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

Abstract

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.

Ethnic Minorities with Diabetes Differ in Depressive and Anxiety Symptoms and Diabetes-Distress

“…In line with findings regarding depression, the overall prevalence of anxiety in a Dutch general hospital setting was 51.7% for ethnic minorities and 36.6% in native Dutch [ 18 ]. In a large population based sample in the US, anxiety was related to ethnicity in patients with diabetes [ 23 ].…”

“…We hypothesized that all ethnic minorities would report higher levels of emotional distress in comparison to native Dutch persons and that in particular Turkish and Moroccan persons would report high levels of depression and anxiety [18]. As to the between-ethnic differences in diabetes-distress we had no hypothesis.…”

“…Similar to diabetes and its complications, the prevalence of emotional distress differs between ethnic subgroups. In persons without diabetes, Turkish or Moroccan minority status in both general Western population [ 17 ] and Dutch hospital settings is associated with increased rates of depression [ 18 ]. In persons with diabetes in UK secondary care, Ali et al (2009) found that South-Asians report less depressive symptoms than white persons with diabetes [ 19 ].…”

Ethnic Differences in the Association of Depressive Symptoms with Clinical Outcome in Dialysis Patients

“…This study shows immigrant dialysis patients have a higher prevalence of depressive symptoms compared to native Dutch dialysis patients. These results are comparable with other European studies, which also found a higher prevalence in immigrant patients compared to native Dutch [6, 7, 32, 33]. US studies indicate that Black dialysis patients have a higher prevalence of depressive symptoms compared to White dialysis patients [15, 34, 35].…”

“…First, cohort studies and registry data have shown that ethnicity influences the prevalence rate of depression. Ethnic minority groups seem to have a higher burden of depressive symptoms in the dialysis population [7, 35].…”