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BackgroundAlthough evidence-based and effective treatments are available for people with depression, a substantial number does not seek or receive help. Therefore, it is important to gain a better understanding of the reasons why people do or do not seek help. This study examined what predisposing and need factors are associated with help-seeking among people with major depression.MethodsA cross-sectional study was conducted in 102 subjects with major depression. Respondents were recruited from the general population in collaboration with three Municipal Health Services (GGD) across different regions in the Netherlands. Inclusion criteria were: being aged 18 years or older, a high score on a screening instrument for depression (K10 > 20), and a diagnosis of major depression established through the Composite International Diagnostic Interview (CIDI 2.1).ResultsOf the total sample, 65 % (n = 66) had received help in the past six months. Results showed that respondents with a longer duration of symptoms and those with lower personal stigma were more likely to seek help. Other determinants were not significantly related to help-seeking.ConclusionsLonger duration of symptoms was found to be an important determinant of help-seeking among people with depression. It is concerning that stigma was related to less help-seeking. Knowledge and understanding of depression should be promoted in society, hopefully leading to reduced stigma and increased help-seeking.

PurposeTo investigate the reliability and validity of the SQUASH physical activity (PA) questionnaire in a multi-ethnic population living in the Netherlands.MethodsWe included participants from the HELIUS study, a population-based cohort study. In this study we included Dutch (n = 114), Turkish (n = 88), Moroccan (n = 74), South-Asian Surinamese (n = 98) and African Surinamese (n = 91) adults, aged 18–70 years. The SQUASH was self-administered twice to assess test-re-test reliability (mean interval 6–7 weeks) and participants wore an accelerometer and heart rate monitor (Actiheart) to enable assessment of construct validity.ResultsWe observed low test-re-test reliability; Intra class correlation coefficients ranged from low (0.05 for moderate/high intensity PA in African Surinamese women) to acceptable (0.78 for light intensity PA in Moroccan women). The discrepancy between self-reported and measured PA differed on the basis of the intensity of activity: self-reported light intensity PA was lower than measured but self-reported moderate/high intensity PA was higher than measured, with wide limits of agreement. The discrepancy between questionnaire and Actiheart measures of moderate intensity PA did not differ between ethnic minority and Dutch participants with correction for relevant confounders. Additionally, the SQUASH overestimated the number of participants meeting the Dutch PA norm; Cohen’s kappas for the agreement were poor, the highest being 0.30 in Dutch women.ConclusionWe found considerable variation in the test-re-test reliability and validity of self-reported PA with no consistency based on ethnic origin. Our findings imply that the SQUASH does not provide a valid basis for comparison of PA between ethnic groups.

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Background and Objective: We examined the reliability and validity of self-reported limitations encountered in the activities of daily living (ADL) as measure of functional performance, for Turkish, Moroccan, and indigenous Dutch elderly in the Netherlands.Methods: We obtained data on self-reported ADL measured by Katz' ADL index and on five related health outcomes among a general population sample of 304 Dutch, 330 Turkish, and 299 Moroccan respondents aged 55e74 years, in Amsterdam, the Netherlands (response: 60%).Results: Katz' ADL index demonstrated good internal consistencies for each ethnic group (Cronbach's alphas: 0.84e0.94). Regarding validity, the ADL index showed relatively strong associations with related outcomes, that is, long-term limitations in mobility and SF-36 physical functioning (rank correlations: 0.64 and À0.60, respectively). Associations with more general health outcomes, number of chronic disorders, Center for Epidemiologic Studies-Depression scale symptoms, and SF-36 role performance were weaker, as expected. Associations were stronger for Moroccans than for indigenous Dutch elderly regarding both SF-36 outcomes and depressive symptoms.Conclusion: Katz' ADL index is valid to assess functional performance of Turkish, Moroccan, and Dutch elderly, but comparisons with Moroccan elderly should be handled with caution. The explanation of these findings and their generalizability to other ethnic groups deserve further study. Ó