Zusammenfassung
Anliegen: Untersuchung des Zusammenhangs zwischen Migrationsstatus und depressiven Symptomen in der älteren Bevölkerung in Deutschland. Methode: In einer Querschnittstudie mit einer repräsentativen Stichprobe der ab 50-jährigen deutschen Bevölkerung (n = 2890) wurden depressive Symptome mit der EURO-D-Skala erfasst. Ergebnisse: Migranten (definiert als Personen mit eigener Migrationserfahrung) wiesen eine höhere Prävalenz depressiver Symptome (EURO-D ≥ 4 Punkte) auf (28 %) als Nichtmigranten (19 %). Nach Adjustierung für relevante Kovariablen blieb diese signifikante Assoziation bestehen. Schlussfolgerungen: Die Ergebnisse sprechen für eine Assoziation zwischen Migrationserfahrung und depressiven Symptomen in der ab 50-jährigen Bevölkerung.
Abstract
Objective: To assess the association between migrant status and depressive symptoms among the older population in Germany. Methods: In a cross-sectional study with the German subsample of the Survey of Health, Ageing and Retirement in Europe (SHARE), a population-based sample of 2890 German residents aged 50 years or older (mean age 65 years, 55 % women), the association between migrant status (defined as being born outside of, and having immigrated to Germany) and depressive symptoms (≥ 4 points on the EURO-D scale) was examined by multiple logistic regression analysis. Results: A total of 539 respondents (19 %) were migrants. Prevalence of depressive symptoms was higher in migrants (28 %) than in non-migrants (19 %, p < 0.001). Migrant status remained associated with depressive symptoms (odds ratio 1.50, 95 % confidence interval 1.11–2.01) in logistic regression analysis adjusting for sociodemographic factors, indicators of physical health, and cognitive function. Conclusions: The results suggest an association between migrant status and depressive symptoms in the older population in Germany that was independent of other predictors of late-life depression included in this analysis.
Schlüsselwörter
depressive Symptome - Migration - repräsentative Studie - EURO-D-Skala
Keywords
depressive symptoms - migrants - population-based study - EURO-D scale
Literatur
1
Chapman D P, Perry G S.
Depression as a major component of public health for older adults.
Prev Chronic Dis.
2008;
5
A22
2 Weyerer S, Bickel H. Epidemiologie depressiver Erkrankungen und suizidaler Handlungen.. In: Weyerer H, Bickel S Epidemiologie psychischer Erkrankungen im höheren Lebensalter.. Stuttgart: Kohlhammer; 2007: 115-136
3
Cole M G, Dendukuri N.
Risk factors for depression among elderly community subjects: a systematic review and meta-analysis.
Am J Psychiatry.
2003;
160
1147-1156
4
Fiske A, Wetherell J L, Gatz M.
Depression in older adults.
Annu Rev Clin Psychol.
2009;
5
363-389
5
Glaesmer H, Kallert T W, Brahler E et al.
The prevalence of depressive symptomatology in the german elderly population and the impact of methodical aspects on the identified prevalence.
Psychiat Prax.
2010;
37
71-77
6
Weyerer S, Eifflaender-Gorfer S, Kohler L et al.
Prevalence and risk factors for depression in non-demented primary care attenders aged 75 years and older.
J Affect Disord.
2008;
111
153-163
7
Blazer D G, Hybels C F.
Origins of depression in later life.
Psychol Med.
2005;
35
1-12
8
Bhugra D.
Migration and mental health.
Acta Psychiatr Scand.
2004;
109
243-258
9
Lindert J, Ehrenstein O S, Priebe S et al.
Depression and anxiety in labor migrants and refugees – a systematic review and meta-analysis.
Soc Sci Med.
2009;
69
246-257
10
Livingston G, Leavey G, Kitchen G et al.
Mental health of migrant elders – the Islington study.
Br J Psychiatry.
2001;
179
361-366
11
Haasen C, Levit O, Gelbert A et al.
Relationship between mental distress and acculturation among migrants.
Psychiat Prax.
2007;
34
339-342
12 Statistisches Bundesamt .Statistisches Jahrbuch 2009 für die Bundesrepublik Deutschland.. Wiesbaden: Statistisches Bundesamt; 2009
13
Aichberger M C, Schouler-Ocak M, Mundt A et al.
Depression in middle-aged and older first generation migrants in Europe: results from the Survey of Health, Ageing and Retirement in Europe (SHARE).
Eur Psychiatry.
2010;
25
468-475
14
Cantor-Graae E, Selten J P.
Schizophrenia and migration: a meta-analysis and review.
Am J Psychiatry.
2005;
162
12-24
15
McCracken C F, Boneham M A, Copeland J R et al.
Prevalence of dementia and depression among elderly people in black and ethnic minorities.
Br J Psychiatry.
1997;
171
269-273
16
van der Wurff F B, Beekman A T, Dijkshoorn H et al.
Prevalence and risk-factors for depression in elderly Turkish and Moroccan migrants in the Netherlands.
