Affective disorders among Jews: a historical review and meta-analysis

Depression stigma and treatment preferences among Orthodox and non-Orthodox Jews

Anecdotal reports of increased stigma toward mental illness among Orthodox Jews seems to conflict with an existing literature describing less stigmatization toward depression among Jewish individuals. This online survey study investigated stigma toward depression and treatment preference among Orthodox and non-Orthodox Jews (N = 391). All participants were presented with a depression vignette to assess for stigma and then randomized to a vignette depicting a treatment modality (behaviorally oriented or insight oriented) to assess for treatment preference across several delivery options (individual, group, or Internet). Results indicated elevated depression stigma among Orthodox Jews as expressed by elevated levels of secrecy, treatment-seeking stigma, family/marriage stigma, and stigmatizing experiences, but not attitudinal social distancing. No group differences were found with respect to overall treatment preference, treatment modality, or manner of delivery. Overall, participants preferred individual therapy more than group and Internet therapy and preferred group therapy more than Internet therapy. Clinical and research implications are discussed.

Psychiatric disease incidence among Danish Seventh-day Adventists and Baptists

PURPOSE

Previous studies suggest that religious practice can have a positive effect on mental health, but may also have potential for harm. In Denmark, unique possibilities are available for studying the influence of religious practice on mental health: Denmark is characterized as a secular society and it is possible to follow members of religious societies in nationwide registers. In this study, we follow a cohort of Danish Seventh-day Adventists (SDA) and Baptists in a nationwide psychiatry register and compare the incidence in this cohort with the general population.

METHODS

We followed a cohort of 5,614 SDA and 3,663 Baptists in the Danish Psychiatric Central Register, which contained information on psychiatric hospitalizations from 1970 to 2009. Psychiatric disease incidence in the cohort was compared with that in the general Danish population as standardized incidence ratios and within-cohort comparisons were made with a Cox model.

RESULTS

The cohort had decreased incidence of abuse disorders compared to the general population. Furthermore, among Baptists, decreased incidence of unipolar disorders among men and decreased incidence of schizophrenia among women were observed. Surprisingly, we observed an increased incidence rate of unipolar disorder among women.

CONCLUSIONS

In this nationwide cohort study with 40 years of follow-up, we observed increased incidence rates of unipolar disorders among women and decreased rates of alcohol- and drug-related psychiatric disorders compared to the general Danish population. We have no mechanistic explanation for the increased incidence of unipolar disorders among women, but discuss several hypotheses that could explain this observation.

Psychiatric epidemiology and international mental health as a career in cultural psychiatry

Psychiatric epidemiology is one of the many paths to a career in cultural psychiatry. Psychiatric epidemiology has made numerous substantive contributions to cultural psychiatry. Areas in which psychiatric epidemiologists have contributed to cultural psychiatry include the undertaking of cross-national comparisons, studying the mental health of populations of importance to cultural psychiatry, studying risk factors that are of cultural importance such as immigration and social class, studying trauma, examining the role of stigma in cultural settings, and investigating cultural influences on mental health service delivery. This article highlights examples from the author's own research examining cross-national comparisons, trauma, and mental health service delivery. Research is vital to enable the field of cultural psychiatry to be a vibrant, evidence-based discipline within psychiatry.

Gender disparities in the treatment of late-life depression: qualitative and quantitative findings from the IMPACT trial

OBJECTIVES

The objectives of this study were to examine gender differences in recruitment, depression presentation, and depression treatment history in a large effectiveness trial; and to use qualitative data to generate hypotheses about reasons for observed gender differences.

METHODS

Data from IMPACT, a multisite trial of a disease management program for late-life depression in primary care were used to examine gender differences quantitatively. Qualitative interviews were conducted with 30 key informants from IMPACT (referring physicians, depression care managers, and study recruiters) to learn more about challenges in recruiting and treating depressed older men and then analyzed thematically.

RESULTS

Compared with older women, older men were significantly less likely to be referred to IMPACT, to endorse core depressive symptoms, and to have received prior depression treatment. Gender differences in prior depression treatment persisted after adjustment for covariates. Qualitative themes identified as important contributors to gender disparities included 1) how men experience and express their depression, 2) traditional masculine values, and 3) the stigma of chronic mental illness.

CONCLUSION

This study provides further evidence of the gender gap in depression care, identifies possible contributing factors, and suggests avenues for future research.