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Prevalence of Mental Disorders and Health Service Utilization among Individuals with Turkish Migration Backgrounds in Germany: A Study Protocol for an Epidemiological Investigation

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DOI: 10.4236/ojpsych.2016.63029    962 Downloads   1,189 Views  

ABSTRACT

Background: There is a lack of reliable epidemiological data on prevalence and comorbidity rates of mental disorders in the migrant population in Germany. Despite existing national and international data on the extent of psychosocial burdens in migrant populations the prevalence among the study population remains unclear. The aim of this study was to collect prevalence data for the largest migrant population in Germany-individuals with Turkish migration backgrounds—using a culturally and linguistically sensitive approach. Methods: The study employs a cross-sectional design. The multi-centre study (Hamburg, Berlin) is based on a sample of individuals with Turkish migration backgrounds living in the two cities stratified by age, gender, and education. The study programme consists of three phases: 1) a qualitative focus group to collect information on how to increase the participation rate of the target population as a minority group in Germany; 2) a translation phase to create culture and linguistic sensitive versions of the assessment tools (e.g., the Composite International Diagnostic Interview (CIDI) for Turkish speaking individuals; and 3) a baseline community study to assess the lifetime, 12-month and four-week prevalence and comorbidity rates of mental disorder, health care utilization and help-seeking behaviour in individuals of Turkish migration backgrounds living in Germany. Discussion: The study provides important data on the lifetime prevalence of mental disorders and health care utilization of individuals with Turkish migration backgrounds. Furthermore, the study is an important step towards gaining a better understanding of potential barriers to participation, creating resources for difficult-to- reach minorities, and understanding the need for assessing mental disorders in migrant populations. These results can offer a starting point for the initiation of the necessary structural changes for mental health care services and policies for groups with migration backgrounds.

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Mösko, M. , Dingoyan, D. , Penka, S. , Vardar, A. , Schulz, H. , Koch, U. , Heinz, A. and Kluge, U. (2016) Prevalence of Mental Disorders and Health Service Utilization among Individuals with Turkish Migration Backgrounds in Germany: A Study Protocol for an Epidemiological Investigation. Open Journal of Psychiatry, 6, 237-252. doi: 10.4236/ojpsych.2016.63029.

