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美国阿拉伯人群中的抑郁与焦虑:一项荟萃分析。

Depression and Anxiety Among Arab Individuals in the United States: A Meta-analysis.

作者信息

El-Refaay Shaimaa Mosad, Kenny Christina, Weiss Sandra

机构信息

School of Nursing, UCSF, 2 Koret Way Rm 411Y, San Francisco, CA, 94143, USA.

Division of Geriatrics, School of Nursing, UCSF, San Francisco, USA.

出版信息

J Immigr Minor Health. 2025 Apr;27(2):329-350. doi: 10.1007/s10903-024-01648-9. Epub 2024 Nov 27.

DOI:10.1007/s10903-024-01648-9
PMID:39602001
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11903594/
Abstract

Emerging research suggests that the increasing population of Arab immigrants and refugees living in the United States (U.S.) has a greater risk for depression and anxiety than other groups. The purpose of this meta-analysis was to estimate the prevalence of depression and anxiety for Arabs in the U.S., to examine the moderating effects of key demographic variables (gender, immigration status, ethnicity) and study characteristics (research design and quality) on the prevalence of anxiety and depression, and to evaluate the direct effects of additional demographic and study characteristics on prevalence rates. Using guidelines from the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P), we searched PubMed, Embase, CINHAL, ProQuest, and the Web of Science databases for articles published between January 2000 and March 2023. Two reviewers each individually extracted the articles' data and evaluated the reported study's methodological quality using a well-established checklist. Statistical analyses consisted of random effects models to estimate the pooled prevalence of depression and anxiety across all studies, separate random effects models for distinct demographic (e.g., immigration status) and methodologic (e.g., study quality) subgroups that might have unique prevalence rates, and a meta-regression to identify additional variables (e.g., age of individuals) that might influence prevalence rates. Our review included 17 studies with a total sample population size of 22, 558 participants. Results indicated that the estimated prevalence of depression overall was 48% (CI 34, 63%) and 58% (CI 33, 83%) for the prevalence of anxiety. Our subgroup analyses uncovered notable variations in prevalence rates based on gender composition, immigration status, ethnicity, and research quality while results of the meta-regressions demonstrated effects of publication year and age of the Arab individual on the estimated prevalence of depression and anxiety. The high prevalence rates for depression and anxiety identified through this meta-analysis are very concerning and underscore the urgent need to address mental health concerns in Arab communities. Results of subgroup and meta-regression analyses suggest that refugees, individuals from specific countries of origin, and younger Arabic persons may need particular attention by clinicians in screening for and treating their depression and anxiety. Our results also signify the need for further high-quality studies to more rigorously assess prevalence of these mental health problems, since we found evidence of potential publication bias and approximately one third of the studies in the review had less optimal methodological quality based on our evaluation. Ultimately, in-depth research regarding the causes of anxiety or depression among Arab individuals will be essential to the development of culturally competent interventions that may reduce their very high prevalence rates.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb8a/11903594/2db67d9aa336/10903_2024_1648_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb8a/11903594/5c9cbe873943/10903_2024_1648_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb8a/11903594/f10ec2048eb3/10903_2024_1648_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb8a/11903594/68597e4c0fcd/10903_2024_1648_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb8a/11903594/2db67d9aa336/10903_2024_1648_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb8a/11903594/5c9cbe873943/10903_2024_1648_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb8a/11903594/f10ec2048eb3/10903_2024_1648_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb8a/11903594/68597e4c0fcd/10903_2024_1648_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb8a/11903594/2db67d9aa336/10903_2024_1648_Fig4_HTML.jpg
摘要

新出现的研究表明,生活在美国的阿拉伯移民和难民人口不断增加,他们患抑郁症和焦虑症的风险比其他群体更高。这项荟萃分析的目的是估计美国阿拉伯人抑郁症和焦虑症的患病率,研究关键人口统计学变量(性别、移民身份、种族)和研究特征(研究设计和质量)对焦虑症和抑郁症患病率的调节作用,并评估其他人口统计学和研究特征对患病率的直接影响。我们按照系统评价与荟萃分析方案的首选报告项目(PRISMA-P)指南,在PubMed、Embase、CINHAL、ProQuest和科学网数据库中搜索了2000年1月至2023年3月发表的文章。两位评审员各自独立提取文章数据,并使用一份成熟的清单评估所报告研究的方法学质量。统计分析包括随机效应模型,以估计所有研究中抑郁症和焦虑症的合并患病率;针对可能具有独特患病率的不同人口统计学(如移民身份)和方法学(如研究质量)亚组的单独随机效应模型;以及荟萃回归,以识别可能影响患病率的其他变量(如个体年龄)。我们的综述纳入了17项研究,总样本量为22558名参与者。结果表明,抑郁症的总体估计患病率为48%(置信区间34%,63%),焦虑症的患病率为58%(置信区间33%,83%)。我们的亚组分析发现,基于性别构成、移民身份、种族和研究质量,患病率存在显著差异,而荟萃回归结果表明,发表年份和阿拉伯个体的年龄对抑郁症和焦虑症的估计患病率有影响。通过这项荟萃分析确定的抑郁症和焦虑症的高患病率令人十分担忧,凸显了在阿拉伯社区解决心理健康问题的迫切需要。亚组和荟萃回归分析结果表明,难民、来自特定原籍国的个体以及年轻的阿拉伯人在筛查和治疗他们的抑郁症和焦虑症时可能需要临床医生给予特别关注。我们的结果还表明需要进一步开展高质量研究,以更严格地评估这些心理健康问题的患病率,因为我们发现了潜在发表偏倚的证据,并且根据我们的评估,综述中的约三分之一研究的方法学质量不太理想。最终,深入研究阿拉伯个体焦虑或抑郁的原因对于开发可能降低其极高患病率的具有文化胜任力的干预措施至关重要。

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