Department of Psychiatry, School of Medicine, Pontificia Universidad Catolica de Chile, Diagonal Paraguay 362, Santiago, 8330077, Chile.
Department of Psychiatry and Mental Health, University of Concepción, Concepción, Chile.
BMC Public Health. 2023 Jun 30;23(1):1274. doi: 10.1186/s12889-023-15793-7.
The Inner Santiago Health Study (ISHS) aimed to (i) estimate the prevalence of common mental disorders (CMD; i.e. depressive and anxiety disorders) among immigrants of Peruvian origin in Chile; (ii) determine whether such immigrants are at higher risk of CMD when compared with the native-born geographically matched population (i.e. non-immigrants); and (iii) identify factors associated with higher risk of any CMD among this immigrant group. A secondary aim was to describe access to mental health services by Peruvian immigrants meeting criteria for any CMD.
Findings are based on a population-based cross-sectional household mental health survey of 608 immigrant and 656 non-immigrant adults (18-64 years) residing in Santiago de Chile. Diagnoses of ICD-10 depressive and anxiety disorders and of any CMD were obtained using the Revised Clinical Interview Schedule. The relationships between demographic, economic, psychosocial, and migration-specific predictor variables, and risk of any CMD were analyzed with a series of stepwise multivariate logistic regression models.
The one-week prevalence of any CMD was 29.1% (95% CI: 25.2-33.1) among immigrants and 34.7% (95% CI: 30.7-38.7) among non-immigrants. Depending on the statistical model used in the pooled sample, we found the prevalence of any CMD among non-immigrants to be higher (OR=1.53; 95% CI: 1.05-2.25) or similar (OR=1.34; 95% CI: 0.94-19.2) when compared with immigrants. In the multivariate stepwise regression of any CMD in immigrants only, the prevalence was higher for females, those with primary compared to higher education, in debt and exposed to discrimination. Conversely, higher levels of functional social support, sense of comprehensibility, and manageability were associated with a lower risk of any CMD in immigrants. In addition, no differences were observed between immigrants and non-immigrants reporting any CMD in mental health service utilization.
Our results evidence high levels of current CMD in this immigrant group, particularly amongst women. However, lower adjusted prevalence of any CMD in immigrants compared to non-immigrants was limited to preliminary statistical models, thus failing to provide clear support for a "healthy immigrant effect". The study sheds new light on differences in CMD prevalence by immigrant status in Latin America by examining differential exposure to risk factors in immigrant versus non-immigrant groups.
圣地亚哥内城健康研究(ISHS)旨在:(i)评估原籍秘鲁的智利移民中常见精神障碍(CMD;即抑郁和焦虑障碍)的流行率;(ii)确定与出生于当地的地理匹配人群(即非移民)相比,此类移民患 CMD 的风险是否更高;(iii)确定与该移民群体中任何 CMD 风险较高相关的因素。次要目标是描述符合任何 CMD 标准的秘鲁移民获得精神卫生服务的情况。
研究结果基于圣地亚哥 608 名移民和 656 名非移民成年人(18-64 岁)的基于人群的横断面家庭心理健康调查。使用修订后的临床访谈时间表获得 ICD-10 抑郁和焦虑障碍以及任何 CMD 的诊断。使用一系列逐步多元逻辑回归模型分析人口统计学、经济、心理社会和移民特定预测变量与任何 CMD 风险之间的关系。
在移民中,任何 CMD 的一周患病率为 29.1%(95%CI:25.2-33.1),在非移民中为 34.7%(95%CI:30.7-38.7)。根据 pooled 样本中使用的统计模型,我们发现非移民中任何 CMD 的患病率更高(OR=1.53;95%CI:1.05-2.25)或相似(OR=1.34;95%CI:0.94-19.2)与移民相比。在移民中任何 CMD 的多元逐步回归中,女性、接受过初等教育而非高等教育、负债和遭受歧视的人,其患病率更高。相反,更高水平的功能性社会支持、可理解性和可管理性与移民中任何 CMD 的风险降低相关。此外,在报告任何 CMD 的心理健康服务利用方面,移民和非移民之间没有差异。
我们的研究结果表明,该移民群体中当前 CMD 的发生率较高,尤其是女性。然而,与非移民相比,移民中任何 CMD 的调整后患病率较低,仅限于初步的统计模型,因此未能为“健康移民效应”提供明确支持。该研究通过检查移民与非移民群体中不同的危险因素暴露情况,为拉丁美洲移民状况对 CMD 患病率差异提供了新的认识。