Similarity in depressive symptom profile in a population-based study of migrants in the Netherlands

Abstract

Objective Depression is a clinical syndrome developed in Western Europe and North-America. The expression of symptoms and the impact of symptoms on functioning may therefore be expected to vary across cultures and languages. Our first aim was to study differences in depressive symptom profile between indigenous and non-Western immigrant populations in the Netherlands. We hypothesized that differences in expression of depressive symptoms would be more likely in the domains of mood and cognitions, and less likely in the domains of psychomotor and vegetative symptoms. Our second aim was to study ethnic differences in the association of depressive symptoms and general functioning. Method In a random community sample stratified for ethnicity in Amsterdam, the Netherlands, depressive symptoms were assessed by bilingual interviewers using the Composite International Diagnostic Interview (CIDI 2.1) and the Symptom Checklist-90-Revised (SCL-90-R). Impairments in functioning were measured by the World Health Organization Disability Assessment Schedule II (WHODAS II). Results were obtained from 812 subjects: N = 321 native Dutch, N = 213 Turkish-Dutch, N = 191 Moroccan-Dutch, N = 87 Surinamese-Dutch. Differences in depressive symptom expression were tested by differential item functioning. Results The prevalence of DSM-IV depressive disorder and the overall level of depressive symptoms were higher in the Turkish and Moroccan immigrant groups compared to native Dutch subjects. Ethnic differences in item functioning of depressive symptoms were rare, and equally unlikely in all four symptom domains. Depression was equally associated with functional impairment across ethnic groups. Conclusion Although depressive symptoms were more common among migrants than in the indigenous population, both the depressive symptom profile and the associated functional impairments were comparable. These findings may help diminishing concerns about the validity of using existing diagnostic procedures among ethnic minority groups.

Ethnic and migrational impact on the clinical manifestation of depression

“…In a recent study from the Netherlands which compared native Dutch and Turkish, Moroccan and Surinamese immigrant groups, a higher prevalence and a higher severity level of depression in TurkishDutch versus native Dutch people but no ethnic differences in the depressive symptom profile were found [50]. However, assessment instruments applied differed from those used in our study.…”

Ethnic Variation in Emotion Regulation

“…Furthermore, the present results substantiate earlier studies demonstrating that cultural differences in emotional processes shrink or disappear when it comes to psychopathology (Schrier et al, 2010). Therefore, it can be assumed that Turkish immigrant patients may benefit from an ER skills training that is commonly applied in Western therapeutic approaches (e.g., Beck, Rush, Shaw, & Emery, 1979).…”

Similarities in manifestations of depression in Turkish-Dutch, Moroccan-Dutch and native Dutch citizens of Amsterdam

“…Our hypotheses that cultural differences would show most readily in the domains of cognitive evaluations or mood disturbances, but would be absent in the domains of psychomotor symptoms and the domain of vegetative symptoms were not confirmed by our findings: the five SCL-90-R and the five CIDI symptoms which showed item bias were scattered over the four domains 15 .…”

“…The studies are published separately and as part of a thesis by the first author [15][16][17][18][19] . This paper summarises the main findings and discusses the clinical implications.…”