References

[1] United Nations, Department of Economic and Social Affairs. Trends in International Migrant Stock: The 2013 Revision. 2013.
[2] Eurostat: European Social Statistics 2013 Edition. 31. Luxembourg 2013.
http://ec.europa.eu/eurostat/statistics-explained/index.php/Category:Population_and_social_conditions_-_statistical_publications
[3] UNHCR: UNHCR Global Trends 2014. UNHCR 2015.
http://unhcr.org/556725e69.html
[4] Prince, M., Patel, V., Saxena, S., Maj, M., Maselko, J., Phillips, M.R. and Rahman, A. (2007) No Mental Health without Mental Health. Lancet, 370, 859-877.
http://dx.doi.org/10.1016/S0140-6736(07)61238-0
[5] Wittchen, H.U., Jacobi, F., Rehm, J., Gustavsson, A., Svensson, M., J?nsson, B., Olesen, J., Allgulander, C., Alonso, J., Faravelli, C., Fratiglioni, L., Jennum, P., Lieb, R., Maercker, A., van Os, J., Preisig, M., Salvador-Carulla, L., Simon, R. and Steinhausen, H.C. (2011) The Size and Burden of Mental Disorders and Other Disorders of the Brain in Europe 2010. European Neuropsychopharmacology, 21, 655-679.
http://dx.doi.org/10.1016/j.euroneuro.2011.07.018
[6] Kirkcaldy, B., Wittig, U., Furnham, A., Merbach, M. and Siefen, R.G. (2006) Health and Migration. Psychosocial Determinants. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 49, 873-883.
http://dx.doi.org/10.1007/s00103-006-0021-9
[7] Rechel, B., Mladovsky, P., Ingleby, D., Mackenbach, J.P. and McKee, M. (2013) Migration and Health in an Increasingly Diverse Europe. The Lancet, 381, 1235-1245.
http://dx.doi.org/10.1016/S0140-6736(12)62086-8
[8] Kristiansen, M., Mygind, A. and Krasnik, A. (2007) Health Effects of Migration. Danish Medical Bulletin, 1, 46-7.
[9] Lechner, I. and Mielck, A. (1998) Die Verkleinerung des “Healthy-Migrant Effects”: Entwicklung der Morbidit?t von ausl?ndischen und deutschen Befragten im sozio?konomischen Panel 1984-1992. Das Gesundheitswesen, 60, 715-720.
[10] Shuval, J.T. (1993) Migration and Stress. In: Goldberger, L.B. and Shlomo, B., Eds., Handbook of Stress: Theoretical and Clinical Aspects. Free Press, New York, 641-657.
[11] Groenemeyer, A. and Mansel, J., Eds. (2003) Die Ethnisierung von Alltagskonflikten. Leske + Budrich, Opladen.
http://dx.doi.org/10.1007/978-3-322-99668-8
[12] Swinnen, S.G. and Selten, J.P. (2007) Mood Disorders and Migration. British Journal of Psychiatry, 190, 6-10.
http://dx.doi.org/10.1192/bjp.bp.105.020800
[13] Grant, B.F., Stinson, F.S., Hasin, D.S., Dawson, D.A., Chou, S. and Anderson, K. (2004) Immigration and Lifetime Prevalence of DSM-IV Psychiatric Disorders among Mexican Americans and Non-Hispanic Whites in the United States. Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 61, 1226-1233.
http://dx.doi.org/10.1001/archpsyc.61.12.1226
[14] Alegria, M., Canino, G., Shrout, P.E., Woo, M., Duan, N., Vila, D., Torres, M., Chen, C.H. and Meng, X.L. (2008) Prevalence of Mental Illness in Immigrant and Non-Immigrant U.S. Latino Groups. The American Journal of Psychiatry, 165, 359-369. http://dx.doi.org/10.1176/appi.ajp.2007.07040704
[15] Takeuchi, D.T., Zane, N., Hong, S., Chae, D.H., Gong, F., Gee, G.C., Walton, E., Sue, S. and Alegría, M. (2007) Immigration-Related Factors and Mental Disorders among Asian Americans. American Journal of Public Health, 97, 84-90.
http://dx.doi.org/10.2105/AJPH.2006.088401
[16] Breslau, J. and Chang, D.F. (2006) Psychiatric Disorders among Foreign-Born and US-Born Asian-Americans in a US National Survey. Social Psychiatry & Psychiatric Epidemiology, 41, 943-950.
http://dx.doi.org/10.1007/s00127-006-0119-2
[17] Vega, W.A., Sribney, W.M., Aguilar-Gaxiola, S. and Kolody, B. (2004) 12-Month Prevalence of DSM-III-R Psychiatric Disorders among Mexican Americans: Nativity, Social Assimilation, and Age Determinants. The Journal of Nervous & Mental Disease, 192, 532-541.
http://dx.doi.org/10.1097/01.nmd.0000135477.57357.b2
[18] Alderete, E., Vega, W.A. and Kolody, B. (2000) Effects of Time in the United States and Indian Ethnicity on DSM- III-R Psychiatric Disorders among Mexican Americans in California. The Journal of Nervous & Mental Disease, 188, 90-100.
http://dx.doi.org/10.1097/00005053-200002000-00005
[19] Hjern, A., Wicks, S. and Dahlman, C. (2004) Social Adversity Contributes to High Morbidity in Psychoses in Immigrants—A National Cohort Study in Two Generations of Swedish Residents. Psychological Medicine, 34, 1025-1033.
