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1.
Crim Behav Ment Health ; 34(3): 311-338, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38527155

RESUMEN

BACKGROUND: Acquired brain injury (ABI) is a major health problem, often with negative effects on behaviour and mental health as well as cognition. Prevalence of ABI is exceptionally high among offenders and increases their re-offending risk. Information on risk factors for ABI and its outcomes among offenders that could guide effective treatment for them is, nevertheless, scarce and dispersed. However, there is a more substantial literature about the general population that could inform work with brain-injured offenders, especially when selecting for samples or subgroups with similar relevant characteristics, such as lower socio-economic status (SES), pre-injury lower tested intelligence score (<85) and pre-injury mental health problems. AIMS: To explore brain injury data from non-offender samples of otherwise similar socio-economic and mental health and ability characteristics to offenders then, first, to describe their untreated outcomes and, secondly, outcomes after frequently used interventions in these circumstances, noting factors associated with their effectiveness. METHOD: Three databases were systematically searched for the years 2010-2022; first, using terms for brain injury or damage and cognitive (dys)function, mental health or quality of life. Second, in a separate search, we used these terms and terms for interventions and rehabilitation. In the second review, studies were selected for clear, distinguishable data on age, sex, SES and lifestyle factors to facilitate inferences for offenders. A narrative analytical approach was adopted for both reviews. RESULTS: Samples with characteristics that are typical in offender groups, including lower SES, lower pre-injury intelligence quotient (<85), prior cognitive impairments and prior mental health problems, had poorer cognitive and behavioural outcomes following ABI than those without such additional problems, together with lower treatment adherence. With respect to treatment, adequate motivation and self-awareness were associated with better cognitive and behavioural outcomes than when these were low or absent, regardless of the outcome measured. CONCLUSIONS: More complex pre-injury mental health problems and social disadvantages typical of offenders are associated with poorer post-brain injury recovery. This paper adds to practical knowledge by bringing together work that follows specific outcome trajectories. Overall, succesful ABI-interventions in the general population that aim at pre-injury difficulties comparable to those seen among offenders, show that personalising injury-specific treatments and taking account of these difficulties, maximised positive outcomes.


Asunto(s)
Lesiones Encefálicas , Criminales , Humanos , Criminales/psicología , Lesiones Encefálicas/terapia , Adulto , Calidad de Vida , Masculino
3.
Arch Gerontol Geriatr ; 101: 104687, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35305440

RESUMEN

OBJECTIVE: In Europe there is a growing number of informal caregivers above 55 years of age, some of whom experience high levels of psychological distress. Our aim is to investigate the prevalence of psychological distress and its association with perceived mastery among elderly informal caregivers. METHODS: In a large representative random sample of citizens from four cities in the Netherlands, we compared psychological distress among older and younger informal caregivers. Next, we selected informal caregivers aged 55 years and older (n = 2663). Mastery was measured by means of the Pearlin Mastery Scale and psychological distress by means of the Kessler psychological distress scale (K10). We presented weighted percentages and conducted multivariate logistic regression analyses. RESULTS: The prevalence of psychological distress was 41.9% among elderly informal caregivers, as opposed to 52.6% among younger informal caregivers. Among the older informal caregivers there was an association between insufficient sense of mastery and psychological distress (OR = 21.3; 95% CI = 12.8-35.5), which persisted after correction for covariates (OR = 4.9; 95% CI = 2.8-8.6). CONCLUSION: The association between insufficient sense of mastery and psychological distress in elderly caregivers is strong. Mastery should be considered a point of engagement for preventive interventions on caregiver distress.


