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Walker AL, de Rooij SR, Dimitrova MV, Witteveen AB, Verhoeven CJ, de Jonge A, Vrijkotte TGM, Henrichs J. Psychosocial and peripartum determinants of postpartum depression: Findings from a prospective population-based cohort. The ABCD study. Compr Psychiatry 2021; 108:152239. [PMID: 33905988 DOI: 10.1016/j.comppsych.2021.152239] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/07/2021] [Accepted: 03/13/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Postpartum depression is prevalent and concerns a serious health problem for women and their families. The current large-scale birth cohort study investigated: (1) the associations of various potential determinants of postpartum depression using a multidimensional approach, and (2) the individual contribution of obstetric and perinatal determinants and pregnancy-specific anxiety to the risk of postpartum depression. METHODS This study was based on a large-scale birth cohort study in Amsterdam, the Netherlands (ABCD-study). In 5109 women depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (cut-off ≥16 indicating high risk of postpartum depression). Determinants were assessed using self-report or perinatal registries. RESULTS In the final multivariable model, other-Western and non-Western ethnic background, increased antepartum depressive symptoms, increased antepartum anxiety, increased pregnancy-specific anxiety, being unemployed, poor sleep quality, unwanted pregnancy, abuse, multiparity, and congenital abnormality were all independently related to an increased risk of postpartum depression. The strongest risk factors for postpartum depression were antepartum depressive symptoms (adjusted odds ratio (AOR) = 3.86, 95% confidence interval (CI) 3.02-4.92), having a baby with a congenital abnormality (AOR = 2.33, 95% CI 1.46-3.73), and abuse (AOR = 1.95, 95% CI 1.02-3.73). The final model accounted for 24.5% of the variance. LIMITATIONS Our dataset did not provide information on social support or maternal and family history of depression. Next to these determinants, future research should include biological factors. CONCLUSIONS The determinants identified provide opportunities for the development of multidimensional early screening and early intervention strategies for women with an increased risk of postpartum depression.
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Affiliation(s)
- Annika L Walker
- Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG - Amsterdam Public Health, De Boelelaan 1117, Amsterdam, Netherlands.
| | - Susanne R de Rooij
- Amsterdam University Medical Center, University of Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam University Medical Center, University of Amsterdam, Department of Public & Occupational Health, Amsterdam Public Health Research Institute, Academic UMC, Meibergdreef 9, Amsterdam, Netherlands; Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands
| | - Marta V Dimitrova
- Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG - Amsterdam Public Health, De Boelelaan 1117, Amsterdam, Netherlands
| | - Anke B Witteveen
- Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG - Amsterdam Public Health, De Boelelaan 1117, Amsterdam, Netherlands
| | - Corine J Verhoeven
- Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG - Amsterdam Public Health, De Boelelaan 1117, Amsterdam, Netherlands; Department of Obstetrics and Gynecology, Maxima Medical Centre, Veldhoven, Netherlands; Division of Midwifery, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Ank de Jonge
- Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG - Amsterdam Public Health, De Boelelaan 1117, Amsterdam, Netherlands
| | - Tanja G M Vrijkotte
- Amsterdam University Medical Center, University of Amsterdam, Department of Public & Occupational Health, Amsterdam Public Health Research Institute, Academic UMC, Meibergdreef 9, Amsterdam, Netherlands
| | - Jens Henrichs
- Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG - Amsterdam Public Health, De Boelelaan 1117, Amsterdam, Netherlands
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Siddiqui F, Lindblad U, Nilsson PM, Bennet L. Effects of a randomized, culturally adapted, lifestyle intervention on mental health among Middle-Eastern immigrants. Eur J Public Health 2020; 29:888-894. [PMID: 30809646 DOI: 10.1093/eurpub/ckz020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Middle-Eastern immigrants in Sweden are at increased risk for type 2 diabetes (T2D) and poor mental health. Physical activity not only prevents/delays onset of T2D but also shows favorable effects on mental health. However, the effects of a culturally adapted lifestyle intervention on mental health among Middle-Eastern immigrants have not been explored before. We aimed to study the effects of a randomized controlled, culturally adapted lifestyle intervention on anxiety and depression levels in diabetes-prone Iraqi immigrants. METHODS Participants (n = 96) were randomized to intervention group, IG (n = 50) or control group, CG (n = 46). The IG received seven group sessions addressing lifestyle change and the CG received treatment as usual. Montgomery-Åsberg Depression Rating Scale (MADRS-S) and Hospital Anxiety and Depression Scale (HADS) assessed mental health at start, mid (2 months) and end of the study (4 months). Proportional odds ratio (OR) model was used to study the effect of the intervention. RESULTS The odds of scoring lower on MADRS-S and HADS depression scale at visit 3 vs. baseline were higher in the IG compared to the CG (MADRS-S OR 5.9, 95% CI: 1.6-22.5; HADS OR 4.4, 95% CI: 0.9-20.3). The findings persisted after adjustment for age, sex, body mass index, time since migration, sedentary lifestyle and language spoken at home. Group differences were non-significant at visit 2 vs. baseline. CONCLUSION A culturally adapted lifestyle intervention addressing T2D prevention in Middle-Eastern immigrants has favorable effects on mental health. The effect was more pronounced at the 4 months than at 2 months follow-up, indicating beneficial effect of longer study duration. TRIAL REGISTRATION www.clinicaltrials.gov NCT01420198.