http://dx.doi.org/10.1017/S003329170300148X
[20] Levecque, K., Lodewyckx, I. and Vranken, J. (2007) Depression and Generalized Anxiety in the General Population in Belgium: A Comparison between Native and Immigrant Groups. Journal of Affective Disorders, 97, 229-239.
http://dx.doi.org/10.1016/j.jad.2006.06.022
[21] Bengi-Arslan, L., Verhulst, F.C. and Crijnen, A.A.M. (2002) Prevalence and Determinants of Minor Psychiatric Disorder in Turkish Immigrants Living in the Netherlands. Social Psychiatry & Psychiatric Epidemiology, 37, 118-124.
http://dx.doi.org/10.1007/s001270200003
[22] De Wit, M.A., Tuinebreijer, W.C., Dekker, J., Beekman, A.J., Gorissen, W., Schrier, A.C., Penninx, B.W., Komproe, I.H. and Verhoeff, A.P. (2008) Depressive and Anxiety Disorders in Different Ethnic Groups: A Population Based Study among Native Dutch, and Turkish, Moroccan and Surinamese Migrants in Amsterdam. Social Psychiatry and Psychiatric Epidemiology, 43, 905-912.
http://dx.doi.org/10.1007/s00127-008-0382-5
[23] Razum, O., Zeeb, H., Meesmann, U., Schenk, L., Bredehorst, M., Brzoska, P., Dercks, T., Glodny, S., Menkhaus, B., Salman, R., Sa?, A.C. and Ulrich, R. (2008) Migration und Gesundheit. Schwerpunktbericht der Gesundheitsberichter- stattung des Bundes. Robert Koch-Institut, Berlin.
[24] M?sko, M., Dingoyan, D. and Schulz, H. (2015) Interkulturalit?t in der gesundheitlichen Versorgung. In: Koch, U. and Bengel, J., Eds., Enzyklopaedie Medizin Psychologie, Hogrefe, G?ttingen, Band 2.
[25] Bermejo, I., Mayninger, E., Kriston, L. and H?rter, M. (2010) Mental Disorders in People with Migration Background Compared with German General Population. Psychiatrische Praxis, 37, 225-232.
http://dx.doi.org/10.1055/s-0029-1223513
[26] Glaesmer, H., Br?hler, E., Wittig, U., Martin, A., Mewes, R. and Rief, W. (2009) Sind Migranten h?ufiger von psychischen St?rungen betroffen? Eine Untersuchung an einer repr?sentativen Stichprobe der deutschen Allgemein- bev?lkerung. Psychiatrische Praxis, 36, 16-22.
http://dx.doi.org/10.1055/s-2008-1067566
[27] Statistisches Bundesamt (2013) Bev?lkerung und Erwerbst?tigkeit. Bev?lkerung mit Migrationshintergrund. Erge- bnisse des Mikrozensus 2012. Fachserie 1, Reihe 2.2. Statistisches Bundesamt, Wiesbaden.
[28] Dingoyan, D., Schulz, H. and M?sko, M. (2012) The Willingness to Participate in Health Research Studies of Individuals with Turkish Migration Backgrounds: Barriers and Resources. A Qualitative Analysis of Focus Groups. European Psychiatry, 27, S4-S9.
http://dx.doi.org/10.1016/S0924-9338(12)75701-2
[29] Dingoyan, D., M?sko, M., Imamo?lu, Y., von Wolff, A., Strehle, J., Wittchen, H.U., Schulz, H., Koch, U., Heinz, A. and Kluge, U. Development and Feasibility of the Computerized Turkish Edition of the Composite International Interview (DIA-X CIDI Version 2.8TR). International Journal of Methods in Psychiatric Research. (In Press).
[30] Statistisches Amt für Hamburg und Schleswig-Holstein (2012) Bev?lkerung mit Migrationshintergrund in den Hamburger Stadtteilen Ende Januar 2012.
http://www.statistik-nord.de/publikationen/publikationen/presseinformationen/dokumentenansicht/bevoelkerung-mit-migrationshintergrund-in-den-hamburger-stadtteilen-ende-januar-2012/
[31] Humpert, A. and Schneiderheinze, K. (2000) Stichprobenziehung für telefonische Zuwandererumfragen. Einsatzm?g- lichkeiten der Namensforschung. ZUMA-Nachrichten, 47, 36-64.
[32] Wittchen, H.U. and Pfister, H. (1997) Instruktionsmanual zur Durchführung von DIA-X Interviews. Swets & Zeitlinger, Frankfurt.
[33] American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders. 5th Edition, American Psychiatric Publishing, Arlington.
[34] World Health Organization (2013) International Statistical Classification of Diseases and Related Health Problems. 10th Revision, Edition 2012, World Health Organization, Geneva.
[35] Wittchen, H.U., Lachner, G., Wunderlich, U. and Pfister, H. (1998) Test-Retest Reliability of the Computerized DSM-IV Version of the Munich-Composite International Diagnostic Interview (M-CIDI). Social Psychiatry and Psychiatric Epidemiology, 33, 568-578.
http://dx.doi.org/10.1007/s001270050095