Asunto(s)
Cuidadores , Trastornos Mentales , Anciano , Cuidadores/psicología , Europa (Continente) , Humanos , Análisis Multivariante , Prevalencia , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología
4.
Front Psychiatry ; 13: 779714, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35242062

RESUMEN

BACKGROUND: Public health-inspired programs for Countering Violent Extremism (CVE) have developed internationally in a relatively short period of time. Research into these programs is scarce. There is a need for information that helps drive public health interventions. OBJECTIVES: To present data on the occurrence of psychiatric disorders, self-sufficiency problems and adverse childhood experiences (ACE) in a population suspected of violent extremism. METHODS: A cross-sectional study, with data from screening reports for 34 adult subjects included in a multi-agency case-based approach on violent extremism in Amsterdam, the Netherlands. Subjects were screened in the period between December 2015 to May 2021. Screening reports, which included the Screener for Intelligence and Learning Disabilities (SCIL) and the Dutch version of the Self-sufficiency Matrix (SSM-D), were used to gather information on the main outcome measures. RESULTS: Major psychiatric disease categories were found to be mood and anxiety disorders and mild intellectual disability (each 29.4%), substance related disorders (35.3%), personality disorders (41.2%), and psychotic disorders (14.7%). Complex self-sufficiency problems, measured by the number of people who had self-sufficiency problems in 4+ domains and the number of people who had similar self-sufficiency problems as homeless people in Amsterdam, were found in 35.3 and 32.4% of the client sample. The most prevalent ACE were emotional neglect (47.1%), household mental illness (44.1%), and loss of a parent (38.2%), 35.3% had been exposed to 4+ ACE. An association was found between NACE and self-sufficiency problems on two domains, namely "Mental Health" (rho = 0.51, p = 0.002) and "Law and order" (rho = 0.42, p = 0.013). CONCLUSIONS: An accumulation of social and psychiatric problems in people suspected of violent extremism underlines the importance of professionals in health and social care being actively involved in developing CVE approaches.

5.
Front Psychiatry ; 12: 658328, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34025480

RESUMEN

Background and Aims: The prevalence of acquired brain injury (ABI) in offender populations appears much higher than in the general population, being estimated at 50% compared to 12%, respectively. Taking into account ABI-related cognitive and social impairments or behavioral changes in forensic treatments might be relevant and may improve treatment outcomes. The aim of the current review is to summarize and integrate the literature on psychological interventions or treatments for consequences of ABI in the forensic setting. Reviewing this literature could provide crucial information for improving treatment options for offenders with ABI, which may contribute to reducing recidivism. Methods: The PubMed/MEDLINE, PsychInfo, CINAHL, COCHRANE, and Web of Science databases were searched for studies in adult offenders with ABI that evaluated the effect of psychological interventions with a focus on ABI-related impairments and recidivism. Results: This review identified four intervention studies that met the inclusion criteria. These included an adult population (≥18-year-old) in a forensic setting (given the focus of the current review on treatment, defined here as an environment in which offenders are treated while being incarcerated or as outpatients), non-pharmacological treatments and were published in English or Dutch between 2005 and 2020. All studies reported some positive effects of the intervention on interpersonal behavior, cognition and recidivism. The aspects of the interventions that seemed most beneficial included personalized treatment and re-entry plans, support for the individual and their environment and psychoeducation about the effects of ABI. Discussion: Although positive effects were reported in the studies reviewed, all studies had methodological limitations in terms of sample size, study design and outcome measures which affects the strength of the evidence. This limits strong conclusions and generalizability to the entire offender population. Conclusion: Despite high prevalence of ABI in offender populations, interventions in forensic settings seldom address the effect of ABI. The few studies that did take ABI into account reported positive effects, but those results should be interpreted with caution. Future studies are warranted, since this does seem an important venue to improve treatment, which could eventually contribute to reducing recidivism.

