultimately improve their psychological wellbeing.
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Affiliation(s)
- Helena Honkaniemi
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden.
| | - Sol Pía Juárez
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | | | - Mikael Rostila
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
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Record-Lemon RM, Chevalier M, Mackenzie M, Moura ML, Pradhan K, Silva V, Young RA. Transition Processes and Outcomes for Immigrant and Refugee Youth: a Narrative Review from a Goal-Directed Perspective. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2020. [DOI: 10.1007/s12134-019-00743-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Brydsten A, Rostila M, Dunlavy A. Social integration and mental health - a decomposition approach to mental health inequalities between the foreign-born and native-born in Sweden. Int J Equity Health 2019; 18:48. [PMID: 30944004 PMCID: PMC6889340 DOI: 10.1186/s12939-019-0950-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 03/11/2019] [Indexed: 01/18/2023] Open
Abstract
Background The increasing mental health inequalities between native- and foreign-born persons in Sweden is an important public health issue. Improving social integration has been stressed as a key strategy to combat this development. While a vast amount of studies have confirmed the importance of social integration for good mental health, less is known about the role of different types of social integration, and how they relate to mental health inequalities. This study aimed to examine the extent to which indicators of social integration explained mental health inequalities between the native- and foreign-born. Methods Based on the Health on Equal Terms survey from 2011/2015 in Västra Götaland, Sweden (n = 71,643), a non-linear Oaxaca–Blinder decomposition analysis was performed comparing native- and foreign-born individuals from Nordic-, European- and non-European countries. The General Health Questionnaire was used to assess psychological distress, while 11 items assessed employment conditions and economic disparities, social relations, and experiences of discrimination to measure different aspects of social integration. Results Differences in social integration explained large proportions of observed mental health differences between the native- and foreign-born. Important indicators included low levels of social activity (20%), trust in others (17%) and social support (16%), but also labour market disadvantages, such as being outside the labour market (15%), unemployment (10%) and experiencing financial strain (16%). In analyses stratified by region of origin, low trust in others and discrimination contributed to the mental health gap between the native-born and European-born (17 and 9%, respectively), and the native-born and non-European-born (19 and 10%, respectively). Precarious labour market position was a particularly important factor in the mental health gap between the native-born and Nordic-origin (22%), and non-European origin (36%) populations. Conclusion Social integration factors play a central role in explaining the mental health inequality between natives and migrants in Sweden. Our findings suggest that public health actions targeting mental health gaps could benefit from focusing on inequalities in social and economic recourses between natives and migrants in Sweden. Areas of priority include improving migrants’ financial strain, as well as increasing trust in others and social support and opportunities for civic engagement.
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Affiliation(s)
- Anna Brydsten
- Department of Public Health Science, Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, SE-105 91, Stockholm, Sweden.
| | - Mikael Rostila
- Department of Public Health Science, Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, SE-105 91, Stockholm, Sweden
| | - Andrea Dunlavy
- Department of Public Health Science, Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, SE-105 91, Stockholm, Sweden
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Abstract
Abstract.Background: Asylum seekers have increased risk of suicide and
suicidal behavior, with differences related to origin, gender, and age. There
are barriers to communication in clinical encounters between asylum seekers and
clinicians. There is insufficient knowledge about how communication in the
clinical encounter affects the suicide risk in female asylum seekers.
Aims: To explore the documented communication between
female asylum-seeking suicide attempters and clinicians and how it affects
treatment. Method: The medical records of 18 asylum-seeking
women who had attempted suicide were analyzed with content analysis.
Results: Communication between patients and clinicians was
affected by: the unbearable realities of the women; difficulties for clinicians
in decoding languages of distress, and understanding trauma and subjective
meanings of suicide; challenges of combining patients' and clinicians'
perspectives; and a sense of shared powerlessness. Limitations:
The medical records did not give direct access to the patient's experience,
only to the patient as documented by the clinician. Conclusion:
The results suggest that clinicians working with asylum seekers who have
attempted suicide need to develop an understanding of social and cultural
factors and of trauma issues. A question for further study is how an enhanced
integration of context and subjectivity in psychiatric practice would equip
clinicians for the specific challenges encountered.
