TY - JOUR

T1 - The relationship between acculturation strategies and depressive and anxiety disorders in Turkish migrants in the Netherlands

AU - Ünlü Ince, Burcin

AU - Fassaert, Thijs

AU - de Wit, Matty A. S.

AU - Cuijpers, Pim

AU - Smit, Jan

AU - Ruwaard, Jeroen

AU - Riper, Heleen

N1 - Funding Information: The data-collection of this study was funded by the Municipality of Amsterdam, the mental health care institutions Arkin (formerly Jellinek Mentrum and AMC de Meren), GGZinGeest (formerly Stichting Buitenamstel Geestgronden). There was no extra funding for the academic collaboration. The authors would like to thank Arnoud Verhoeff, Henriëtte Dijkshoorn, Joanne Ujcic, Daan Uitenbroek for the AHM data and Jeroen Knipscheer for the LAS questionnaire. Publisher Copyright: © 2014 Ünlü Ince et al.; licensee BioMed Central Ltd.

PY - 2014/9/5

Y1 - 2014/9/5

N2 - 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.

AB - 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.

KW - Health sciences

KW - Psychology

KW - Acculturation; Anxiety; Assimilation; Depression; Integration; Marginalization; Migrants; Separation

UR - http://www.scopus.com/inward/record.url?scp=84908140005&partnerID=8YFLogxK

UR - https://www.mendeley.com/catalogue/7bfafaf8-9887-337a-8893-a367d4d9b973/

U2 - 10.1186/s12888-014-0252-5

DO - 10.1186/s12888-014-0252-5

M3 - Journal articles

C2 - 25189615

VL - 14

JO - BMC Psychiatry

JF - BMC Psychiatry

SN - 1471-244X

IS - 1

M1 - 252

ER -