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Affiliation(s)
- Faiza Siddiqui
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Ulf Lindblad
- Department of Community Medicine/Primary Health Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Peter M Nilsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Louise Bennet
- Department of Clinical Sciences, Lund University, Malmö, Sweden.,Center for Primary Health Care Research, Region Skåne and Lund University, Malmö, Sweden
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Perini W, Snijder MB, Schene AH, Kunst AE. Prevalence of depressive symptoms among patients with a chronic nonspecific lung disease in five ethnic minority groups. Gen Hosp Psychiatry 2015; 37:513-7. [PMID: 26384524 DOI: 10.1016/j.genhosppsych.2015.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 08/09/2015] [Accepted: 08/18/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Earlier studies found chronic nonspecific lung disease (CNSLD) to be associated with depressive symptoms. We aimed to assess whether the association between CNSLD and depressive symptoms varies between ethnic groups. METHODS We used questionnaire data from 10916 participants of the HELIUS study in Amsterdam from six different ethnic groups. We applied logistic regression analysis to determine the association between CNSLD and depressive symptoms and interaction terms to test whether this association varied between ethnic groups. RESULTS CNSLD prevalence was higher among South-Asian Surinamese, Turkish and Moroccans (10.1% to 12.5%) than African Surinamese, Dutch and Ghanaians (4.8% to 6.3%). The prevalence of depressive symptoms was higher among participants with CNSLD (28.4% vs. 13.7%). This association was not significantly different between ethnic groups. The absolute prevalence of depressive symptoms was higher among the CNSLD patients from ethnic minority groups (19.2 % to 35.6%) as compared with the Dutch-origin majority group (11.2%). CONCLUSIONS CNSLD is associated with a high risk of depressive symptoms, especially among the five ethnic minority groups. These results imply a need to monitor the mental health of CNSLD patients in particular when a patient is from an ethnic minority group.
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Affiliation(s)
- Wilco Perini
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - Marieke B Snijder
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Aart H Schene
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Anton E Kunst
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Straiton ML, Powell K, Reneflot A, Diaz E. Managing Mental Health Problems Among Immigrant Women Attending Primary Health Care Services. Health Care Women Int 2015; 37:118-39. [PMID: 26251953 DOI: 10.1080/07399332.2015.1077844] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Researchers in Norway explore treatment options in primary care for immigrant women with mental health problems compared with nonimmigrant women. Three national registers were linked together for 2008. Immigrant women from Sweden, Poland, the Philippines, Thailand, Pakistan, and Russia were selected for analysis and compared with Norwegian women. Using logistic regression, we investigated whether treatment type varied by country of origin. Rates of sickness leave and psychiatric referrals were similar across all groups. Conversational therapy and use of antidepressants and anxiolytics were lower among Filipina, Thai, Pakistani, and Russian women than among Norwegians. Using the broad term "immigrants" masks important differences in treatment and health service use. By closely examining mental health treatment differences by country of origin, gaps in service provision and treatment uptake may be identified and addressed with more success.
