Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
Arq Psychotrauma Expert Group, Diemen, the Netherlands; Clinical Psychology, Utrecht University, Utrecht, the Netherlands.
J Affect Disord. 2019 Mar 15;247:134-155. doi: 10.1016/j.jad.2018.12.060. Epub 2018 Dec 21.
This study examined the state of the art relevant for clinical practice on symptom manifestation of depression or depression-related idioms of distress, the treatment effectiveness and obstacles and facilitators for therapeutic success in Turkish and Moroccan immigrant populations with depression in Europe.
We conducted a systematic search in PsycINFO, MEDLINE, Science Direct, Web of Knowledge, and Cochrane databases (1970- 31 July 2017). Peer-reviewed studies, with adult populations, and an instrument assessing depressive symptoms met inclusion criteria and were evaluated following quality guidelines.
We included 13 studies on symptom manifestation, 6 on treatment effectiveness, and 17 on obstacles and facilitators, published between 2000 and 2017, from Germany, the Netherlands, Austria and Sweden (n Turkish individuals = 11,533; n Moroccan individuals = 5278; n native individuals = 303,212). Both ethnic groups more often reported combined mood and somatic symptoms (and anxiety in the case of Turkish groups) than natives, and had higher levels of symptoms. There was no report on effectiveness of pharmacotherapy and there was weak evidence of the effectiveness of examined psychological treatments for depression in Turkish groups. No treatment has been examined in Moroccan groups. Salient obstacles to therapeutic success were socioeconomic problems, higher level of psychological symptoms at baseline, and negative attitudes towards psychotherapy. Possible facilitators were interventions attuned to social, cultural and individual needs. Results were most representative of first generation, low SES Turkish immigrant patients, and Moroccan-Dutch members of the general populations.
Turkish and Moroccan immigrants with depression presented a comorbid symptom profile with more intertwined depressive and somatic complaints. There were indications that the available therapies are insufficient for Turkish groups, but the current evidence is scarce and heterogeneous, and RCTs suffer from methodological limitations.
本研究考察了欧洲土耳其和摩洛哥移民人群中抑郁症的症状表现、抑郁相关痛苦的惯用表达、治疗效果以及治疗成功的障碍和促进因素等临床实践相关的最新研究现状。
我们在 PsycINFO、MEDLINE、Science Direct、Web of Knowledge 和 Cochrane 数据库（1970 年至 2017 年 7 月 31 日）中进行了系统检索。纳入评估抑郁症状的成人研究，并根据质量指南进行评估。
我们纳入了 13 项关于症状表现的研究、6 项关于治疗效果的研究和 17 项关于障碍和促进因素的研究，这些研究发表于 2000 年至 2017 年，来自德国、荷兰、奥地利和瑞典（土耳其人 n=11533；摩洛哥人 n=5278；本地人 n=303212）。两个族裔群体比本地人更常报告混合的情绪和躯体症状（土耳其群体还会报告焦虑），并且症状水平更高。没有关于药物治疗效果的报告，也没有关于针对土耳其群体的抑郁症心理治疗效果的证据。没有治疗方法在摩洛哥群体中得到检验。治疗成功的主要障碍是社会经济问题、基线时更高的心理症状水平以及对心理治疗的消极态度。可能的促进因素是针对社会、文化和个体需求的干预措施。结果主要代表第一代、低社会经济地位的土耳其移民患者和摩洛哥-荷兰普通人群中的成员。
患有抑郁症的土耳其和摩洛哥移民表现出一种伴发症状的特征，抑郁和躯体症状交织更为紧密。有迹象表明，现有的治疗方法对土耳其群体不够有效，但目前的证据很少且异质性较大，并且 RCT 受到方法学限制。