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Affiliation(s)
- Maria Sundvall
- 1 Transcultural Center, Stockholm County Council, Sweden.,2 Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - David Titelman
- 3 National Center for Suicide Research and Prevention of Mental Ill-Health, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Sofie Bäärnhielm
- 1 Transcultural Center, Stockholm County Council, Sweden.,4 Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
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Björkenstam E, Björkenstam C, Jablonska B, Kosidou K. Cumulative exposure to childhood adversity, and treated attention deficit/hyperactivity disorder: a cohort study of 543 650 adolescents and young adults in Sweden. Psychol Med 2018; 48:498-507. [PMID: 28738913 DOI: 10.1017/s0033291717001933] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Though childhood adversity (CA) has been associated with the risk of attention deficit/hyperactivity disorder (ADHD), little is known about the effect of cumulative CAs and whether there are clusters of CAs that are more closely related with ADHD. METHODS We used a Swedish cohort of 543 650 individuals born 1987-1991. Register-based CAs included familial death, substantial parental substance abuse and psychiatric disorder, substantial parental criminality, parental separation, household public assistance recipiency, and residential instability. Individuals were followed from year 2006 when they were 15-19 years of age, for treated ADHD, defined as a registered ICD diagnosis and/or prescription of medications to treat ADHD. Logistic regression analysis was used to calculate odds ratios (OR) with 95% confidence intervals (CI). Latent Class Analyses (LCA) were used to identify clusters based on the different CAs. RESULTS All CAs increased the odds of ADHD in late adolescence and early adulthood; ORs ranged from 1.6 (95% CI 1.5-1.8) for familial death to 2.7 (95% CI 2.6-2.9) for household public assistance. We found a dose-response relationship between cumulative CA and ADHD; individuals with 4+ CAs had a markedly increased risk for ADHD (OR 5.5, 95% CI 5.0-6.0). LCA analyses revealed six distinct classes of CA associated with ADHD, of which 'exposure to most adversities' entailed highest risk. CONCLUSION CA is a strong risk factor for ADHD, particularly when accumulated. Early and efficient detection of CA is of importance for interventions targeted to improve long-term mental health outcomes among disadvantaged children.
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Affiliation(s)
- E Björkenstam
- Division of Social Medicine,Department of Public Health Sciences,Karolinska Institutet,Stockholm,Sweden
| | - C Björkenstam
- Department of Epidemiology,Fielding School of Public Health, University of California Los Angeles,Los Angeles,USA
| | - B Jablonska
- Division Public Health Epidemiology,Department of Public Health Sciences,Karolinska Institutet,Stockholm,Sweden
| | - K Kosidou
- Division Public Health Epidemiology,Department of Public Health Sciences,Karolinska Institutet,Stockholm,Sweden
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Anagnostopoulos DC, Giannakopoulos G, Christodoulou NG. The synergy of the refugee crisis and the financial crisis in Greece: Impact on mental health. Int J Soc Psychiatry 2017; 63:352-358. [PMID: 28351293 DOI: 10.1177/0020764017700444] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The current global financial crisis that started in 2008 resulted in a significant decline in global trade, slowing/reversing economic growth worldwide, and a dramatic increase in public sector debt. At the same time, the global migrant/refugee crisis has reached extreme rates, with millions of people being forced to abandon their homes and communities because of war, political violence or related threats. There is a broad consensus about the deleterious consequences of these crises on psychological well-being, depression, anxiety disorders, insomnia, alcohol abuse and suicidal behavior. Although the separate consequences of economic recession and immigration are extensively discussed in previous research, we know very little about the processes through which the intersection of economic crisis and migrant crisis contributes to the vulnerabilities of natives and migrants during these crises. Of particular concern is the status of children, adolescents and their families, who constitute one of the most vulnerable groups in society. AIM To discuss the contexts that economic and migrant crises shape and suggest possible effects of this intersection on mental health risks, especially among children, adolescents and their families, through reflecting on the recent experience in Greece. METHOD Review of the literature and critical analysis of the effects of the confluent crises. CONCLUSION The interactive effects of these two crises need further exploration. Novel and diverse models of psychological understanding need to be developed in order to manage the effects of the confluent crises. The role of mental health professionals is crucial in this respect, offering culturally flexible, accommodating and empathetic approaches, allowing healing and acceptance in the face of adversity.
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Affiliation(s)
- Dimitris C Anagnostopoulos
- 1 Department of Child Psychiatry, Schoolof Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - George Giannakopoulos
- 1 Department of Child Psychiatry, Schoolof Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Nikos G Christodoulou
- 2 University of Nottingham and Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
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Sidorchuk A, Engström K, Johnson CM, Kayser Leeoza N, Möller J. Employment status and psychological distress in a population-based cross-sectional study in Sweden: the impact of migration. BMJ Open 2017; 7:e014698. [PMID: 28389494 PMCID: PMC5558822 DOI: 10.1136/bmjopen-2016-014698] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Unemployment and temporary employment are known to impact psychological health. However, the extent to which the effect is altered by migration-related and sociodemographic determinants is less clear. The purpose of this study was to investigate whether the association between employment status and psychological distress differs between immigrants and Swedish-born and to what extent, the association is modified by gender and reason for immigration. DESIGN Cross-sectional survey study. PARTICIPANTS AND SETTING Data from public health surveys undertaken in 2002, 2006 and 2010 from random samples of Stockholm County residents, Sweden, were used to analyse a weighted sample of 51 118 individuals aged 18-64 (43 444 Swedish-born, 4055 non-refugees, 3619 refugees). According to their activity in the labour market, the participants were categorised into permanently/self-employed, temporarily employed and unemployed. OUTCOMES MEASURES Associations between self-reported employment and psychological distress measured by a 12-item version of the General Health Questionnaire were explored across individuals with different migration status and reasons for immigration using logistic regression and pairwise comparisons. The analyses were stratified by gender and adjusted for age, socioeconomic characteristics and survey year. RESULTS Unemployment was associated with elevated likelihood of psychological distress across the study population, regardless of migration status and gender. Fully adjusted models revealed nearly a 3-fold higher odds of distress in unemployed Swedish-born (OR 3.05, 95% CI 2.66 to 3.51), non-refugees (OR 3.51, 95% CI 2.44 to 5.05) and refugees (OR 2.91, 95% CI 2.20 to 3.85) when compared with permanently/self-employed. Temporary employment also increased the likelihood of distress, particularly among refugees and Swedish-born. CONCLUSIONS The effect of unemployment on increased likelihood of poor psychological well-being overcomes gender-specific and migration-specific differences and is equally pronounced for Swedish-born, non-refugees and refugees. Exclusion from the labour market appears to be a major determinant of psychological health inequalities in contemporary Sweden.