7.
Child Abuse Negl ; 101: 104354, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31926457

RESUMEN

BACKGROUND: Although adverse childhood experiences (ACE) are related to many single negative outcomes, its relation with multiproblem situations in early adulthood is largely unknown. OBJECTIVE: To examine ACE's relation with self-sufficiency problems (SSP) in important life-domains among a sample of young adult violent offenders. PARTICIPANTS AND SETTING: Participants were drafted from a local diversion program for violent repeat offenders. Young adults who agreed to a social-psychiatric screening and who had a history of juvenile probation were eligible to participate. METHODS: The screening included the assessment of SSP (N = 523). ACE prevalences were retrieved from historic juvenile probation files (N = 122). The ACE-SSP relation was assessed with multivariable regression analyses with ACE and SSP as cumulative measures. RESULTS: Offenders presented with 6.1 SSPs from 10 life-domains on average and had been exposed to 3.1 ACEs. Exposure to 4+ ACEs was observed for 42 % of the sample. ACE was positively associated with SSP (ß = .38, p < .01) and with impaired functioning in the distinct domains finances (OR = 1.53, p < .05), addiction (OR = 1.33, p < .05), community participation (OR = 1.28, p < .05) and housing (OR = 1.22, p < .05). CONCLUSIONS: Both ACE and SSP are common among violent offenders. Higher diversity in ACE was associated with higher diversity in SSP. Juvenile probation for high-risk juveniles should focus on preventing functioning problems in multiple life-domains. Diversion efforts for young adult offenders require sensitivity to personal histories and vigilance about multi-problem situations.


Asunto(s)
Experiencias Adversas de la Infancia , Criminales/psicología , Violencia/psicología , Adulto , Humanos , Masculino , Países Bajos/epidemiología , Medición de Riesgo/métodos , Factores de Riesgo , Problemas Sociales , Adulto Joven
8.
Ned Tijdschr Geneeskd ; 1632019 08 29.
Artículo en Holandés | MEDLINE | ID: mdl-31483583

RESUMEN

OBJECTIVE Many healthcare professionals are confronted in their practice with migrants who don't have a valid residence permit. With this study, we want to provide more insight in the health problems and healthcare consumption of this group. DESIGN Retrospective file study. METHOD Data were taken from files created by municipal health-service physicians when medically screening people who present to the municipality to apply for 24-hour shelter on the basis of their health condition. Symptoms and disorders were coded according to the International Classification of Primary Care (ICPC), and use of medication according to the Anatomical Therapeutic Chemical Classification (ATC). RESULTS The study population consisted of 356 people, mainly men, 39 years of age on average (range: 18-80 years). Compared with the total population of people without a valid residence permit who presented to the municipality (n = 1010), in the study population both women (25.6%) and people in age categories above 45 years of age (32.0%) were overrepresented. At the time of screening, 45.2% had a regular, stable place of residence. Most people without a valid residence permit (98.6%) reported one or more health problems. Psychological symptoms, such as stress (78.5%), insomnia (69.7%) and feelings of depression, were the most common ones. At the same time, many people without a valid residence permit were receiving medical care (86.8%). CONCLUSION A majority of people without a valid residence permit who present to apply for 24-hour shelter have health problems. Stress and other psychological symptoms are the most common ones. At the same time, a large part is receiving adequate care. This means that barriers to care, at least in Amsterdam, do not seem too high.


Asunto(s)
Atención a la Salud , Emigrantes e Inmigrantes , Estado de Salud , Migrantes , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Depresión/epidemiología , Trastorno Depresivo , Emigrantes e Inmigrantes/legislación & jurisprudencia , Emigrantes e Inmigrantes/psicología , Femenino , Vivienda , Humanos , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Aceptación de la Atención de Salud/estadística & datos numéricos , Atención Primaria de Salud , Estudios Retrospectivos , Factores Sexuales , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Estrés Psicológico/epidemiología , Migrantes/legislación & jurisprudencia , Migrantes/psicología , Adulto Joven
9.
Int J Offender Ther Comp Criminol ; 62(4): 978-999, 2018 03.
Artículo en Inglés | MEDLINE | ID: mdl-29409403

RESUMEN

The relation between mild to borderline intellectual disability (MBID) and violent offense behavior was studied among a group of former juvenile delinquents currently in a diversion program for persistent young adult violent offenders from Amsterdam ( N = 146). Offenders were considered MBID if they had received juvenile probation from the local youth care agency specialized in intellectual disability (21%). A file study was used to estimate prevalence rates of criminogenic risk factors. Police data were used to depict recent criminal behavior. Nearly all offenders grew up in large and unstable multi-problem households and had psychosocial problems. More MBID offenders displayed externalizing behavior before the age of 12, were susceptible to peer pressure, and had low social-relational skills. MBID offenders committed more violent property crimes than offenders without MBID. Youth care interventions for MBID offenders should focus on the acquisition of social-relational skills and on the pedagogical skills of parents.


