Impact of Migration on Explanatory Models of Illness and Addiction Severity in Patients With Drug Dependence in a Paris Suburb

Abstract

Objectives of this study were to assess explanatory models (considering illness experience and meaning), addiction severity among patients with drug dependence, and the role of migration. Adapted Explanatory Model Interview Catalogue interviews were conducted with 70 outpatients in a Paris suburb. Among them, 42 were either first- or second-generation immigrants, most from North Africa. Explanatory models were analyzed qualitatively and quantitatively according to migration status, assessing potential confounders with multivariate linear models. Explanatory models were heterogeneous. Compared with nonmigrants, migrants reported fewer somatic and violence-related symptoms. They attributed the causes of their addiction more frequently to social and magico-religious factors and less to psychological factors. Conversely, no difference in addiction severity was found between migrants and nonmigrants. Considering local patterns of illness experience and meaning of drug dependence is a critical component of culturally sensitive clinical care.

Causal beliefs about mental illness: A scoping review

“…Studies have documented causal beliefs regarding mental distress among a variety of populations worldwide, including residents of Zimbabwe (Patel & Mann, 1997), India (Nadkarni et al, 2013), and south Boston (Scheper-Hughes, 1987). Research has also described explanatory models among migrants, whose cultural models for understanding distress may differ from local professional models; studies have examined such populations as South Asians living in the UK (Bhikha et al, 2015;Jacob et al, 1998), Russian and Turkish migrants in Germany (Penka et al, 2008), and North African migrants in Paris (Taïeb et al, 2012). Research has documented explanatory models for a wide range of mental illnesses and forms of mental distress, including depression (Okello & Neema, 2007), psychosis (Joel et al, 2003), and addiction (Taïeb et al, 2012).…”

Vigilancia y análisis de zonas de frontera, puertos de entrada y de población inmigrante1

“…Esto se logró con la aplicación de una lista de chequeo con 17 ítems y se realizó un análisis estadístico para explicar la asociación (45). Otro campo revisado fue la evaluación de los modelos explicativos a partir de datos de entrevistas, considerando la experiencia de la enfermedad y el significado, la severidad de la adicción entre pacientes drogodependientes, entre no migrantes y las generaciones de migrantes de los suburbios de Paris (46).…”

A qualitative study about explanatory models of alcohol use disorder among patients and relatives in a Ugandan mental hospital

“…Concepts that are accepted and clearly associated with addictive behaviour by immigrant populations must be used [19]. In a Paris suburb, immigrants, mostly from North Africa, attributed the causes of their addiction more frequently to social and magico-religious factors and less to psychological factors than nonmigrants [20]. Qualitative studies on the expectations and meanings of the use of alcohol would help us understand better the reasons why people drink and why they drink in a particular way.…”