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Affiliation(s)
- Anna Sidorchuk
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Karin Engström
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Centre of Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Charisse M Johnson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Naima Kayser Leeoza
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Jette Möller
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Zhang J, Liu Y, Sun L. Life satisfaction and degree of suicide intent: A test of the strain theory of suicide. Compr Psychiatry 2017; 74:1-8. [PMID: 28040550 DOI: 10.1016/j.comppsych.2016.12.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 11/28/2016] [Accepted: 12/15/2016] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Various factors contribute to suicide. Psychological strains are hypothesized to precede suicidal thought and attempt. Life satisfaction can be a measure of relative deprivation strain and aspiration-reality strain. AIMS This study was to compare the suicide attempters with various levels of life satisfaction and find out how life satisfaction affects the degree of suicide intent among medically serious suicide attempters. METHODS Subjects for study were recruited in some rural counties in China. Interview data were from hospital emergency rooms with medically serious attempters of suicide (n=791). The subjects were aged between 15 and 54years and 293 males and 498 females. Face to face interview was conducted for each suicide attempter with a semi-structural protocol including life satisfaction, physical health, demographic, sociological, and psychological measures, as well as psychological strains. FINDINGS The multiple linear regression analysis showed that mental disorder, aspiration strain and relative deprivation strain were significant risk factors for high intent of suicide among suicide attempters. The interaction between the two psychological strains also indicated that both failed aspiration and self-perceived low economic status in village play an important role in suicidal intent. CONCLUSION Low level of life satisfaction is associated with strong intent for suicide. Lack of life satisfaction is exemplified by relative deprivation perceived by the individuals and the discrepancy between an individual's aspiration for life and his/her reality. The findings from the suicide attempt data in rural China support the Strain Theory of Suicide.
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Affiliation(s)
- Jie Zhang
- Shandong University Center for Suicide Prevention Research, China; State University of New York Buffalo State, USA.
| | - Yanzheng Liu
- Shandong University Center for Suicide Prevention Research, China
| | - Long Sun
- Shandong University Center for Suicide Prevention Research, China
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Björkenstam E, Cheng S, Burström B, Pebley AR, Björkenstam C, Kosidou K. Association between income trajectories in childhood and psychiatric disorder: a Swedish population-based study. J Epidemiol Community Health 2017; 71:648-654. [DOI: 10.1136/jech-2016-208513] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 02/07/2017] [Accepted: 02/11/2017] [Indexed: 11/04/2022]
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Vancea M, Utzet M. How unemployment and precarious employment affect the health of young people: A scoping study on social determinants. Scand J Public Health 2016; 45:73-84. [DOI: 10.1177/1403494816679555] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background: The impact of unemployment and precarious employment on the health of young people is not well understood. However, according to social causation, higher socio-economic positions and thus better working conditions are beneficial to health in general. We tried to synthesize the results of studies that test this hypothesis in the case of young people. Methods: We conducted a scoping study mapping all the academic articles published in the period 2006–2016 in Europe. The literature was searched in PubMed/Medline, Science Direct, Web of Science and Scopus. Results: We identified 1770 studies, of which only 46 met the inclusion criteria. There are more studies that focus on the relationship between unemployment and health than between precarious employment and health (28 and 16, respectively). The vast majority of the studies (44) found support for the social causation hypothesis, the most common health outcomes being mental health disorders, health risk behaviour, poor quality of life and occupational injuries. The causal mechanisms behind this association relied mainly on the life-course perspective, the breadwinner model, and the lack of social and economic benefits provided by standard employment. Conclusions:There is evidence that young people are especially vulnerable to health problems when unemployed or working in precarious conditions. Active labour market and training programmes, inclusive social security measures, improved working conditions and targeted health programmes are important for addressing this vulnerability. Further research should strive to enhance the causal model by including a gender perspective, longitudinal data, more indicators on precariousness and third factor explanations.