Asunto(s)
Conducta Criminal , Criminales , Discapacidad Intelectual/psicología , Delincuencia Juvenil , Adolescente , Niño , Trastornos de la Conducta Infantil/psicología , Estudios de Cohortes , Conflicto Familiar , Humanos , Masculino , Países Bajos , Influencia de los Compañeros , Factores de Riesgo , Habilidades Sociales , Adulto Joven
10.
Eur J Public Health ; 25(2): 243-8, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25416918

RESUMEN

BACKGROUND: European research on the association between perceived ethnic discrimination (PED) and health is importantly lacking. It is also unknown how much PED contributes to disease prevalence. In this study, we quantified the contribution of PED to depression in five ethnic groups in a middle-size European city. METHODS: We used cross-sectional data from the HELIUS study (Healthy Life in an Urban Setting), collected from January 2011 to June 2013 in Amsterdam, The Netherlands. We included a random sample of 1753 ethnic Dutch, 1143 South-Asian Surinamese, 1794 African Surinamese, 1098 Ghanaians and 850 Turks, aged 18-70 years. PED was assessed using the Everyday Discrimination Scale. Patient Health Questionnaire-9 was used for assessing depressive symptoms and major depressive disorder (MDD). We used logistic regression and calculated the contribution of PED to depressive symptoms and MDD using the population attributable fractions. RESULTS: Depressive symptoms and MDD were most common in Turks and South-Asian Surinamese, and lowest in ethnic Dutch. PED had a positive association with depressive symptoms and MDD in only the ethnic minority groups. The contributions of PED to depressive symptoms and MDD were around 25% in both the Surinamese groups, and Turks, and ∼15% in Ghanaians. CONCLUSION: We conclude that PED contributes considerably to depression in ethnic minority groups in a European context. As such, ethnic inequalities in depression could be reduced substantially if ethnic minority groups would not perceive any ethnic discrimination. We encourage more European research on the health impact of PED.


Asunto(s)
Trastorno Depresivo/epidemiología , Trastorno Depresivo/psicología , Etnicidad/psicología , Etnicidad/estadística & datos numéricos , Prejuicio/psicología , Prejuicio/estadística & datos numéricos , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Prevalencia , Adulto Joven
11.
BMC Psychiatry ; 14: 252, 2014 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-25189615

RESUMEN

BACKGROUND: Turkish migrants in the Netherlands have a high prevalence of depressive and/or anxiety disorders. Acculturation has been shown to be related to higher levels of psychological distress, although it is not clear whether this also holds for depressive and anxiety disorders in Turkish migrants. This study aims to clarify the relationship between acculturation strategies (integration, assimilation, separation and marginalization) and the prevalence of depressive and anxiety disorders as well as utilisation of GP care among Turkish migrants. METHODS: Existing data from an epidemiological study conducted among Dutch, Turkish and Moroccan inhabitants of Amsterdam were re-examined. Four scales of acculturation strategies were created in combination with the bi-dimensional approach of acculturation by factor analysis. The Lowlands Acculturation Scale and the Composite International Diagnostic Interview were used to assess acculturation and mood and anxiety disorders. Socio-demographic variables, depressive, anxiety and co-morbidity of both disorders and the use of health care services were associated with the four acculturation strategies by means of Chi-Squared and Likelihood tests. Three two-step logistic regression analyses were performed to control for possible, confounding variables. RESULTS: The sample consisted of 210 Turkish migrants. Significant associations were found between the acculturation strategies and age (p < .01), education (p < .01), daily occupation (p < .01) and having a long-term relationship (p = .03). A significant association was found between acculturation strategies and depressive disorders (p = .049): integration was associated with a lower risk of depression, separation with a higher risk. Using the axis separately, participation in Dutch society showed a significant relationship with a decreased risk of depressive, anxiety and co-morbidity of both disorders (OR = .15; 95% CI: .024 - .98). Non-participation showed no significant association. No association was found between the acculturation strategies and uptake of GP care. CONCLUSIONS: Turkish migrants who integrate may have a lower risk of developing a depressive disorder. Participation in Dutch culture is associated with a decreased risk of depressive, anxiety and co-morbidity of both disorders. Further research should focus on the assessment of acculturation in the detection of depression.


