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Purpose: This study explored (in)equities between ethnic groups in the Netherlands regarding their access to health care for symptoms of common mental disorders (CMD)., Methods: Data were used from a health survey conducted in four Dutch cities in 2008, including 11,678 Dutch, 700 Turkish, 571 Moroccans, 956 Surinamese and 226 Antilleans/Arubans. The prevalence of a medium to high risk of having CMD per ethnic group and of health care consumption by ethnic groups of people, likely having CMD, was calculated, using SPSS Complex Samples weighting for gender, age and district. Logistic regression models were used for assessing the association between health care utilisation and need, demographic factors, social structure and enabling resources., Results: The prevalence of a medium to high risk of having CMD was 42.9 % (Dutch), 50.3 % (Turkish), 37.3 % (Moroccans), 51.5 % (Surinamese) and 44.9 % (Antilleans/Arubans). The 1-year prevalence of contacts with the general practitioner by ethnic groups of people who were likely having CMD was 81.2 % (Dutch), 87.2 % (Turkish), 88.4 % (Moroccans), 88.6 % (Surinamese) and 76.6 % (Antilleans/Arubans). Concerning specialised mental health care, this one-year prevalence was 15.9 % (Dutch), 25.8 % (Turkish), 19.7 % (Moroccans), 17.1 % (Surinamese) and 20.5 % (Antilleans/Arubans). The elevated use of health care by some ethnic minority groups was partly associated with need and demographic factors., Conclusions: There are no indications for an inequitable access to health care for symptoms of CMD among different ethnic groups in the Netherlands.

Background: There is growing body of evidence of an association between cardiovascular risk factors and depressive and anxiety symptoms. The purpose of this study was to investigate whether these associations are similar in ethnic minority groups., Methods: A random urban population sample, aged 18+, stratified by ethnicity (484 native Dutch subjects, 383 Turkish-Dutch subjects, and 316 Moroccan-Dutch subjects), in Amsterdam, the Netherlands, was interviewed with the Kessler Psychological Distress scale (K10) in combination with measurements of several cardiovascular risk factors. The association of psychological distress (defined as a K10 score above cut-off of 20) with cardiovascular risk factors (obesity, abdominal obesity, hypertension, hypercholesterolemia, low HDL cholesterol levels or diabetes), ethnicity and their interaction was analyzed using logistic regression analyses, stratified by gender and adjusted for age., Results: Cardiovascular risk factors were not significantly associated with psychological distress in any of the gender/ethnic groups, with the exception of a positive association of obesity and hypertension with psychological distress in native Dutch women and a negative association of hypertension and psychological distress in Turkish men. Interaction terms of cardiovascular risk factors and ethnicity were approaching significance only in the association of obesity with the K10 in women., Conclusion: In this cross-sectional multi-ethnic adult population sample the majority of the investigated cardiovascular risk factors were not associated with psychological distress. The association of obesity with psychological distress varies by gender and ethnicity. Our findings indicate that the prevention of obesity and psychological distress calls for an integrated approach in native Dutch women, but not necessarily in Turkish-Dutch and Moroccan-Dutch women, in whom these problems may be targeted separately.

Objective: Depression is a clinical syndrome developed in Western Europe and North-America. The expression of symptoms and the impact of symptoms on functioning may therefore be expected to vary across cultures and languages. Our first aim was to study differences in depressive symptom profile between indigenous and non-Western immigrant populations in the Netherlands. We hypothesized that differences in expression of depressive symptoms would be more likely in the domains of mood and cognitions, and less likely in the domains of psychomotor and vegetative symptoms. Our second aim was to study ethnic differences in the association of depressive symptoms and general functioning., Method: In a random community sample stratified for ethnicity in Amsterdam, the Netherlands, depressive symptoms were assessed by bilingual interviewers using the Composite International Diagnostic Interview (CIDI 2.1) and the Symptom Checklist-90-Revised (SCL-90-R). Impairments in functioning were measured by the World Health Organization Disability Assessment Schedule II (WHODAS II). Results were obtained from 812 subjects: N = 321 native Dutch, N = 213 Turkish-Dutch, N = 191 Moroccan-Dutch, N = 87 Surinamese-Dutch. Differences in depressive symptom expression were tested by differential item functioning., Results: The prevalence of DSM-IV depressive disorder and the overall level of depressive symptoms were higher in the Turkish and Moroccan immigrant groups compared to native Dutch subjects. Ethnic differences in item functioning of depressive symptoms were rare, and equally unlikely in all four symptom domains. Depression was equally associated with functional impairment across ethnic groups., Conclusion: Although depressive symptoms were more common among migrants than in the indigenous population, both the depressive symptom profile and the associated functional impairments were comparable. These findings may help diminishing concerns about the validity of using existing diagnostic procedures among ethnic minority groups.

Background: Depressive patients may derive consolation as well as struggle from their religion. Outside the Western-Christian cultures these phenomena did not receive much empirical exploration. The current study aims to describe how positive and negative religious coping strategies relate to depressive symptoms in different ethnic groups in The Netherlands., Methods: Interview data were derived from the second phase of the Amsterdam Health Monitor, a population based survey, with stratification for ethnicity (native Dutch N=309, Moroccan 180, Turkish 202, Surinamese/Antillean 85). Religious coping was assessed using a 10-item version of Pargament's Brief RCOPE; depression assessment included the SCL-90-R and the Composite International Diagnostic Interview., Results: The five positive religious coping items constituted one sub-scale, but the five negative religious coping items had to be examined as representing separate coping strategies. Across the ethnic groups, negative religious coping strategies had several positive associations with depressive symptoms, subthreshold depression, and major depressive disorder: the most robust association was found for the item 'wondered whether God has abandoned me'. Other significant associations were found for interpreting situations as punishment by God, questioning whether God exists, and expressing anger to God., Limitations: Due to the two-phase design and low participation in this urban sample, the non-response was substantial. Therefore, the study focused on associations, not on prevalences., Conclusion: The more or less universal finding about 'feeling abandoned by God' may suggest how depression represents an existential void, irrespective of the religious background., (2010 Elsevier B.V. All rights reserved.)