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Affiliation(s)
- Mihaela Vancea
- Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Center for Scientific Research and Technological Development in Social Sciences and Humanities, Universidad de la Frontera, Temuco, Chile
| | - Mireia Utzet
- Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Universitat Autònoma de Barcelona, Facultat de Medicina, GRAAL-Biostatistics Unit, Bellaterra, Spain
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Describing the linkages of the immigration, refugees and citizenship Canada permanent resident data and vital statistics death registry to Ontario's administrative health database. BMC Med Inform Decis Mak 2016; 16:135. [PMID: 27769227 PMCID: PMC5073414 DOI: 10.1186/s12911-016-0375-3] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 10/13/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Ontario, the most populous province in Canada, has a universal healthcare system that routinely collects health administrative data on its 13 million legal residents that is used for health research. Record linkage has become a vital tool for this research by enriching this data with the Immigration, Refugees and Citizenship Canada Permanent Resident (IRCC-PR) database and the Office of the Registrar General's Vital Statistics-Death (ORG-VSD) registry. Our objectives were to estimate linkage rates and compare characteristics of individuals in the linked versus unlinked files. METHODS We used both deterministic and probabilistic linkage methods to link the IRCC-PR database (1985-2012) and ORG-VSD registry (1990-2012) to the Ontario's Registered Persons Database. Linkage rates were estimated and standardized differences were used to assess differences in socio-demographic and other characteristics between the linked and unlinked records. RESULTS The overall linkage rates for the IRCC-PR database and ORG-VSD registry were 86.4 and 96.2 %, respectively. The majority (68.2 %) of the record linkages in IRCC-PR were achieved after three deterministic passes, 18.2 % were linked probabilistically, and 13.6 % were unlinked. Similarly the majority (79.8 %) of the record linkages in the ORG-VSD were linked using deterministic record linkage, 16.3 % were linked after probabilistic and manual review, and 3.9 % were unlinked. Unlinked and linked files were similar for most characteristics, such as age and marital status for IRCC-PR and sex and most causes of death for ORG-VSD. However, lower linkage rates were observed among people born in East Asia (78 %) in the IRCC-PR database and certain causes of death in the ORG-VSD registry, namely perinatal conditions (61.3 %) and congenital anomalies (81.3 %). CONCLUSIONS The linkages of immigration and vital statistics data to existing population-based healthcare data in Ontario, Canada will enable many novel cross-sectional and longitudinal studies to be conducted. Analytic techniques to account for sub-optimal linkage rates may be required in studies of certain ethnic groups or certain causes of death among children and infants.
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Doré I, O'Loughlin JL, Beauchamp G, Martineau M, Fournier L. Volume and social context of physical activity in association with mental health, anxiety and depression among youth. Prev Med 2016; 91:344-350. [PMID: 27609745 DOI: 10.1016/j.ypmed.2016.09.006] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 09/02/2016] [Accepted: 09/04/2016] [Indexed: 11/17/2022]
Abstract
There is growing interest in physical activity (PA) to prevent mental disorders in youth. However, few studies examine the association between PA and mental health. Further, how PA volume and context relate to mental health and mental disorders remains unclear, especially among youth in transition to adulthood. This study examined the cross-sectional associations among PA volume and context, mental health, and symptoms of anxiety and depression in post-secondary students. A total of 1527 post-secondary students (97.4% were age 16-24years) recruited in a CEGEP in Quebec, Canada completed a self-report questionnaire during class-time in October 2013. Multivariate linear regression was used to model the associations between PA volume and context and mental health, anxiety and depression controlling for sex, age and perceived socioeconomic status. Volume of moderate-to-vigorous leisure time PA (MVPA) was positively associated with mental health (β (95% CI)=0.072 (0.045, 0.099)) and inversely associated with symptoms of anxiety (-0.011 (-0.020, -0.001)) and depression (-0.010 (-0.017, -0.003)). Volume including all PA intensities was associated with mental health (0.052 (0.028, 0.076)). After controlling for PA volume, active youth involved in team sports had better mental health than those who engaged in PA individually. PA volume and the social context of PA are independently associated with mental health among youth. MVPA is inversely associated with anxiety and depressive symptoms.
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Affiliation(s)
- Isabelle Doré
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Department of Social and Preventive Medicine, School of Public Health (ESPUM), Université de Montréal, Montréal, Qc, Canada.
| | - Jennifer L O'Loughlin
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Department of Social and Preventive Medicine, School of Public Health (ESPUM), Université de Montréal, Montréal, Qc, Canada.
| | - Guy Beauchamp
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Qc, Canada.
| | | | - Louise Fournier
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada; Department of Social and Preventive Medicine, School of Public Health (ESPUM), Université de Montréal, Montréal, Qc, Canada.
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Webb RT, Antonsen S, Pedersen CB, Mok PLH, Cantor-Graae E, Agerbo E. Attempted suicide and violent criminality among Danish second-generation immigrants according to parental place of origin. Int J Soc Psychiatry 2016; 62:186-97. [PMID: 26613752 PMCID: PMC5089542 DOI: 10.1177/0020764015615904] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Immigrant populations in Western European countries have grown in their size and diversity, but little is known about risks of self-directed and externalised violence among second-generation immigrants. AIMS To compare risks for attempted suicides and violent offending among second-generation immigrants to Denmark according to parental region of origin versus the native Danish population. METHODS Data from interlinked national Danish registers were used (N = 1,973,614). Parental origin outside Denmark was categorised thus: Asia, Africa, Middle East, Greenland, other Scandinavian countries, elsewhere in Europe and all other regions. We estimated gender-specific cumulative incidence and incidence rate ratios (IRRs) versus native Danes. RESULTS In virtually all subgroups of second-generation immigrants, risk was elevated for the two adverse outcomes in both genders. Females generally had greater elevations in attempted suicide risk, and males had greater elevations in violent offending risk. For attempted suicide, especially large IRRs were observed for males and females whose parents emigrated from Greenland; for violent offending, risks were particularly raised for males and females of Middle Eastern, Greenlandic and African origin. Adjustment for socioeconomic status partially explained these associations. CONCLUSION Western European nations should develop preventive programmes tailored towards specific second-generation immigrant populations, with integrated approaches jointly tackling suicidality and violence.