Asunto(s)
Aculturación , Trastornos de Ansiedad/etnología , Trastorno Depresivo/etnología , Migrantes/psicología , Adolescente , Adulto , Anciano , Trastornos de Ansiedad/psicología , Comorbilidad , Métodos Epidemiológicos , Etnicidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Aceptación de la Atención de Salud/etnología , Aceptación de la Atención de Salud/psicología , Turquía/etnología , Adulto Joven
12.
Community Ment Health J ; 50(7): 870-8, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24515344

RESUMEN

The current study set out to develop a decision support tool based on the Self-Sufficiency Matrix (Dutch version; SSM-D) for the clinical decision to allocate homeless people to the public mental health care system at the central access point of public mental health care in Amsterdam, The Netherlands. Logistic regression and receiver operating characteristic-curve analyses were used to model professional decisions and establish four decision categories based on SSM-D scores from half of the research population (Total n = 612). The model and decision categories were found to be accurate and reliable in predicting professional decisions in the second half of the population. Results indicate that the decision support tool based on the SSM-D is useful and feasible. The method to develop the SSM-D as a decision support tool could be applied to decision-making processes in other systems and services where the SSM-D has been implemented, to further increase the utility of the instrument.


Asunto(s)
Técnicas de Apoyo para la Decisión , Personas con Mala Vivienda , Servicios de Salud Mental , Adulto , Femenino , Personas con Mala Vivienda/psicología , Humanos , Modelos Logísticos , Masculino , Trastornos Mentales/terapia , Servicios de Salud Mental/organización & administración , Modelos Estadísticos , Países Bajos , Curva ROC , Reproducibilidad de los Resultados , Asignación de Recursos/métodos , Autoeficacia
13.
Soc Psychiatry Psychiatr Epidemiol ; 49(7): 1139-49, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24549837

RESUMEN

PURPOSE: This study explored (in)equities between ethnic groups in the Netherlands regarding their access to health care for symptoms of common mental disorders (CMD). METHODS: Data were used from a health survey conducted in four Dutch cities in 2008, including 11,678 Dutch, 700 Turkish, 571 Moroccans, 956 Surinamese and 226 Antilleans/Arubans. The prevalence of a medium to high risk of having CMD per ethnic group and of health care consumption by ethnic groups of people, likely having CMD, was calculated, using SPSS Complex Samples weighting for gender, age and district. Logistic regression models were used for assessing the association between health care utilisation and need, demographic factors, social structure and enabling resources. RESULTS: The prevalence of a medium to high risk of having CMD was 42.9 % (Dutch), 50.3 % (Turkish), 37.3 % (Moroccans), 51.5 % (Surinamese) and 44.9 % (Antilleans/Arubans). The 1-year prevalence of contacts with the general practitioner by ethnic groups of people who were likely having CMD was 81.2 % (Dutch), 87.2 % (Turkish), 88.4 % (Moroccans), 88.6 % (Surinamese) and 76.6 % (Antilleans/Arubans). Concerning specialised mental health care, this one-year prevalence was 15.9 % (Dutch), 25.8 % (Turkish), 19.7 % (Moroccans), 17.1 % (Surinamese) and 20.5 % (Antilleans/Arubans). The elevated use of health care by some ethnic minority groups was partly associated with need and demographic factors. CONCLUSIONS: There are no indications for an inequitable access to health care for symptoms of CMD among different ethnic groups in the Netherlands.