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Affiliation(s)
- Melanie L Straiton
- a Division of Mental Health , Norwegian Institute of Public Health , Oslo , Norway.,b School of Psychology , University of Adelaide , Adelaide , South Australia , Australia
| | - Kathryn Powell
- c School of Population Health , University of Adelaide , Adelaide , South Australia , Australia
| | - Anne Reneflot
- a Division of Mental Health , Norwegian Institute of Public Health , Oslo , Norway
| | - Esperanza Diaz
- d Department of Global Public Health and Primary Health Care , University of Bergen , Bergen , Norway
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Abstract
The purpose of this paper is to analyse the extent to which length of residence in the country and country of origin are of importance to older immigrants' use of long-term care services compared to native older people. The analyses were conducted on a population of over 65s living in the Municipality of Copenhagen on 1st Jan 2007. Information was drawn from the administrative registers of the Municipality of Copenhagen on the population's use in 2007 of home care and of residential care in a nursing home. These data were combined by Statistics Denmark with demographic data, socio-economic data and data on the use of health services. It was found that older immigrants are less likely than ethnic Danes to use municipal long-term care services when other predisposing, enabling and need factors are controlled for. The difference is greatest between ethnic Danes and immigrants from non-western countries who have only lived in Denmark for a few years. The difference decreases the longer the immigrant has lived in the country. The findings may be explained, at least in part, by poorer language skills and poorer knowledge of the Danish welfare system among older immigrants and the fact that they are more likely to be cared for by relatives than ethnic Danes are. However, in the course of time language skills improve and knowledge of the system increases and life style with respect to care may approach that of older Danes.
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Affiliation(s)
- Eigil Boll Hansen
- KORA, Danish Institute for Local and Regional Government Research, Købmagergade 22, 1150 Copenhagen K, Denmark
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Koopmans GT, Uiters E, Devillé W, Foets M. The use of outpatient mental health care services of migrants vis-a-vis Dutch natives: equal access? Int J Soc Psychiatry 2013; 59:342-50. [PMID: 22392446 DOI: 10.1177/0020764012437129] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Although the use of outpatient mental health care services by migrants in the Netherlands has increased in recent years, whether it aligns with the need for care is unclear. AIMS To investigate ethnic-related differences in utilization in outpatient mental health care, taking need into account, and to examine whether socio-economic or cultural barriers explain such differences. METHODS Data for the native population was taken from the second Dutch National Survey of General Practice (N = 7,772). An additional random sample was drawn (N = 1,305) from four migrant groups (Surinamese, Dutch Antilleans, Moroccans and Turks) living in the Netherlands. Participants were surveyed on mental health care utilization, indicators of need, educational level, proficiency in Dutch and acculturation. RESULTS Use of outpatient mental health care was about 5% for the indigenous population. Among migrants, percentages of use ranged from 6.5% (Moroccans) to 9.0% (Turks). Corrected for need, however, all non-Dutch groups had a lower chance of service utilization than the native group. Acculturation predicted utilization but did not explain all ethnic-related differences; proficiency in Dutch and health beliefs were not explanatory factors. CONCLUSIONS In non-Dutch-speaking migrant groups, utilization is about half the level of the native Dutch, suggesting that a substantial gap exists. Our study found that acculturation only partially explains the differences.
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Affiliation(s)
- G T Koopmans
- Institute of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands.
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Hesselink AE, Verhoeff AP, Stronks K. Ethnic health care advisors: a good strategy to improve the access to health care and social welfare services for ethnic minorities? J Community Health 2010; 34:419-29. [PMID: 19718526 PMCID: PMC2744829 DOI: 10.1007/s10900-009-9171-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Empirical studies indicate that ethnic minorities have limited access to health care and welfare services compared with the host population. To improve this access, ethnic health care (HC) advisors were introduced in four districts in Amsterdam, the Netherlands. HC advisors work for all health care and welfare services and their main task is to provide information on health care and welfare to individuals and groups and refer individuals to services. Action research was carried out over a period of 2 years to find out whether and how this function can contribute to improve access to services for ethnic minorities. Information was gathered by semi-structured interviews, analysing registration forms and reports, and attending meetings. The function’s implementation and characteristics differed per district. The ethnicity of the health care advisors corresponded to the main ethnic groups in the district: Moroccan and Turkish (three districts) and sub-Sahara African and Surinamese (one district). HC advisors reached many ethnic inhabitants (n = 2,224) through individual contacts. Half of them were referred to health care and welfare services. In total, 576 group classes were given. These were mostly attended by Moroccan and Turkish females. Outreach activities and office hours at popular locations appeared to be important characteristics for actually reaching ethnic minorities. Furthermore, direct contact with a well-organized back office seems to be important. HC advisors were able to reach many ethnic minorities, provide information about the health care and welfare system, and refer them to services. Besides adapting the function to the local situation, some general aspects for success can be indicated: the ethnic background of the HC advisor should correspond to the main ethnic minority groups in the district, HC advisors need to conduct outreach work, there must be a well-organized back office to refer clients to, and there needs to be enough commitment among professionals of local health and welfare services.