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Affiliation(s)
- Roger T Webb
- Centre for Mental Health and Safety, University of Manchester, Manchester, UK
| | - Sussie Antonsen
- National Centre for Register-based Research (NCRR) and Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
| | - Carsten B Pedersen
- National Centre for Register-based Research (NCRR) and Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
| | - Pearl L H Mok
- Centre for Mental Health and Safety, University of Manchester, Manchester, UK
| | | | - Esben Agerbo
- National Centre for Register-based Research (NCRR) and Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
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Umubyeyi A, Mogren I, Ntaganira J, Krantz G. Help-seeking behaviours, barriers to care and self-efficacy for seeking mental health care: a population-based study in Rwanda. Soc Psychiatry Psychiatr Epidemiol 2016; 51:81-92. [PMID: 26433379 PMCID: PMC4720720 DOI: 10.1007/s00127-015-1130-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 09/22/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE Mental disorders commonly affect young people but usually go unrecognized and untreated. This study aimed to investigate help-seeking behaviours, barriers to care and self-efficacy for seeking mental health care among young adults with current depression and/or suicidality in a low-income setting. METHODS This cross-sectional study used two sub-populations: a sub-sample of those suffering from current depression and/or suicidality (n = 247) and another of those not suffering from these conditions and not suffering from any other mental condition investigated (n = 502). Help-seeking behaviours, barriers to care and self-efficacy for mental health care seeking were measured among those suffering from current depression and/or suicidality (n, %). Logistic regression was used to identify risk factors for experiencing barriers to care. Self-efficacy for seeking mental health care was compared between men and women in the two sub-populations. RESULTS Of the 247 men and women with current depression and/or suicidality, 36.0 % sought help at a health care unit and 64.0 % from trusted people in the community. Only six people received help from a mental health professional. The identified barriers were mainly related to accessibility and acceptability of health services. For the population suffering from current depression and/or suicidality, the self-efficacy scale for seeking mental health care suggested a low confidence in accessing mental health care but a high confidence in respondents' ability to successfully communicate with health care staff and to cope with consequences of seeking care. CONCLUSION The current study clearly highlights young adults' poor access to mental health care services. To reach universal health coverage, substantial resources need to be allocated to mental health, coupled with initiatives to improve mental health literacy in the general population.
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Affiliation(s)
- Aline Umubyeyi
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda. .,Department of Public Health and Community Medicine, Section for Epidemiology and Social Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
| | - Ingrid Mogren
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - Joseph Ntaganira
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Gunilla Krantz
- Department of Public Health and Community Medicine, Section for Epidemiology and Social Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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Björkenstam E, Dalman C, Vinnerljung B, Weitoft GR, Walder DJ, Burström B. Childhood household dysfunction, school performance and psychiatric care utilisation in young adults: a register study of 96 399 individuals in Stockholm County. J Epidemiol Community Health 2015; 70:473-80. [PMID: 26646690 DOI: 10.1136/jech-2015-206329] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 11/13/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND Exposure to childhood household dysfunction increases the risk of psychiatric morbidity. Although school performance also has been linked with psychiatric morbidity, limited research has considered school performance as a mediating factor. To address this gap in the literature, the current register study examined whether school performance mediates the association between childhood household dysfunction (experienced between birth and age 14 years) and psychiatric care utilisation in young adulthood. METHODS We used a Swedish cohort of 96 399 individuals born during 1987-1991. Indicators of childhood household dysfunction were familial death, parental substance abuse and psychiatric morbidity, parental somatic disease, parental criminality, parental separation/single-parent household, public assistance recipiency and residential instability. Final school grades from the 9th year of compulsory school were used to create five categories. Estimates of risk of psychiatric care utilisation (measured as inpatient, outpatient and primary care) after the age of 18 years were calculated as HRs with 95% CIs. Mediation was tested with the bootstrap approach. RESULTS Cumulative exposure to childhood household dysfunction was positively associated with psychiatric care utilisation. Specifically, individuals exposed to three or more indicators with incomplete school grades had the highest risk (HR=3.7 (95% CI 3.3 to 4.1) after adjusting for demographics), compared to individuals exposed to no indicators with highest grades. School performance was found to mediate the relationship. CONCLUSIONS Our findings suggest that future efforts to prevent or mitigate the negative effects of childhood household dysfunction on psychiatric morbidity may benefit from integration of strategies that improve school performance among vulnerable youth.
