Mental Health Determinants Among a Psychiatric Outpatient Sample of Vietnamese Migrants in Germany

Wolf, S.; Hahn, Eric; Wingenfeld, Katja; Nguyen, Main Huong; Poser, Anita von; Nguyen, Thi Hoa; Hanewald, Bernd; Böge, Kerem; Bajbouj, Malek; Dettling, Michael; Nguyen, Van Tuan; Ta, Thi Minh Tam

doi:10.3389/fpsyt.2020.580103

Cited by 3 publications

(5 citation statements)

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“…In studies from different countries all over the world it is shown that discrimination can lead to poorer mental health in immigrants [ 21 , 26 , 33 – 37 ]. In line with findings on the role of lower socioeconomic status on mental health of non-migrants, this factor also seems to negatively influence the mental health of immigrants [ 34 ].…”

Section: Introductionsupporting

confidence: 85%

Predictors for successful psychotherapy: Does migration status matter?

2021

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Background We investigated, if migration status, and additional sociodemographic and clinical factors, are associated with somatization and depressiveness at admission and with remission after inpatient psychotherapy. Methods Multiple linear and binary logistic regression analyses were used to identify predictors for severity of somatoform and depressive symptoms at admission of inpatient psychotherapy (T0), and for remission after inpatient psychotherapy (T1). We tested the association between symptoms concerning somatization (PHQ-15: Patient-Health-Questionnaire Somatization Module) and depression (PHQ-9: Patient-Health-Questionnaire Depression Module) and several sociodemographic and clinical factors in 263 patients at admission. For remission after treatment, we additionally included severity of symptoms at admission, number of diagnoses and duration of treatment in the regression models. Remission after treatment was defined as response plus a post value of less than 10 points in the respective questionnaire. Clinical relevance was interpreted using effect sizes (regression coefficients, Odds Ratio (OR)) and Confidence Intervals (CI). Findings Significant and clinically relevant predictors for high symptom severity at T0 were lower education (β = -0.13, p = 0.04), pretreatment(s) (β = 0.205, p = 0.002) and migration status (β = 0.139, p = 0.023) for somatization, and potential clinically relevant predictors (|β|>0.1) for depression were living alone (β = -0.116, p = 0.083), pretreatment(s) (β = 0.118, p = 0.071) and migration status (β = 0.113, p = 0.069). At T1 patients with pretreatment(s) (OR = 0.284 [95% CI: 0.144, 0.560], p<0.001) and multiple diagnoses (OR = 0.678 [95% CI: 0.472, 0.973], p = 0.035) were significantly and clinically relevant less likely to show a remission of depressive symptoms. In addition, a potentially clinically meaningful effect of migration status on remission of depressive symptoms (OR = 0.562 [95% CI: 0.264, 1.198], p = 0.136) cannot be ruled out. For somatoform symptoms pretreatment(s) (OR = 0.403, [95% CI: 0.156, 1.041], p = 0.061) and education (OR = 1.603, [95% CI: 0.670, 3.839], p = 0.289) may be regarded as clinically relevant predictors for remission. Conclusion The results of our study suggest that migration status has a clinically relevant influence on severity of somatoform and depressive symptoms at admission. Clinical relevance of migration status can also be assumed regarding the remission of depression. Migration status and further factors affecting the effectiveness of the treatment should be analyzed in future research among larger samples with sufficient power to replicate these findings.

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Section: Introductionsupporting

confidence: 85%

Predictors for successful psychotherapy: Does migration status matter?

2021

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“…Previous studies noted poor mental health of unemployed migrants living in Western countries. This includes Turkish migrants in the Netherlands ( Bengi-Arslan et al, 2002 ), Southeast Asians in Canada ( Beiser and Hou, 2001 ; Beiser and Hou, 2006 ), Somali refugees in London ( Warfa et al, 2012 ), South Asians in Canada ( Dean and Wilson, 2009 ), Vietnamese migrants in Germany ( Wolf et al, 2020 ), Asian Americans ( John et al, 2012 ), Kurdish migrants in Finland ( Rask et al, 2016 ), African refugees in the United States ( Abdelkerim and Grace, 2012 ) and Indian and Chinese migrants in New Zealand ( Pernice et al, 2009 ). Previous evidence has highlighted how unemployment affects the mental health of immigrant men, especially those from ethnic minorities, and has revealed that these effects differ from those observed in host populations.…”

Section: Discussionmentioning

confidence: 99%

“…Depression is one of the most common symptoms experienced by unemployed Asian men ( Beiser et al, 1993 ; Bengi-Arslan et al, 2002 ; Disney, 2021 ; John et al, 2012 ; Warfa et al, 2012 ; Wolf et al, 2020 ). In some Western countries, unemployed migrant men from ethnic minority countries are more likely to report generalised anxiety disorder (GAD) ( Disney, 2021 ), hopelessness, social dysfunction, somatic symptoms ( Bengi-Arslan et al, 2002 ), PTSD ( Disney, 2021 ) in response to lengthy job searches and inability to find employment in their relevant skill set ( Axelsson, 2017 ; Dean and Wilson, 2009 ).…”

Section: Discussionmentioning

confidence: 99%

Employment-related mental health outcomes among Australian migrants: A 19-year longitudinal study