Asunto(s)
Trastornos de Ansiedad/etnología , Ciudades/estadística & datos numéricos , Trastorno Depresivo/etnología , Etnicidad/psicología , Etnicidad/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Salud Mental , Trastornos de Ansiedad/epidemiología , Trastorno Depresivo/epidemiología , Femenino , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Encuestas Epidemiológicas , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Grupos Minoritarios/psicología , Grupos Minoritarios/estadística & datos numéricos , Países Bajos/epidemiología , Países Bajos/etnología , Prevalencia , Adulto Joven
14.
Community Ment Health J ; 50(5): 583-90, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24337475

RESUMEN

Measuring treatment outcomes can be challenging in patients who experience multiple interlinked problems, as is the case in public mental health care (PMHC). This study describes the development and psychometric properties of a Dutch version of the self-sufficiency matrix (SSM-D), an instrument that measures outcomes and originates from the US. In two different settings, clients were rated using the SSM-D in combination with the Health of the Nation Outcome Scales (HoNOS) and the Camberwell assessment of need short appraisal schedule (CANSAS). The results provided support for adequate psychometric properties of the SSM-D. The SSM-D had a solid single factor structure and internal consistency of the scale was excellent. In addition, convergent validity of the SSM-D was indicated by strong correlations between HoNOS and CANSAS, as well as between several subdomains. Further research is needed to establish whether the results presented here can be obtained in other PMHC settings.


Asunto(s)
Escalas de Valoración Psiquiátrica/normas , Psicometría , Autoeficacia , Femenino , Humanos , Masculino , Servicios de Salud Mental , Países Bajos , Adulto Joven
15.
J Nerv Ment Dis ; 201(5): 421-8, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23595096

RESUMEN

It is well established that personality traits are associated with anxiety and depressive disorders in Western populations, but it is not known whether this is true also for people from non-Western cultures. In this study, we examined whether ethnicity moderates the association between personality dimensions and anxiety or depressive disorders or symptoms. In a random urban population sample, stratified by ethnicity, in Amsterdam, the Netherlands, we interviewed 309 native Dutch subjects, 203 Turkish-Dutch subjects, and 170 Moroccan-Dutch subjects. Dimensions of personality were measured using the NEO Five-Factor Inventory. Anxiety and depressive disorders and symptom levels were assessed with the Composite International Diagnostic Interview and the Symptom Checklist-90-Revised. The association between personality factors and disorders or symptoms of anxiety and depression was very similar in the three ethnic groups: all show the typical profile of high neuroticism and low extraversion, agreeableness, and conscientiousness.


Asunto(s)
Trastornos de Ansiedad/etnología , Comparación Transcultural , Trastorno Depresivo/etnología , Personalidad , Trastornos de Ansiedad/psicología , Lista de Verificación , Trastorno Depresivo/psicología , Extraversión Psicológica , Femenino , Humanos , Entrevista Psicológica , Masculino , Persona de Mediana Edad , Marruecos/etnología , Países Bajos , Neuroticismo , Determinación de la Personalidad , Inventario de Personalidad , Turquía/etnología
16.
Int J Soc Psychiatry ; 58(2): 186-94, 2012 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21307085

RESUMEN

BACKGROUND: Overlap of depressive and anxiety symptoms is supposedly more common in non-Western populations. This can lead to diagnostic uncertainity and undertreatment. AIMS: The aim of this study was to assess cross-cultural differences regarding the comorbidity of anxiety and depressive disorders in a comparative population study. METHODS: In a random urban population sample, stratified for descent, in Amsterdam, the Netherlands, diagnostic interviews were held by bilingual interviewers. Diagnoses of anxiety and depressive disorders, based on the Composite International Diagnostic Interview, were obtained for 307 native Dutch subjects, 205 Turkish-Dutch subjects and 186 Moroccan-Dutch subjects. RESULTS: The prevalence rate of comorbid anxiety and depressive disorders was higher in Turkish-Dutch (9.8 %) and Moroccan-Dutch (3.8%) subjects compared to native Dutch subjects (2.3%). However, this could be explained by differences in baseline prevalence rate and level of severity of the separate disorders. The onset order of anxiety disorders and depressive disorders was comparable in each ethnic group. CONCLUSIONS: The high prevalence rate of comorbid anxiety and depressive diorders in non-Western immigrants in the Netherlands necessitates assesssment and treatment of both disorders. There was no indication of a - culturally influenced - stronger overlap between anxiety and depressive disorders in non-Western immigrants in the Netherlands.


