Altrecht Institute for Mental Health Care, Utrecht, The Netherlands.
Soc Psychiatry Psychiatr Epidemiol. 2010 Oct;45(10):941-51. doi: 10.1007/s00127-009-0135-0. Epub 2009 Sep 10.
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.
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.
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.
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.
抑郁症是在西欧和北美发展起来的一种临床综合征。因此，可以预期症状的表现和对功能的影响会因文化和语言的不同而有所不同。我们的第一个目的是研究荷兰本土和非西方移民群体之间抑郁症状特征的差异。我们假设，在情绪和认知领域，表达抑郁症状的差异更有可能，而在精神运动和植物性症状领域则不太可能。我们的第二个目的是研究抑郁症状与一般功能之间的关联在不同种族群体中的差异。
在荷兰阿姆斯特丹按族裔分层的随机社区样本中，使用双语访谈者使用复合国际诊断访谈（CIDI 2.1）和症状清单-90 修订版（SCL-90-R）评估抑郁症状。功能障碍通过世界卫生组织残疾评估表 II（WHODAS II）进行测量。结果来自 812 名受试者：N = 321 名荷兰本地人，N = 213 名土耳其裔荷兰人，N = 191 名摩洛哥裔荷兰人，N = 87 名苏里南裔荷兰人。通过差异项目功能测试来检验抑郁症状表达的差异。
与荷兰本土人相比，土耳其和摩洛哥移民群体中 DSM-IV 抑郁障碍的患病率和总体抑郁症状水平更高。抑郁症状的项目功能差异在种族间很少见，且在所有四个症状领域都不太可能出现。抑郁症状与功能障碍在各民族群体中同样相关。
尽管移民中的抑郁症状比本土人群更为常见，但抑郁症状的表现和相关的功能障碍是相似的。这些发现可能有助于减少对在少数民族群体中使用现有诊断程序的有效性的担忧。
