Depression, anxiety and suicidal ideation among 1st and 2nd generation migrants - results from the Gutenberg health study

Abstract

BackgroundEven though migrants constitute a large proportion of the German population, there is a lack of representative studies on their mental health. Hence, the present study explored mental health characteristics and suicidal ideation comparing 1st and 2nd generation migrants to non-migrants and subgroups within 1st generation migrants.MethodsWe investigated cross-sectional data of 14,943 participants of the Gutenberg Health Study (GHS), a population-based, prospective, single-center cohort study in Mid-Germany (age 35 to 74 years). Migration status was assessed according to the German microcensus criteria. Depression and anxiety were measured by the PHQ (PHQ-8, GAD-2, Panic module), social anxiety by the Mini SPIN and Distressed Personality (Type D) by the DS-14. Suicidal ideation was assessed by the single item of the PHQ-9.ResultsA total of n = 3,525 participants had a migration background; the proportion of 1st generation (immigrated after 1949) migrants was 10.6 % (2nd generation 13 %). Among the 1st generation migrants those with Polish (N = 295) and Turkish (N = 141) origins were the largest groups from single countries. Controlling for sex, age and socioeconomic status, 1st generation migrants reported significantly more depression (OR 1.24; CI 1.01-1.52), generalized anxiety (OR 1.38; CI 1.13-1.68), panic attacks in the past 4 weeks (OR 1.43; CI 1.16-1.77); Type D (OR 1.28; CI 1.13-1.45) and suicidal ideation (1.44; CI 1.19-1.74) compared to non-migrants. The mental health of 2nd generation migrants did not differ from native Germans; they had the highest socioeconomic status of the three groups. Compared to native Germans, Turkish migrants of both sexes reported more depression and panic, particularly a strongly increased suicidal ideation (OR 3.02; CI 1.80-5.04) after taking sex, age, and socioeconomic status into account. Polish migrants only reported an increased rate of suicidal ideation and Type D. Turkish migrants exceeded Polish migrants regarding depression (OR = 2.61; 95 % CI 1.21-5.67), and panic attacks (OR=3.38; 95 % CI 1.45-7.85). In the subgroup analyses years lived in Germany was not significant.ConclusionsOne of few representative community studies shows that compared to native Germans depression, anxiety and suicidal ideation were more frequently reported by 1st generation migrants, particularly of Turkish origin. Overall, 2nd generation migrants appear to have adjusted successfully. Limitations refer to a lack of data for persons without German language skills and missing mental health data in the Turkish sample. Further analyses need to address causes of mental strains and health care needs and provision.

Acculturation and other risk factors of depressive disorders in individuals with Turkish migration backgrounds

“…By comparison with a recent study of the German native population and a meta-analysis of European studies, 12-month prevalence rates of diagnosed depression were at 6% for the German population and 6.9% for the population of the European Union [52, 53]. Higher prevalence of depression among Turkish migrants of both migration generations compared to the host population and other migrant groups has been found in previous population-based studies [26–31]. This paper demonstrates that individuals of older age and individuals with low socioeconomic status in particular display high prevalence rates of depressive disorders.…”

Is assessment of depression equivalent for migrants of different cultural backgrounds? Results from the German population-based Gutenberg Health Study (GHS)

“…A more detailed discussion of this result can be found in Beutel et al. (). This finding is in line with previous studies with Turkish migrants in Germany (Igel, Brähler, & Grande, ; Morawa & Erim, ), however contradictory findings were reported by Mewes et al.…”

“…Further, Morawa and Erim () reported higher levels of depression and lower quality of life in Turkish migrants ( N = 109) compared to Polish migrants, who did not differ from the German population. As we have previously reported in another study based on the Gutenberg Health Study (GHS) data, about 24% of the participants reported a migration background (Beutel et al., ). Only first‐generation migrants (compared to second‐generation migrants) especially with Turkish origin reported increased depression and anxiety.…”

“…In line with Beutel et al (2016), for the subsequent analyses migration was also defined according to the definition of the German microcensus. All those who migrated to the area of the Federal Republic of Germany after 1949 (first-generation migrants, N = 1,325) and all non-German citizens born in Germany and all citizens born in Germany with at least one migrated parent or a parent abroad (as second-generation migrants, N = 1,864) were included.…”

“…Migrants came from Arabic Islamic countries (N = 88, 6.6%), Asia (N = 130, 9.8%), Eastern Europe (N = 102, N = 7.7%), Middle and Southern Europe (N = 315, N = 23.8%), Poland (N = 272, 20.5%), Turkey (N = 88, 6.6%) and Western Europe, USA, Canada, Israel, and Australia (N = 268; 20.2%). Further details on our samplecan be found elsewhere (cf Beutel et al, 2016)…”