Asunto(s)
Ansiedad/etnología , Comorbilidad , Depresión/etnología , Adulto , Anciano , Ansiedad/epidemiología , Comparación Transcultural , Depresión/epidemiología , Femenino , Humanos , Entrevista Psicológica , Masculino , Persona de Mediana Edad , Marruecos/etnología , Países Bajos/epidemiología , Turquía/etnología
17.
Int J Soc Psychiatry ; 57(2): 132-43, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-19933252

RESUMEN

BACKGROUND: Political and social developments point at increasing marginalization of Muslim migrants, but little is known about its consequences for the mental health of this particular group. AIM: To explore the relationship between acculturation and psychological distress among first-generation Muslim migrants from Turkey and Morocco in the Netherlands. METHODS: A cross-sectional study. Respondents were interviewed in their preferred language. Acculturation was measured with the Lowlands Acculturation Scale (LAS) and psychological distress with the Kessler Psychological Distress Scale (K10). Data were complete for 321 subjects and analyzed with multivariate linear regression. RESULTS: Less skills for living in Dutch society was associated with distress (p = 0.032). Feelings of loss were related to distress among Moroccans (p = 0.037). There was an interaction between traditionalism and ethnic background (p = 0.037); traditionalism was related to less distress among Moroccans (p = 0.020), but not among Turkish. Finally, there was an interaction by gender among Turks (p = 0.029); conservative norms and values seemed to be related to distress among men (p = 0.062), not women. CONCLUSION: Successful contact and participation in Dutch society, and maintenance of heritage culture and identity were moderately associated with less psychological distress. Improving mastery of the dominant language in host societies, and allowing migrants to preserve their traditions, might be effective measures in improving the mental well-being of migrants.


Asunto(s)
Aculturación , Islamismo/psicología , Estrés Psicológico/etnología , Estrés Psicológico/epidemiología , Adulto , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Entrevistas como Asunto , Modelos Lineales , Masculino , Salud Mental , Persona de Mediana Edad , Marruecos/etnología , Países Bajos/epidemiología , Turquía/etnología
18.
Gen Hosp Psychiatry ; 32(4): 368-76, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20633740

RESUMEN

OBJECTIVE: There is widespread concern about access to good quality health care for ethnic minority groups. This study investigates differences between ethnic groups regarding prevalence of anxiety and depression, and adherence to treatment guidelines by family practitioners in urban areas in the Netherlands. METHOD: Data from electronic medical records, collected for the Netherlands Information Network of General Practice. Diagnoses were based on the International Classification of Primary Care. Adherence to guidelines included at least five consultations, prescription of psychotropics for 6 weeks at most (indicative of cessation in case of nonresponse) or 5 months at least (suggesting continuation in case of response), and/or a referral to a mental health care specialist. Data were analyzed using multilevel logistic regression analyses. RESULTS: A total of 6413 patients (4.4% of practice population) were diagnosed with anxiety and/or depression. Prevalence was highest in Turkish patients (5.2%). Of diagnosed patients, 42.9% received guideline-concordant treatment. Only Surinamese/Antillean patients were less likely than ethnic Dutch to receive treatments according to guidelines. CONCLUSION: Prevalence of and quality of care for anxiety and depression were comparable between ethnic minority clients, but some differences suggest that efforts to educate primary care providers in management of anxiety/depression should be continued and tailored to specific ethnic groups.


