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The influence of stigma on depression, overall psychological distress, and somatization among female Turkish migrants

Published online by Cambridge University Press:  15 April 2020

A. Heredia Montesinos ,
M.A. Rapp ,
S. Temur-Erman ,
A. Heinz ,
U. Hegerl  and
M. Schouler-Ocak
A. Heredia Montesinos*
Affiliation:
Department of Psychiatry and Psychotherapy at St Hedwig Hospital, Charité - University Medicine Berlin, Germany. Grosse Hamburger Straße 5–11, 10115Berlin, Germany
M.A. Rapp
Affiliation:
Department of Psychiatry and Psychotherapy at St Hedwig Hospital, Charité - University Medicine Berlin, Germany. Grosse Hamburger Straße 5–11, 10115Berlin, Germany
S. Temur-Erman
Affiliation:
Department of Psychiatry and Psychotherapy at St Hedwig Hospital, Charité - University Medicine Berlin, Germany. Grosse Hamburger Straße 5–11, 10115Berlin, Germany
A. Heinz
Affiliation:
Department of Psychiatry and Psychotherapy, Charité – Berlin, Germany
U. Hegerl
Affiliation:
Ulrich Hegerl, M.D., Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
M. Schouler-Ocak
Affiliation:
Department of Psychiatry and Psychotherapy at St Hedwig Hospital, Charité - University Medicine Berlin, Germany. Grosse Hamburger Straße 5–11, 10115Berlin, Germany
*
*Corresponding Author. E-mail address:amanda.heredia-montesinos@charite.de (A. Heredia Montesinos)
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Abstract

Background

Even though some studies suggest that in Mediterranean and non-western cultures more somatic and less psychological symptoms are reported, this so-called ‘somatization’ hypothesis has been challenged. Reviews show that somatic symptoms are a core component of depressive episodes regardless of cultural background. The expression of symptoms might be related to the psychosocial, social and cultural context surrounding the patient rather than ‘ethnicity’ or related constructs. Also, stigma associated with mental disorders can affect patients'symptom presentation.

Methods

The interrelationships of perceived stigmatization (Explanatory Model Interview Catalogue - Stigma Scale), depression (Beck Depression Index II), overall psychological distress (Symptom Checklist-90-R), and somatic symptoms (The screening for SOMATOFORM SYMPTOMS II) was assessed in a sample of female patients with Turkish descent with a diagnosis of depression (N = 63).

Results

Depression, overall psychological distress, and somatic symptoms were positively and significantly related. Stigma was positively related to depression and overall psychological distress. There was no significant relationship between stigma and somatic symptoms, neither among the severely depressed group (N = 39), nor among the less depressed group (N = 24).

Conclusion

The positive relationships between stigma, depression, and overall psychological distress indicate that patients who are more depressed and who have higher levels of overall psychological distress experience their condition as more stigmatizing. Since somatic symptoms and stigma were not related (neither positively, nor negatively), it appears that depressive symptoms and other symptoms of psychological distress affect concerns about stigmatizing attitudes in a way that somatic symptoms do not. This result challenges common assumption of the ‘somatization’hypothesis, i.e. that depression is ‘somatized’because of concern about stigmatizing attitudes.

Keywords

StigmatizationDepressionSomatic symptomsTurkish migrants
Type
Research Article
Information
European Psychiatry , Volume 27 , Issue S2: Migration and Mental Health , June 2012 , pp. S22 - S26
Copyright
Copyright © 2012 Elsevier Masson SAS

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