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Affiliation(s)
- Emma Björkenstam
- Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden Department of Community Health Sciences, Fielding School of Public Health and California Center for Population Research, University of California Los Angeles, Los Angeles, California, USA
| | - Christina Dalman
- Department of Public Health Sciences, Division Public Health Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Bo Vinnerljung
- Department of Social Work, Stockholm University, Stockholm, Sweden
| | | | - Deborah J Walder
- Department of Psychology, Brooklyn College and The Graduate Center of The City University of New York, New York, New York, USA
| | - Bo Burström
- Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden
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Plener PL, Munz LM, Allroggen M, Kapusta ND, Fegert JM, Groschwitz RC. Immigration as risk factor for non-suicidal self-injury and suicide attempts in adolescents in Germany. Child Adolesc Psychiatry Ment Health 2015; 9:34. [PMID: 26417389 PMCID: PMC4584432 DOI: 10.1186/s13034-015-0065-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 06/24/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Whereas non-suicidal self-injury (NSSI) and suicide attempts (SA) are rather common among adolescents, the description of risk factors has often failed to take migration into perspective. Our study aimed to describe immigration status in adolescents with regards to their lifetime history of NSSI and SA. METHODS We carried out a population based study in a school community of ninth-graders (N = 452, mean age 14.85, SD 0.58) in southern Germany. Data were collected via adolescent self report on sociodemographic variables and on NSSI and SA using the Self Harm Behavior Questionnaire. RESULTS Adolescents born outside Germany showed an elevated rate of a lifetime history of NSSI and SA. When compared to German adolescents without a (family) history of migration (NSSI 19.16%, SA 3.24%), adolescents who were born in another country had an elevated risk for NSSI (42.86%, OR 3.36) and SA (17.86%, OR 6.78), which was higher than the risk of adolescents who had at least one parent who had emigrated from another country (NSSI 30.08%, OR 2.46 and SA 8.94%, OR 4.45). CONCLUSION Our findings should inform intervention services and prevention programs for NSSI and suicidality in youth. Adopting such programs to include culturally sensible modules could improve the outcome in ethnically diverse adolescents.
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Affiliation(s)
- Paul L Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany
| | - Lara M Munz
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany
| | - Marc Allroggen
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany
| | - Nestor D Kapusta
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany
| | - Rebecca C Groschwitz
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany
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Webb RT, Antonsen S, Mok PLH, Agerbo E, Pedersen CB. National Cohort Study of Suicidality and Violent Criminality among Danish Immigrants. PLoS One 2015; 10:e0131915. [PMID: 26121654 PMCID: PMC4488292 DOI: 10.1371/journal.pone.0131915] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 06/08/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Immigrant populations in western societies have grown in their size and diversity yet evidence is incomplete for their risks of suicidality and criminal violence. We examined these correlated harmful behaviours in a national cohort. AIMS (i) Compare absolute risk between first and second generation immigrants, foreign-born adoptees and native Danes by plotting cumulative incidence curves to onset of early middle age; (ii) estimate sex-specific relative risks for these immigrant type subgroups vs. native Danes; (iii) examine effect modification by higher vs. lower socio-economic status. METHODS In a cohort of over two million persons, attempted suicides and violent crimes were investigated using data from multiple interlinked registers. We plotted sex-specific cumulative incidence curves and estimated incidence rate ratios. RESULTS In the whole study cohort, 1414 people died by suicide, 46,943 attempted suicide, and 51,344 were convicted of committing a violent crime. Among all immigrant subgroups combined, compared with native Danes, relative risk of attempted suicide was greater in female immigrants (incidence rate ratio, 1.59; 95% confidence interval: CI 1.54-1.64) than in male immigrants (1.26; CI 1.20-1.32), and vice versa for relative risk of violent offending in male immigrants (2.36; CI 2.31-2.42) than in female immigrants (1.74; CI 1.62-1.87). Risk for both adverse outcomes was significantly elevated in virtually every gender-specific immigrant type subgroup examined. Violent crime risk was markedly raised in first generation immigrant males and in the Danish born male children of two immigrant parents. However, male immigrants of lower social status had lower risk of attempted suicide than their native Danish peers. CONCLUSION Young immigrants of both first and second generation status face serious challenges and vulnerabilities that western societies need to urgently address. Relative risk patterns for these adverse outcomes vary greatly between the genders and also by socioeconomic status. This high degree of heterogeneity points to the existence of modifiable factors that are amenable to positive change and a potential for effective intervention.
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Affiliation(s)
- Roger T. Webb
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, United Kingdom
- * E-mail:
| | - Sussie Antonsen
- NCRR—National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- CIRRAU—Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Pearl L. H. Mok
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, United Kingdom
| | - Esben Agerbo
- NCRR—National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- CIRRAU—Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Carsten B. Pedersen
- NCRR—National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- CIRRAU—Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
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Ngamini Ngui A, Vasiliadis HM, Préville M. Individual and area-level factors correlated with death by suicide in older adults. Prev Med 2015; 75:44-8. [PMID: 25819059 DOI: 10.1016/j.ypmed.2015.03.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 01/05/2015] [Accepted: 03/18/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To determine the influence of individual and area-level characteristics associated with suicide in older adults. METHOD This study used two complementary data sources. The first used administrative data from the Quebec Coroner's office and included information on suicide deaths in older adults aged 65years and over who died by suicide between 2000 and 2005 (n=903 persons). The second data source, which was used to identify the control group, came from a longitudinal study on seniors' health that was conducted in Quebec between 2004 and 2005 (n=2493 persons). Logistic regression analyses were used to test for associations between suicide and individual and area-level level characteristics. RESULTS Suicide was associated with male gender, age, the presence of a physical and mental disorder and the use of health services. At the area-level level, suicide was associated with a higher population density, concentration of men, lower rates of education and higher rate of unemployment. Gender specific analyses also showed different patterns of associations on suicide risk. CONCLUSIONS Suicide in older adults is associated with area-level and individual characteristics. This suggests that policies targeting only one level of risk factors are less likely to significantly influence suicide among this population.