Asunto(s)
Trastornos de Ansiedad/terapia , Trastorno Depresivo/terapia , Etnicidad , Médicos de Familia/normas , Calidad de la Atención de Salud , Adulto , Trastornos de Ansiedad/diagnóstico , Trastorno Depresivo/diagnóstico , Etnicidad/psicología , Femenino , Adhesión a Directriz/estadística & datos numéricos , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Marruecos/etnología , Países Bajos , Calidad de la Atención de Salud/normas , Suriname/etnología , Turquía/etnología , Población Urbana
19.
Psychiatr Serv ; 61(7): 690-7, 2010 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-20592004

RESUMEN

OBJECTIVE: There are widespread concerns about disparities in mental health treatment for ethnic minority groups. However, previous research in this area has been limited mainly to the United States and Great Britain, raising doubts about the external validity with respect to other European countries. This study addressed ethnic differences in characteristics of outpatient treatment for depression in the Netherlands. METHODS: Longitudinal data (2001-2005) were extracted from a nationwide psychiatric case register. The sample consisted of 17,270 episodes of outpatient depression care. Information was available about timeliness of the initial treatment contact, treatment intensity, dropout, and early reregistration for mental health care. Data were analyzed with linear, logistic, and Cox regression analyses. RESULTS: When analyses were controlled for illness and demographic characteristics, timeliness and treatment intensity were somewhat less favorable for Moroccan, Turkish, and other non-Western clients compared with ethnic Dutch. No significant differences were found between minority and ethnic Dutch groups in dropout and early reregistration. Some treatment characteristics were in fact more favorable for Surinamese and Antillean clients compared with ethnic Dutch. CONCLUSIONS: The data provided insufficient support for the idea that treatment characteristics are generally less favorable for clients from ethnic minority groups. This finding may be related to the promotion of culturally sensitive approaches to care in mainstream mental health services but may also indicate that the role of traditional barriers, like stigma and taboo, is smaller than is usually suggested. However, the influence of language proficiency, which is notably better among Surinamese and Dutch Antillean compared with Turkish and Moroccan clients, should not be disregarded.


Asunto(s)
Atención Ambulatoria , Depresión/etnología , Depresión/terapia , Adulto , Depresión/epidemiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Modelos de Riesgos Proporcionales , Sistema de Registros
20.
BMC Public Health ; 9: 332, 2009 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-19744326

RESUMEN

BACKGROUND: There is insufficient empirical evidence which shows if and how there is an interrelation between acculturation and health care utilisation. The present study seeks to establish this evidence within first generation Turkish and Moroccan migrants, two of the largest migrant groups in present-day Western Europe. METHODS: Data were derived from the Amsterdam Health Monitor 2004, and were complete for 358 Turkish and 288 Moroccan foreign-born migrants. Use of health services (general practitioner, outpatient specialist and health care for mental health problems) was measured by means of self-report. Acculturation was measured by a structured questionnaire grading (i) ethnic self-identification, (ii) social interaction with ethnic Dutch, (iii) communication in Dutch within one's private social network, (iv) emancipation, and (v) cultural orientation towards the public domain. RESULTS: Acculturation was hardly associated with the use of general practitioner care. However, in case of higher adaptation to the host culture there was less uptake of outpatient specialist care among Turkish respondents (odds ratio [OR] = 0.90, 95% confidence interval [CI] = 0.82-0.99) and Moroccan male respondents (OR = 0.81, 95% CI = 0.71-0.93). Conversely, there was a higher uptake of mental health care among Turkish men (OR = 0.81, 95% CI = 0.71-0.93) and women (OR = 0.81, 95% CI = 0.71-0.93). Uptake of mental health care among Moroccan respondents again appeared lower (OR = 0.74, 95% CI = 0.55-0.99). Language ability appeared to play a central role in the uptake of health care. CONCLUSION: Some results were in accordance with the popular view that an increased participation in the host society is concomitant to an increased use of health services. However, there was heterogeneity across ethnic and gender groups, and across the domains of acculturation. Language ability appeared to play a central role. Further research needs to explore this heterogeneity into more detail. Also, other cultural and/or contextual aspects that influence the use of health services require further identification.


Asunto(s)
Aculturación , Emigración e Inmigración , Servicios de Salud/estadística & datos numéricos , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Marruecos/etnología , Países Bajos , Encuestas y Cuestionarios , Turquía/etnología , Adulto Joven
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