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Affiliation(s)
- Arlette E Hesselink
- Department of Epidemiology and Health Promotion, Public Health Service Amsterdam, P.O. Box 2200, 1000 CE Amsterdam, The Netherlands.
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Tiainen A, Edman G, Flyckt L, Tomson G, Rehnberg C. Regional variations and determinants of direct psychiatric costs in Sweden. Scand J Public Health 2008; 36:483-92. [DOI: 10.1177/1403494808089065] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: The aim of the present study was to investigate socioeconomic and demographic determinants of direct costs for psychiatric disorders in Sweden. The cost categories were inpatient and outpatient costs, and costs for psychopharmacological drugs. Two consecutive years, 2001 and 2002, were chosen as the study period. Methods: The study included all costs for admissions, visits and prescribed drugs for adults aged ≥18 years in 2001 and 2002 in Sweden. These costs were aggregated and analysed at the county level. A multiple linear regression analysis was fitted to the data, and independent variables (i.e. predictors) were chosen on the basis of previous studies. All cost types (e.g. total, inpatient, outpatient and drug costs) were analysed separately in different models. Results: Large variations in total direct psychiatric costs were found between county councils (for example, the total costs varied between euro112 and euro195 per capita in 2001). The results indicate that psychiatric outpatient care is less utilized in rural than in urban areas, and drugs are more often prescribed in rural areas than in urban areas. Areas with a high proportion of women and people aged 65 years and over are strong predictors of mental healthcare costs, i.e. variables showing that the higher the proportion, the lower the direct costs. Conclusions: Factors such as urbanization, gender, age and number of immigrants are reasons for differences in psychiatric direct costs. On the basis of these findings, it seems plausible to conclude that women, older patients and immigrants may benefit from specialized psychiatry, but that such healthcare does not seem to be provided in all regions.
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Affiliation(s)
- Anne Tiainen
- Danderyd Hospital, Psychiatric Clinic, R&D Section, Stockholm, Sweden, , Medical Management Centre (MMC), Karolinska Institutet, Stockholm, Sweden
| | - Gunnar Edman
- Danderyd Hospital, Psychiatric Clinic, R&D Section, Stockholm, Sweden
| | - Lena Flyckt
- Danderyd Hospital, Psychiatric Clinic, R&D Section, Stockholm, Sweden
| | - Göran Tomson
- Medical Management Centre (MMC), Karolinska Institutet, Stockholm, Sweden
| | - Clas Rehnberg
- Medical Management Centre (MMC), Karolinska Institutet, Stockholm, Sweden
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Lindert J, Schouler-Ocak M, Heinz A, Priebe S. Mental health, health care utilisation of migrants in Europe. Eur Psychiatry 2008; 23 Suppl 1:14-20. [PMID: 18371575 DOI: 10.1016/s0924-9338(08)70057-9] [Citation(s) in RCA: 186] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Migration during the 1990s has been high and has been characterised by new migrations. Migration has been a key force in the demographic changes of the European population. Due to the different condition of migration in Europe, variables related to mental health of migrants are: motivation for migration, living conditions in the home and in the host country. AIMS To give an overview on (i) prevalence of mental disorders; suicide; alcohol and drug abuse; (ii) access to mental health and psychosocial care facilities of migrants in the European region, and (iii) utilisation of health and psychosocial institution of these migrants. METHODS Non-system review of the literature concerning mental health disorders of migrants and their access to and their consumption of health care and psychosocial services in Europe. RESULTS It is impossible to consider "migrants" as a homogeneous group concerning the risk for mental illness. The literature showed (i) mental health differs between migrant groups, (ii) access to psychosocial care facilities is influenced by the legal frame of the host country; (iii) mental health and consumption of care facilities is shaped by migrants used patterns of help-seeking and by the legal frame of the host country. CONCLUSION Data on migrant's mental health is scarce. Longitudinal studies are needed to describe mental health adjusting for life conditions in Europe to identify those factors which imply an increased risk of psychiatric disorders and influence help seeking for psychosocial care. In many European countries migrants fall outside the existing health and social services, particularly asylum seekers and undocumented immigrants.