[36] Reed, V., Gander, F., Pfister, H., Steiger, A., Sonntag, H., Trenkwalder, C., Sonntag, A., Hundt, W. and Wittchen, H.U. (1998) To What Degree the Composite International Diagnostic Interview (CIDI) Correctly Identify DSM-IV Disorders? Testing Validity Issues in a Clinical Sample. International Journal of Methods in Psychiatric Research, 7, 142- 155. http://dx.doi.org/10.1002/mpr.44
[37] L?we, B., Wahl, I., Rose, M., Spitzer, C., Glaesmer, H., Wingenfeld, K., Schneider, A. and Br?hler, E. (2010) A 4-Item Measure of Depression and Anxiety: Validation and Standardization of the Patient Health Questionnaire-4 (PHQ-4) in the General Population. Journal of Affective Disorders, 122, 86-95.
http://dx.doi.org/10.1016/j.jad.2009.06.019
[38] Rabung, S., Harfst, T., Koch, U., Wittchen, H.U. and Schulz, H. (2007) “Hamburger Module zur Erfassung allgemeiner Aspekte psychosozialer Gesundheit für die therapeutische Praxis (HEALTH)”—Psychometrische überprüfung eines neuen Selbstbeurteilungsinstruments zur multidimensionalen Erfassung psychosozialer Gesundheit. Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin, 17, 133-140.
http://dx.doi.org/10.1055/s-2007-940198
[39] M?sko, M., Rabung, S., Tingir, B., Pradel, S., Ddippel, A., Winkeler, M., Schneider, J., Dahlbender, R.W., Koch, E., Schouler-Ocak, M., Koch, U. and Schulz, H. (2011) Psychometrische überprüfung der türkischsprachigen Version der “Hamburger Module zur Erfassung allgemeiner Aspekte psychosozialer Gesundheit” (T-HEALTH-49). Psycho- therapie, Psychosomatik, Medizinische Psychologie, 61, 503-511.
http://dx.doi.org/10.1055/s-0031-1291337
[40] Goldberg, D. (1978) Manual of the General Health Questionnaire. NFER-Nelson, Windsor.
[41] Failde, I., Ramos, I. and Fernandez-Palacín, F. (2000) Comparison between the GHQ-28 and SF-36 (MH 1-5) for the Assessment of Mental Health in Patients with Ischaemic Heart Disease. European Journal of Epidemiology, 16, 311- 316.
http://dx.doi.org/10.1023/A:1007688525023
[42] Sterling, M. (2011) General Health Questionnaire—28 (GHQ-28). Journal of Physiotherapy, 57, 259.
http://dx.doi.org/10.1016/S1836-9553(11)70060-1
[43] Bühringer, G., Kraus, L., Sonntag, D., Pfeiffer-Gerschel, T. and Steiner, S. (2007) Pathologisches Glücksspiel in Deutschland: Spiel- und Bev?lkerungsrisiken. Sucht, 53, 296-308.
http://dx.doi.org/10.1024/2007.05.06
[44] Buth, S. and St?ver, H. (2008) Glücksspielteilnahme und Glücksspielprobleme in Deutschland: Ergebnisse einer bundesweiten Repr?sentativbefragung. Suchttherapie, 9, 3-11.
http://dx.doi.org/10.1055/s-2008-1042440
[45] Johnson, E.E., Hamer, R.M. and Nora, R.M. (1998) The Lie/Bet Questionnaire for Screening Pathological Gamblers: A Follow-Up Study. Psychological Reports, 83, 1219-1224.
http://dx.doi.org/10.2466/PR0.83.7.1219-1224
[46] Grüsser, S.M., Hesselbarth, U., Albrecht, U. and M?rsen, C.P. (2006) Berliner Inventar zum Glücksspielverhalten (BIG). Unver?ffentlichtes Manuskript.
[47] Heinz, A., M?rsen, C.P. and Seiferth, N. (2010) Implikationen biopsychosozialer Grundlagen der Glücksspielsucht für Pr?vention und Therapie. Abschlussbericht an die Senatsverwaltung für Gesundheit und Soziales des Landes Berlin. Klinik für Psychiatrie und Psychotherapie, Charité—Universit?tsmedizin Berlin.
[48] Wittchen, H.U., Müller, N., Pfister, H., Winter, S. and Schmidtkunz, B. (1999) Affektive, somatoforme und Angstst?rungen in Deutschland—Erste Ergebnisse des bundesweiten Zusatzsurveys “Psychische St?rungen”. Gesund- heitswesen, 61, 216-222.
[49] Jacobi, F., H?fler, M., Strehle, M., Mack, M., Gerschler, M., Scholl, M., Busch, M.A., Maske, U., Hapke, U., Gaebel, W., Maier, W., Wagner, M., Zielasek, J. and Wittchen, H.U. (2014) Psychische St?rungen in der Allgemein- bev?lkerung. Der Nervenarzt, 85, 77-87.
http://dx.doi.org/10.1007/s00115-013-3961-y
[50] Statistische ?mter des Bundes und der L?nder (2009) Mikrozensus 2010—Stichprobenerhebung über die Bev?lkerung und den Arbeitsmarkt und Arbeitskr?ftestichprobe 2010 der Europ?ischen Union. Statistisches Bundesamt, Wiesbaden.
[51] Harkness, J.A. (2008) Comparative Survey Research: Goals and Challenges. In: De Leeuw, E.D., Hox, J.J. and Dillman, D.A., Eds., International Handbook of Survey Methodology, Lawrence Erlbaum Associates, New York/London, 56-77.
[52] Mayring, P. (2002) Qualitative Inhaltsanalyse—Grundlagen und Techniken. 8th Edition, UTB Beltz Verlag, Stuttgart.

  
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