Ethnic variation in the prevalence of depression and anxiety in primary care: A systematic review and meta-analysis

Tarricone, Ilaria; Stivanello, Elisa; Poggi, Francesca; Castorini, Vanessa; Marseglia, Maila Valentina; Fantini, Maria Pia; Berardi, Domenico

doi:10.1016/j.psychres.2011.05.020

Cited by 40 publications

(29 citation statements)

References 44 publications

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“…Such a difference is also observed in other European countries [11,20]. This was particularly so for the women in our study, since close to 80% of the immigrant women were depressed compared to less than half of the French women ( p <0.001).…”

Section: Discussionsupporting

confidence: 86%

“…The characteristics associated with depression have been described extensively in the general population [1,2] but little among the more vulnerable [4,6]. Not much is known about healthcare-seeking during a depressive episode [7-10], particularly among the poorest groups [11]. The Baudelaire Outpatient Clinic at the Saint-Antoine Hospital in Paris is a general medicine outpatient clinic in one of 32 university-affiliated general hospitals.…”

Section: Introductionmentioning

confidence: 99%

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Depression prevalence and primary care among vulnerable patients at a free outpatient clinic in Paris, France, in 2010: results of a cross-sectional survey

et al. 2013

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BackgroundData on the prevalence of depression and on how a depressive episode prompts the sufferer to seek primary care are not scarce, but the available evidence on the prevalence of depression among immigrants and poor people who frequent general practice facilities is scarce. The Baudelaire Outpatient Clinic at the Saint-Antoine Hospital in Paris provides free medical and social assistance to the poor and/or uninsured. The goal of our study was to estimate the prevalence of depression among these outpatients, to characterize this depressed population, and to analyze its demand for primary care for depressive episodes.MethodsFrom September to December 2010, we conducted a cross-sectional, observational survey among users of the Baudelaire Outpatient Clinic. French-speaking patients attending the clinic between September 15 and December 30, 2010 who agreed to answer a questionnaire administered face-to-face before their consultation were included in the study. The chi-squared test (or Fisher’s exact test for small samples) was used for the comparisons of proportions. Logistic regression models were estimated, along with the odds ratios (OR) and their 95% confidence intervals (95% CIs), for the multivariate analysis of factors associated with depression and healthcare-seeking. Models were estimated separately for men and women, since sex was an interaction factor. The statistical analyses were performed using Stata v. 10 software (StataCorp LP, College Station, Texas, USA).ResultsOf the 250 patients included (mean age: 45 years), 52.0% were men and 52.4% were immigrants. Close to 40% of them reported having no supplemental health insurance. The estimated prevalence of depression in this population was 56.7%. Depression was more prevalent among the women, immigrants, and people from the poorer socioeconomic groups. Only half of these depressed patients, mostly women, reported having discussed their depression with a physician. French nationality and complete health insurance coverage were associated with more-frequent healthcare-seeking. Few patients reported having been asked about their morale by the physician they consulted, and almost 80% would have liked to be asked about this more often.ConclusionDepression is a real public health problem, particularly among people from disadvantaged backgrounds, and should be included in their overall management.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Depression prevalence and primary care among vulnerable patients at a free outpatient clinic in Paris, France, in 2010: results of a cross-sectional survey

et al. 2013

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“…So far, most of the research has focused on depressive and anxiety symptoms of immigrants in the general population [ 5 – 7 ], in primary care [ 11 ], or in mental health care [ 12 ] and focused on other mental disorders as psychotic disorders [ 13 ]. We found no studies examining the prevalence of depressive and anxiety symptoms in immigrants in the general hospital setting and it is not clear whether the prevalence of psychological distress in the hospital setting is also higher among immigrant patients and to which extent compared to native patients.…”