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Affiliation(s)
- J Lindert
- The London School of Medicine and Dentistry, Queen Mary, University of London, London, UK.
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Patients of immigrant origin in inpatient psychiatric facilities. A representative national survey by the Psychiatry and Migration Working Group of the German Federal Conference of Psychiatric Hospital Directors. Eur Psychiatry 2008; 23 Suppl 1:21-7. [PMID: 18371576 DOI: 10.1016/s0924-9338(08)70058-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In a representative nationwide survey, the Psychiatry and Migration Working Group of the German Federal Conference of Psychiatric Hospital Directors (Bundesdirektorenkonferenz) examined the use of inpatient psychiatric and psychotherapeutic services in Germany by patients of immigrant origin. Questionnaires were sent to a total of 350 general hospital psychiatric clinics throughout Germany, and 131 clinics responded. As shown by the 2005 Microcensus [22], almost one-fifth (18.6%) of the German population is of immigrant origin. In our study, persons of immigrant origin comprised 17% of patients in the responding facilities. This indicates that the percentage of inpatient psychiatric services used by patients of immigrant origin is almost proportionate to these patients' percentage of the general population. The largest group of immigrant patients in our study were those of Russian heritage, followed by patients of Turkish, Arabic, or other origin. Almost two-thirds of the immigrant patients were born in Germany, and a considerably larger percentage were German citizens (74%). Sixty-two per cent of all patients of immigrant origin spoke a language other than German (e.g. Russian, Turkish, Polish) at home. Patients of immigrant origin were significantly more likely to receive an ICD-10 F2 diagnosis, and it was precisely patients with this diagnosis who were observed to experience difficulties in communication with caregivers.
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O'Mahony JM, Donnelly TT. The influence of culture on immigrant women's mental health care experiences from the perspectives of health care providers. Issues Ment Health Nurs 2007; 28:453-71. [PMID: 17613147 DOI: 10.1080/01612840701344464] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
It is well documented that serious mental health problems such as depression, schizophrenia, and post migration stress disorders exist among immigrant women. Informed by Kleinman's explanatory model, this qualitative exploratory study was conducted with seven health care providers who provided mental health services to immigrant women. Analysis of the data revealed that (a) immigrant women face many difficulties when accessing mental health care services due to cultural differences, social stigma, and unfamiliarity with Western biomedicine, (b) spiritual beliefs and practices that influence immigrant women's mental health care practices, and (c) the health care provider-client relationship, which exerts great influence on how immigrant women seek mental health care. The study also revealed that cultural background exerts both positive and negative influences on how immigrant women seek mental health care. We suggest that although cultural knowledge and practices influence immigrant women's coping choices and strategies, awareness of social and economic differences among diverse groups of immigrant women is necessary to improve the accessibility of mental health care for immigrant women.
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Gushulak BD, MacPherson DW. Population mobility and health: an overview of the relationships between movement and population health. J Travel Med 2004; 11:171-4. [PMID: 15710059 DOI: 10.2310/7060.2004.18490] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Brian D Gushulak
- Medical Services Branch, Citizenship and Immigration Canada, 219 Laurier Avenue West, Ottawa. Ontario K1A 1L1, Canada
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Lorant V, Kampfl D, Seghers A, Deliège D, Closon MC, Ansseau M. Socio-economic differences in psychiatric in-patient care. Acta Psychiatr Scand 2003; 107:170-7. [PMID: 12580823 DOI: 10.1034/j.1600-0447.2003.00071.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE We seek to investigate socio-economic differences in psychiatric in-patient care regarding admission, treatment and outcome. METHOD This study is undertaken on a comprehensive and exhaustive psychiatric case register of all psychiatric in-patient care carried out in Belgium in 1997 and 1998 (n=144 754). RESULTS Lower socio-economic groups were more likely to be compulsorily admitted, to be cared for in a non-teaching or psychiatric hospital, to be admitted in a hospital with unexpectedly long average length of stay and to be admitted to a ward with a more severe case-mix. They were less likely to receive antidepressants and psychotherapies. The improvements in functioning and in symptoms were also less favourable for these groups. The lowest group had a higher risk of dying in the hospital. CONCLUSION Psychiatric in-patient care is associated with moderate socio-economic differences in access, treatment and outcome. Further research is needed to clarify the causes of such disparities.
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Affiliation(s)
- V Lorant
- Health System Research, School of Public Health, Faculty of Medicine, Université Catholique de Louvain, Brussels, Belgium.
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