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Affiliation(s)
- André Ngamini Ngui
- Centre de réadaptation en dépendance de Montréal - Institut Universitaire, Canada; Hôpital Charles LeMoyne Research Centre, Longueuil, QC, Canada; Centre for Research and Intervention on Suicide and Euthanasia (CRISE), UQÀM, Montréal, QC, Canada.
| | - Helen-Maria Vasiliadis
- Hôpital Charles LeMoyne Research Centre, Longueuil, QC, Canada; Department of Community Health Sciences, Université de Sherbrooke, QC, Canada.
| | - Michel Préville
- Hôpital Charles LeMoyne Research Centre, Longueuil, QC, Canada; Department of Community Health Sciences, Université de Sherbrooke, QC, Canada.
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Gilliver SC, Sundquist J, Li X, Sundquist K. Recent research on the mental health of immigrants to Sweden: a literature review. Eur J Public Health 2015; 24 Suppl 1:72-9. [PMID: 25108001 DOI: 10.1093/eurpub/cku101] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
UNLABELLED The arrival of large numbers of economic migrants and refugees has seen the Swedish immigrant population increase rapidly. Research has shown that immigrants may be more susceptible to mental disorders because of traumatic events prior to immigration and adverse circumstances in their new country. The aim of this literature review is to summarize and interpret recent research on the mental health of immigrants to Sweden. METHODS A systematic search for relevant literature in PubMed was performed on 13 February 2014. Relevant literature was limited to original research articles published between 1 January 1994 and 13 February 2014. Content relating to mental disorders and suicide was reviewed and summarized. RESULTS Nationwide studies showed increased risks of common mental disorders such as depression, as well as psychotic disorders, in immigrants to Sweden compared to native Swedes. However, the results are complex, with notable differences between different immigrant groups and between males and females. Risk of suicide was increased in some immigrant groups, but decreased in others. There has been little qualitative research on the mental health of immigrants and few intervention studies have targeted immigrants. CONCLUSION Immigrants to Sweden are a mixed group with differing, but often increased, risks of mental disorders. Targeted qualitative and intervention studies may facilitate efforts to develop and implement preventive methods for immigrants at high risk of mental ill health, and to tailor treatment to the specific needs of different immigrant groups.
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Affiliation(s)
- Stephen C Gilliver
- 1 Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University / Region Skåne, Malmö, Sweden
| | - Jan Sundquist
- 1 Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University / Region Skåne, Malmö, Sweden2 Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Xinjun Li
- 1 Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University / Region Skåne, Malmö, Sweden
| | - Kristina Sundquist
- 1 Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University / Region Skåne, Malmö, Sweden2 Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
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Dalglish SL, Melchior M, Younes N, Surkan PJ. Work characteristics and suicidal ideation in young adults in France. Soc Psychiatry Psychiatr Epidemiol 2015; 50:613-20. [PMID: 25308058 DOI: 10.1007/s00127-014-0969-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 10/06/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Job insecurity, unemployment, and job strain can predict psychological distress and suicide risk. Young people, who are particularly at risk of suicide, may be especially vulnerable to the deterioration of labor market conditions as a result of the current economic crisis in Europe. We aimed to examine the effects of work and employment characteristics on suicidal ideation in a contemporary sample of young adults. METHODS Using data from a sample of French young adults surveyed in 2011 (TEMPO study, N = 1,214, 18-37 years old) and their parents who took part in a longitudinal cohort study, we used multiple logistic regression to examine the relationship between job insecurity, lifetime and recent unemployment and suicidal ideation in the past 12 months. Our analyses were adjusted for factors associated with suicidal risk including age, sex, educational attainment, living with a partner, insufficient social support, alcohol abuse, depression and parental history of depression. RESULTS Five percent of the sample reported suicidal ideation in the preceding 12 months. Controlling for all covariates, the likelihood of suicidal ideation was associated with job insecurity (OR 2.24, 95% CI 1.08-4.63), lifetime unemployment (OR 2.25, 95% CI 1.17-4.29), and recent unemployment (OR 2.10, 95% CI 1.04-4.25). After stratifying by educational attainment, the association between suicidal ideation and job insecurity was particularly notable for participants with low educational attainment (OR 9.28, 95% CI 1.19-72.33). CONCLUSION Young adults who have unstable and unfavorable employment characteristics are disproportionately likely to be suicidal, which should be monitored, particularly in times of economic downturn.