Maheen,

King

2023

Aust N Z J Psychiatry

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Background: Migrants experience various stressors at different stages of migration based on their country of origin, ethnic backgrounds, migration context and host country. Employment is one important post-settlement factor associated with mental health among migrant groups. The study investigates whether the country of origin modifies the association between employment and mental health for Australian migrants. Methods: Nineteen waves of data from the Household Income and Labour Dynamics in Australia Survey were used. Using fixed-effects regression, we examined the effects of within-person changes in employment status on mental health outcomes as measured by the Mental Health Inventory (MHI-5), controlling for time-varying confounders and stratified by sex and examined effect modification by country of origin. Results: The relationship between unemployment and mental health was modified by country of origin for men but not women. Unemployed men from Asian (β = −4.85, p < 0.001), African and Middle Eastern (β = −3.61, p < 0.05) countries had lower mental health scores compared to employed Australian-born men. For men, there was evidence of effect modification of the association between employment and mental health by country of origin, with the combined effect of being unemployed and being a migrant from an Asian country was almost three points lower than the summed independent risks of these factors (β = −2.72; p = 0.01). Also, for men, the combined mental health effect of not being in the labour force and coming from a non-English-speaking European country was greater than the summed effects of these factors (β = −2.33; p < 0.001). Conclusion: Tailored employment-support programmes may be beneficial for migrants from ethnic minorities, particularly those from Asian, African and Middle Eastern countries in Australia. Further research is needed to understand why the mental health of migrant men from these countries is particularly vulnerable to unemployment.

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“…It is important to recognize that implementing a clinical utilization and non-utilization recruitment strategy introduced heterogeneity in the sample, particularly in terms of variations in depressive symptoms, among the two recruitment pathways. The decision to include clinical utilization as well as non-utilization participants was made to obtain a more naturalistic sample, considering previous research that postulated an under or delayed utilization of professional healthcare services among Vietnamese migrants in Germany ( Ta et al, 2014 ; Wolf et al, 2020 ). Nevertheless, the possibility of biases because of the two-pathway recruitment strategy cannot be entirely ruled out.…”

Section: Discussionmentioning

confidence: 99%

“…Vietnamese represent Germany’s largest Southeast Asian migrant population, with a population of 185,000 ( Destatis, 2020 ). Despite the relatively large number of Vietnamese migrants in Germany, research on this minority group remains scarce ( Kim et al, 2012 ; Nguyen et al, 2021 ; Ta et al, 2014 ; Wolf et al, 2020 ). Depression was found to be the most common diagnosis among Vietnamese migrants in Germany ( Ta et al, 2014 ), with higher ( Merbach et al, 2008 ) to similar ( Hahn et al, 2016 ) levels of depressive symptoms among first-generation Vietnamese migrants compared to the native population born in Germany.…”

Section: Vietnamese Migrants In Germanymentioning

confidence: 99%

Cultural immersion, acculturation strategies, and depressive symptoms among first-generation Vietnamese migrants in Germany

Tuturea,

Hahn,

Mavituna

et al. 2023

Int J Soc Psychiatry

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Background: Worldwide migration represents a major challenge of the 21st century. Despite the strong association between acculturation and mental health, research findings on underlining mechanisms remain inconsistent. Prior research urges to investigate sample characteristics in a more structured manner. Aims: The purpose of this study was to systematically investigate factors impacting acculturation and depressive symptoms in a large, not exclusively clinical, sample of Vietnamese migrants in Germany. Method: This study investigated, with multiple regressions, factors (age at arrival, gender, education, religiousness, language skills, residence status, economic status, occupational status, migration motivation, duration of stay, and depressive symptoms) impacting the two dimensions of acculturation, dominant society immersion (DSI) and ethnic society immersion (ESI), in a not exclusively clinical sample ( n = 582) of first-generation Vietnamese migrants in Germany. Further, this study examined the relationship between depressive symptoms, DSI and ESI with correlations and acculturation strategies with an ANOVA. Results: Integration (72.5%) was the most common acculturation strategy, followed by separation (26.8%). In contrast, assimilation (0.5%) and marginalization (0.2%) were very rare acculturation strategies. As predictive factors for DSI lower depressive symptoms scores, male gender, higher education, and better German language skills were found significant. For ESI, less German language skills and older age at arrival were found to be significant. Higher ESI and DSI were correlated to lower depressive symptom scores. Compared to the three other acculturation strategies, integration was linked to the lowest depressive symptoms scores. Conclusions: The current study identified crucial factors in the acculturation process, such as depressive symptoms, language skills, education, gender, and age at arrival. Our findings emphasize that immersion into both the dominant and the ethnic culture plays an essential supportive role in the mental health of migrants.

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Mental Health Determinants Among a Psychiatric Outpatient Sample of Vietnamese Migrants in Germany

Cited by 3 publications

References 58 publications

Predictors for successful psychotherapy: Does migration status matter?

Predictors for successful psychotherapy: Does migration status matter?

Employment-related mental health outcomes among Australian migrants: A 19-year longitudinal study

Cultural immersion, acculturation strategies, and depressive symptoms among first-generation Vietnamese migrants in Germany

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