Section: Introductionmentioning

confidence: 99%

Psychological Distress in the Hospital Setting: A Comparison between Native Dutch and Immigrant Patients

et al. 2015

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BackgroundPrevalence of psychological distress (i.e. depressive and anxiety symptoms) in medically ill patients is high. Research in the general population shows a higher prevalence of psychological distress among immigrants compared to natives. Our aim was to examine the prevalence of psychological distress in the hospital setting comparing immigrant and native Dutch patients and first and second generation immigrant patients.MethodsPrevalence of psychological distress was assessed using the extended Kessler-10 (EK-10) in 904 patients in a Dutch general teaching hospital. Logistic regression was used to calculate odds ratios to determine differences between native and immigrant patients and first and second generation immigrants in the prevalence of psychological distress. We adjusted for demographic and social variables, socio-economic status, physical quality of life, history of psychiatric disease and health care use.ResultsOf 904 patients, 585 were native Dutch patients and 319 were immigrant patients. The prevalence of psychological distress in native compared to immigrant patients was 54% and 66% respectively, with especially high prevalences among Turkish and Moroccan immigrant patients. The crude OR for prevalence of psychological distress for immigrant patients versus native patients was 1.7 (95% CI 1.2–2.2) and for first versus second generation immigrant patients 2.1 (95% CI 1.2–3.5). After full adjustment ORs were 1.7 (95% CI 1.2–2.3) and 2.2 (95% CI 1.2–4.1) respectively.ConclusionImmigrant patients and first generation immigrant patients were more likely to have psychological distress compared to native patients and second generation immigrant patients respectively. We found a particularly high prevalence of psychological distress in Turkish and Moroccan immigrants.

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“…The comparatively low prevalence of depression, potentially contributed to by underdiagnosis, may have limited the statistical power. Nonetheless, our large nonselective sample is representative of the COPD patient population in Switzerland and is consequently characterised by a high socioeconomic status and low proportion of ethnic minorities—both factors that have been linked to low rates of depression [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Accuracy of the Hospital Anxiety and Depression Scale for Identifying Depression in Chronic Obstructive Pulmonary Disease Patients

et al. 2014

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Psychological morbidity is common in chronic respiratory diseases. The diagnostic accuracy of the Hospital Anxiety and Depression Scale (HADS) and risk factors for comorbid depression in chronic obstructive pulmonary disease (COPD) are addressed. Consecutive COPD patients (GOLD stage I–IV, 40–75 years old) were enrolled in a multicentre, cross-sectional cohort study. Diagnosis of depression was ascertained through clinical records. Lung function, HADS score, 6-minute walking test (6-MWT), MRC dyspnoea score, and COPD Assessment Test (CAT) were evaluated. Two hundred fifty-nine COPD patients (mean age 62.5 years; 32% female; mean FEV1 48% predicted) were included. Patients diagnosed with depression (29/259; 11.2%) had significantly higher HADS-D and HADS-Total scores than nondepressed patients (median (quartiles) HADS-D 6 [4; 9] versus 4 [2; 7], median HADS-Total 14 [10; 20] versus 8 [5; 14]). Receiver-operating characteristic plots showed moderate accuracy for HADS-D, AUC 0.662 (95%CI 0.601–0.719), and HADS-Total, AUC 0.681 (95%CI 0.620–0.737), with optimal cut-off scores of >5 and >9, respectively. Sensitivity and specificity were 62.1% and 62.6% for HADS-D compared to 75.9% and 55.2% for HADS-Total. Age, comorbidities, sex, and lower airflow limitation predicted depression. The HADS exhibits low diagnostic accuracy for depression in COPD patients. Younger men with comorbidities are at increased risk for depression.

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Ethnic variation in the prevalence of depression and anxiety in primary care: A systematic review and meta-analysis

Cited by 40 publications

References 44 publications

Depression prevalence and primary care among vulnerable patients at a free outpatient clinic in Paris, France, in 2010: results of a cross-sectional survey

Depression prevalence and primary care among vulnerable patients at a free outpatient clinic in Paris, France, in 2010: results of a cross-sectional survey

Psychological Distress in the Hospital Setting: A Comparison between Native Dutch and Immigrant Patients

Accuracy of the Hospital Anxiety and Depression Scale for Identifying Depression in Chronic Obstructive Pulmonary Disease Patients

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