Health care utilization among first and second generation immigrants and native-born Germans: a population-based study in Germany

Glaesmer, Heide; Wittig, Ulla; Bräehler, Elmar; Martin, Alexandra; Mewes, Ricarda; Rief, Winfried

doi:10.1007/s00038-010-0205-9

Cited by 60 publications

(64 citation statements)

References 25 publications

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“…This is in line with findings that Turkish people hold cultural values that promote respect towards authority figures and do not question or challenge authorities [63]. Furthermore, our results indicate that previous experiences with psychotherapy are rare in Turkish immigrant inpatients, which is confirmed by studies about health care utilization [64][65][66].…”

Section: Discussionsupporting

confidence: 91%

Motivation for Psychotherapy and Illness Beliefs in Turkish Immigrant Inpatients in Germany: Results of a Cultural Comparison Study

Reich

Bockel

Mewes

2014

J. Racial and Ethnic Health Disparities

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Objective Some immigrant populations, for instance, Turkish immigrants, suffer from worse mental health than the general population. Moreover, psychotherapeutic treatment does not work well in this group. This might be explained by lower motivation for psychotherapy and particular illness beliefs as important early predictors of treatment outcome. We investigate differences in these predictors between Turkish immigrant inpatients and inpatients without a migration background and evaluate whether particular illness beliefs have a negative impact on motivation for psychotherapy. Method Turkish immigrant inpatients and inpatients without a migration background (N=100), suffering from depressive disorder, somatoform disorder, and/or adjustment disorder, completed questionnaires assessing motivation for psychotherapy, depressive and somatic symptoms, illness perception, illness-related locus of control, and causal illness attributions. Results Despite a higher symptom burden, motivation for psychotherapy was lower in Turkish immigrant inpatients than in inpatients without a migration background (d=0.54). This was fully explained by stronger beliefs in supernatural causes of illness and higher fatalistic-external illness-related locus of control in the Turkish immigrant sample (mediation analysis; R 2 =0.27). Conclusions Turkish immigrants believe in supernatural or fatalistic causes of illness and fatalistic-external locus of control to a greater extent than German inpatients without a migration background. These beliefs reduce motivation for psychotherapy and need to be addressed in psychotherapeutic treatment in order to secure positive treatment outcomes.

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Section: Discussionsupporting

confidence: 91%

Motivation for Psychotherapy and Illness Beliefs in Turkish Immigrant Inpatients in Germany: Results of a Cultural Comparison Study

Reich

Bockel

Mewes

2014

J. Racial and Ethnic Health Disparities

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“…In contrast, prevalence rates for PTSD and at least one mental disorder were found to be higher in participants who consider themselves as an immigrant and/or anticipate the attribution by others compared to German natives. At this point, the findings are in line with previous research showing no differences between self-reported mental health among persons with 'migration background' and natives in Germany [1,3,7,10]. However, several studies reported better health [28][29][30][31] in immigrants; some other studies show worse mental health in immigrant populations [6,8,9] compared to native-born participants.…”

Section: Discussionsupporting

confidence: 90%

“…However, there are studies indicating better mental health in different groups of immigrants compared with the native populations [1,7], whereas other studies report worse mental health outcomes among different groups of immigrants [8][9][10]. The findings are often contradictory and thus might be attributed to differences in respect to the methodology of each study [3]. In Germany, a country with a high proportion of immigrants, the term 'person with a migration background', has been established to differentiate between immigrants and natives.…”

Section: Introductionmentioning

confidence: 99%

Mental health among immigrants in Germany – the impact of self-attribution and attribution by others as an immigrant

Nesterko

Friedrich

Brähler

et al. 2019

Preprint

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Background: In Germany, the term ‘migration background' has been established to differentiate between immigrants and natives. In the present study post-traumatic stress disorder (PTSD), anxiety, and depression were analysed in immigrant populations in Germany by considering self-attribution as well as attribution by others on one’s own ‘migration background’. Methods: In a population-based survey (N = 2317), socio-demographic characteristics, migration background (official statistics definition vs. self-attribution as well as the anticipated attribution by others), PTSD (PCL-5), and symptoms of anxiety and depression (PHQ-4) were assessed. Logistic regression models were applied to predict mental health outcomes by considering socio-demographic and immigration-related factors. Results: A total of 10.7% of respondents (N = 248) had a ‘migration background’. Immigrants of the 2nd generation compared to 1st generation immigrants are less likely to see themselves as immigrants. Attribution as an immigrant (self and/or by others) was found as significant predictor for PTSD and depression, but not anxiety. Conclusions: It seems useful to focus on immigration-related factors considering subjective perspectives and not only comparing immigrants and natives using a federal statistics definition. Our findings suggest that research on the association between immigration-related factors such as attribution as an immigrant and mental health outcomes might be a promising approach to better identify subgroups at higher risk of mental distress.

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“…It should be noted that both “native-born” and “second-generation” respondents were born in the United States and therefore these terms are slightly imprecise. Nevertheless, we elected to use these terms are they are consistent with the work of scholars in prior research on immigration and health (e.g., Escobar et al, 2000; Glaesmer et al, 2011). …”

Section: Methodsmentioning

confidence: 99%

Mood, anxiety, and personality disorders among first and second-generation immigrants to the United States

Salas-Wright

Kagotho

Vaughn

2014

Psychiatry Research

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A careful examination of the multigenerational relationship between immigrant status and mental disorders can provide important information about the robustness and nature of the immigrant-mental health link. We examine immigrant status as a protective factor against mental illness, assess intergenerational effects, examine differences across race/ethnicity, and report the prevalence of mood, anxiety, and personality disorders of immigrants across major world regions. We employ data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and compare first (n = 5,363) and second-generation (n = 4826) immigrants from Asia, Africa, Europe, and Latin America to native-born Americans (n = 24,461) with respect to mental disorders. First-generation immigrants are significantly less likely than native-born Americans to be diagnosed with a mood, anxiety, or personality disorder, though the prevalence of mental health diagnoses increases among second generation immigrants. Similar results were observed for immigrants from major world regions as the prevalence of psychiatric morbidity was lower among immigrants from Africa, Latin America, Europe, and Asia compared to native-born Americans. Findings provide evidence in support of the notion that the immigrant paradox may be extended to include mood, anxiety, and personality disorders in the United States.

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Health care utilization among first and second generation immigrants and native-born Germans: a population-based study in Germany

Cited by 60 publications

References 25 publications

Motivation for Psychotherapy and Illness Beliefs in Turkish Immigrant Inpatients in Germany: Results of a Cultural Comparison Study

Motivation for Psychotherapy and Illness Beliefs in Turkish Immigrant Inpatients in Germany: Results of a Cultural Comparison Study

Mental health among immigrants in Germany – the impact of self-attribution and attribution by others as an immigrant

Mood, anxiety, and personality disorders among first and second-generation immigrants to the United States

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