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Amsterdam-Zuidoost, Netherlands

Schrier A.C.,Altrecht Institute for Mental Health Care | De Wit M.A.S.,Documentation and Health Promotion | Rijmen F.,VU University Amsterdam | Tuinebreijer W.C.,Amsterdam Municipal Health Service | And 5 more authors.
Social Psychiatry and Psychiatric Epidemiology | Year: 2010

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. © 2009 Springer-Verlag.

Xiridou M.,National Institute of Public Health and the Environment | Van Veen M.,National Institute of Public Health and the Environment | Prins M.,Amsterdam Municipal Health Service | Prins M.,University of Amsterdam | And 2 more authors.
Sexually Transmitted Infections | Year: 2011

Objectives: Migrants originating from countries with a high HIV prevalence account for a large number of heterosexually acquired HIV infections in western European countries. These migrants may be infected before migrating and they may engage in unsafe sexual practices both in the country of residence and in their country of origin. This report investigates how patterns of migration may affect the heterosexual HIV epidemic in The Netherlands. Methods: A mathematical model was used that describes the transmission of HIV in heterosexual partnerships between African migrants, Caribbean migrants and the local Dutch population. Infection of migrants before migrating to The Netherlands and during trips to their country of origin was also accounted for. Results: The incidence of HIV infection among adult heterosexuals in 2010 was 1.50 new infections per 100 000 individuals per year. If the number of migrants entering the country increases, then the incidence of HIV will increase, although this change among Dutch individuals will be negligible. Moreover, if HIV prevalence among those migrating to The Netherlands (at the time of entry to the country) is higher, then incidence in the respective ethnic group will increase; among other ethnic groups, the increase will be very small. Conclusions: Heterosexual transmission of HIV in The Netherlands occurs mostly within migrant communities. Limiting migration and introducing travel restrictions would probably have no effect on HIV incidence in countries with low HIV prevalence among heterosexuals. Policy making should focus on targeted interventions, to reduce the burden of disease in migrant communities in Europe.

Xiridou M.,National Institute of Public Health and the Environment | Van Houdt R.,Amsterdam Municipal Health Service | Hahne S.,National Institute of Public Health and the Environment | Coutinho R.,National Institute of Public Health and the Environment | And 4 more authors.
Sexually Transmitted Infections | Year: 2013

Objectives The selective vaccination programme against hepatitis B virus (HBV) was introduced in the Netherlands in 2002 targeting high-risk groups, including men who have sex with men (MSM). Despite the high average age of vaccination in MSM, the number of notifications of acute HBV recently declined. We investigate whether this can be attributed to the selective vaccination programme. We examine how vaccination strategies could be improved and the impact of universal infant vaccination introduced in 2011. Methods We use a mathematical model for HBV transmission among MSM. The incidence of HBV was calculated from the model and from notification data of acute HBV. Results A decline was observed in the incidence of HBV since 2006, as calculated from the model; this decline was smaller than that observed in data if all MSM were equally likely to be vaccinated. Assuming that high-risk MSM were more likely to be vaccinated than low-risk MSM resulted in a steeper decline in modelled incidence and better agreement with observed incidence. Vaccinating MSM at a younger age or doubling the vaccination rate would increase the impact of selective vaccination, but is less effective than vaccinating high-risk MSM. Conclusions Selective HBV vaccination of MSM in the Netherlands has had a substantial impact in reducing HBV incidence. The reduction suggests that vaccination rates among high-risk MSM were higher than those among low-risk MSM. Countries that have not yet reached 35-year cohorts with universal childhood vaccination should actively implement or continue selective high-risk MSM vaccination.

Fassaert T.,Amsterdam Municipal Health Service | Peen J.,Arkin Inc | Van Straten A.,Altrecht Institute of Mental Health Care | De Wit M.,Amsterdam Municipal Health Service | And 7 more authors.
Psychiatric Services | Year: 2010

Objective: There are widespread concerns about disparities in mental health treatment for ethnic minority groups. However, previous research in this area has been limited mainly to the United States and Great Britain, raising doubts about the external validity with respect to other European countries. This study addressed ethnic differences in characteristics of outpatient treatment for depression in the Netherlands. Methods: Longitudinal data (2001-2005) were extracted from a nationwide psychiatric case register. The sample consisted of 17,270 episodes of outpatient depression care. Information was available about timeliness of the initial treatment contact, treatment intensity, dropout, and early reregistration for mental health care. Data were analyzed with linear, logistic, and Cox regression analyses. Results: When analyses were controlled for illness and demographic characteristics, timeliness and treatment intensity were somewhat less favorable for Moroccan, Turkish, and other non-Western clients compared with ethnic Dutch. No significant differences were found between minority and ethnic Dutch groups in dropout and early reregistration. Some treatment characteristics were in fact more favorable for Surinamese and Antillean clients compared with ethnic Dutch. Conclusions: The data provided insufficient support for the idea that treatment characteristics are generally less favorable for clients from ethnic minority groups. This finding may be related to the promotion of culturally sensitive approaches to care in mainstream mental health services but may also indicate that the role of traditional barriers, like stigma and taboo, is smaller than is usually suggested. However, the influence of language proficiency, which is notably better among Surinamese and Dutch Antillean compared with Turkish and Moroccan clients, should not be disregarded.

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