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Affiliation(s)
- Sarah L Dalglish
- Johns Hopkins School of Public Health, Social and Behavioral Interventions Program, Department of International Health, Baltimore, MD, USA
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Brown MJ, Cohen SA, Mezuk B. Duration of U.S. residence and suicidality among racial/ethnic minority immigrants. Soc Psychiatry Psychiatr Epidemiol 2015; 50:257-67. [PMID: 25108531 PMCID: PMC4469644 DOI: 10.1007/s00127-014-0947-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 08/01/2014] [Indexed: 01/02/2023]
Abstract
PURPOSE The immigration experience embodies a range of factors including different cultural norms and expectations, which may be particularly important for groups who become racial/ethnic minorities when they migrate to the U.S. However, little is known about the correlates of mental health indicators among these groups. The primary and secondary aims were to determine the association between duration of U.S. residence and suicidality, and 12-month mood, anxiety, and substance use disorders, respectively, among racial/ethnic minority immigrants. METHODS Data were obtained from the National Survey of American Life and the National Latino and Asian American Survey. Multivariable logistic regression was used to determine the association between duration of US residence, and suicidality and 12-month psychopathology. RESULTS Among Afro-Caribbeans, there was a modest positive association between duration of U.S. residence and 12-month psychopathology (P linear trend = 0.016). Among Asians there was a modest positive association between duration of US residence and suicidal ideation and attempts (P linear trend = 0.018, 0.063, respectively). Among Latinos, there was a positive association between duration of US residence, and suicidal ideation, attempts and 12-month psychopathology (P linear trend = 0.001, 0.012, 0.002, respectively). Latinos who had been in the U.S. for >20 years had 2.6 times greater likelihood of suicidal ideation relative to those who had been in the U.S. for <5 years (95% CI 1.01-6.78). CONCLUSIONS The association between duration of US residence and suicidality and psychopathology varies across racial/ethnic minority groups. The results for Latino immigrants are broadly consistent with the goal-striving or acculturation stress hypothesis.
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Affiliation(s)
- Monique J. Brown
- Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA. 830 East Main Street, 8th Floor, Richmond 23219, VA, USA
| | - Steven A. Cohen
- Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Briana Mezuk
- Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA. Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA. Research Center for Group Dynamics, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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Wirback T, Möller J, Larsson JO, Galanti MR, Engström K. Social factors in childhood and risk of depressive symptoms among adolescents--a longitudinal study in Stockholm, Sweden. Int J Equity Health 2014; 13:96. [PMID: 25384415 PMCID: PMC4243322 DOI: 10.1186/s12939-014-0096-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 10/11/2014] [Indexed: 01/01/2023] Open
Abstract
Background In Sweden, self-reported depressive symptoms have increased among young people of both genders, but little is known about social differences in the risk of depressive symptoms among adolescents in welfare states, where such differences can be less pronounced. Therefore, the aim was to investigate whether multiple measures of low social status in childhood affect depressive symptoms in adolescence. A secondary aim was to explore potential gender effect modification. Methods Participants were recruited in 1998 for a longitudinal study named BROMS. The study population at baseline consisted of 3020 children, 11–12 years-old, from 118 schools in Stockholm County, followed up through adolescence. This study is based on 1880 adolescents answering the follow-up survey in 2004, at age 17–18 (62% of the initial cohort). Parental education, occupation, country of birth, employment status and living arrangements were reported at baseline, by parents and adolescents. Depressive symptoms were self-reported by the adolescents in 2004, using a 12-item inventory. The associations between childhood social status and depressive symptoms in adolescence are presented as Odds Ratios (OR), estimated through logistic regression. Gender interaction with social factors was estimated through Synergy Index (SI). Results Increased risk of depressive symptoms was found among adolescents whose parents had low education (OR 1.8, CI = 1.1-3.1), were unskilled workers (OR 2.1, CI = 1.2-3.7), intermediate non-manual workers (OR 1.8, CI = 1.0-3.0), or self-employed (OR 2.2, CI = 1.2-3.7), compared to parents with high education and high non-manual work. In addition, adolescents living exclusively with one adult had an increased risk compared to those living with two (OR 2.8, CI = 1.1-7.5), while having foreign-born parents was not associated with depressive symptoms. An interaction effect was seen between gender and social factors, with an increased risk for girls of low-educated parents (SI = 3.4, CI = 1.3-8.9) or living exclusively with one adult (SI = 4.9, CI = 1.4-6.8). Conclusions The low social position in childhood may increase the risk of depressive symptoms among adolescents even in countries with small social differences and a highly developed welfare system, such as Sweden. Girls with low educated parents or living exclusively with one adult may be particularly vulnerable. This knowledge is of importance when planning preventive interventions or treatment. Electronic supplementary material The online version of this article (doi:10.1186/s12939-014-0096-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Therese Wirback
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
| | - Jette Möller
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
| | - Jan-Olov Larsson
- Department of Women's and Children's Health, FoUU BUP, q3:4 Astrid Lindgren Children's Hospital, 171 77, Stockholm, Sweden.
| | - Maria Rosaria Galanti
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden. .,Centre for Epidemiology and Community Medicine, Stockholm County Council, 171 77, Stockholm, Sweden.
| | - Karin Engström
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden. .,Centre for Epidemiology and Community Medicine, Stockholm County Council, 171 77, Stockholm, Sweden.
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