J Affect Disord.
2004;
83
33-41
17
Fazel M, Wheeler J, Danesh J.
Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review.
Lancet.
2005;
365
1309-1314
18
Schouler-Ocak M, Bretz H J, Hauth I et al.
Patients of immigrant origin in outpatient psychiatric facilities: a comparison between Turkish, eastern European and German patients.
Psychiat Prax.
2010;
37
384-390
19
Schouler-Ocak M, Hartkamp N, Koch E et al.
Patient with a history of immigration in inpatient psychiatric clinics – representative country-wide survey of the „Psychiatry and Immigration“ Working Group of the Federal Directors Conference.
Psychiat Prax.
2009;
36
202
20
Machleidt W, Behrens K, Ziegenbein M et al.
Integration of immigrants into the mental health care system in Germany.
Psychiat Prax.
2007;
34
325-331
21
Zeeb H, Razum O.
Epidemiological research on migrant health in Germany. An overview.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz.
2006;
49
845-852
22
Glaesmer H, Wittig U, Brahler E et al.
Are migrants more susceptible to mental disorders?.
Psychiat Prax.
2009;
36
16-22
23
Bermejo I, Mayninger E, Kriston L et al.
Mental disorders in people with migration background compared with German general population.
Psychiat Prax.
2010;
37
225-232
24 Börsch-Supan A, Jürges H. The Survey of Health, Ageing and Retirement in Europe – Methodology.. Mannheim: Mannheim Research Institute for the Economics of Aging; 2005
25
Castro-Costa E, Dewey M, Stewart R et al.
Ascertaining late-life depressive symptoms in Europe: an evaluation of the survey version of the EURO-D scale in 10 nations. The SHARE project.
Int J Methods Psychiatr Res.
2008;
17
12-29
26
Prince M J, Reischies F, Beekman A T et al.
Development of the EURO-D scale – a European, Union initiative to compare symptoms of depression in 14 European centres.
Br J Psychiatry.
1999;
174
330-338
27
Copeland J R, Beekman A T, Braam A W et al.
Depression among older people in Europe: the EURODEP studies.
World Psychiatry.
2004;
3
45-49
28
Castro-Costa E, Dewey M, Stewart R et al.
Prevalence of depressive symptoms and syndromes in later life in ten European countries: the SHARE study.
Br J Psychiatry.
2007;
191
393-401
29 UNESCO .International Standard Classification of Education ISCED-1997.. Montreal, Quebec, Canada: UNESCO Institute of Statistics; 2006
30 OECD .Growing Unequal? Income Distribution and Poverty in OECD Countries.. Paris: OECD Publishing; 2008
31 Börsch-Supan A, Brugiavini A, Jürges H et al. Health, ageing and retirement in Europe – First Results from the Survey of Health, Ageing and Retirement in Europe.. Mannheim: Mannheim Research Institute for the Economics of Ageing (MEA); 2005
32
Aichberger M C, Busch M A, Reischies F M et al.
Effect of physical inactivity on cognitive performance after 2.5 years of follow-up: Longitudinal results from the survey of health, ageing, and retirement (SHARE).
GeroPsych.
2010;
23
7-15
33
Silveira E R, Ebrahim S.
Social determinants of psychiatric morbidity and well-being in immigrant elders and whites in east London.
Int J Geriatr Psychiatry.
1998;
13
801-812
34
Momartin S, Steel Z, Coello M et al.
A comparison of the mental health of refugees with temporary versus permanent protection visas.
Med J Aust.
2006;
185
357-361
35
Silove D, Sinnerbrink I, Field A et al.
Anxiety, depression and PTSD in asylum-seekers: assocations with pre-migration trauma and post-migration stressors.
Br J Psychiatry.
1997;
170
351-357
36
Igel U, Brahler E, Grande G.
The influence of perceived discrimination on health in migrants.
Psychiat Prax.
2010;
37
183-190
37
Glaesmer H, Gunzelmann T, Martin A et al.
The impact of mental disorders on health care utilization and illness behaviour in the elderly.
Psychiat Prax.
2008;
35
187-193
38
Bhugra D.
Cultural identities and cultural congruency: a new model for evaluating mental distress in immigrants.
Acta Psychiatr Scand.
2005;
111
84-93
39
Kirmayer L J.
Cultural variations in the clinical presentation of depression and anxiety: implications for diagnosis and treatment.
J Clin Psychiatry.
2001;
62
(S 13)
22-30
40
Simon G E, Korff M von, Piccinelli M et al.
An international study of the relation between somatic symptoms and depression.
N Engl J Med.
1999;
341
1329-1335
41 Statistisches Bundesamt .Bevölkerung mit Migrationshintergrund – Ergebnisse des Mikrozensus 2005.. Wiesbaden: Statistisches Bundesamt; 2007
Dr. Markus Busch
Robert Koch-Institut, Abt. Epidemiologie und Gesundheitsberichterstattung
General-Pape-Straße 64
12101 Berlin
eMail: BuschM@rki.de