G. DEPRESSION AND MEDICAL HEALTH COMPLAINTS IN A GROUP
OF ARAB-AMERICAN WOMEN
Sharifa Aboumediene, MD; Mohamed Farrag, PhD, LP;
Mona Dakroub, AS
INTRODUCTION The national background information
for 10% of the subjects was unknown.
Published research on the mental Approximately 16% of the sample in-
health of Arab Americans is rare. Pre- cluded small numbers from other Arab
vious research shows that depression was countries (eg, Palestine, Egypt, Sudan,
the most common problem among and Algeria).
Arab-American mental health clients,1 a
ﬁnding that is consistent with published Measures
epidemiological research. Depression The study used the following mea-
has become the leading cause of dis- sures:
ability in the United States and Europe. —The HSCL-25 Depression Scale (Ar-
It increases the risks of heart attacks and abic version) that has 15 items5 proved
is a frequent serious complicating factor to be very helpful in assessing depression
in stroke, diabetes, and cancer.2 A re- among Arab Americans. This scale was
cently published review of research on found to be a sensitive case-ﬁnder of any
the relationship between depression and depressive disorder in elderly people; re-
risk for coronary artery disease conclud- search has indicated the validity of the
ed that there is substantial evidence for scale.6 The Cronbach Alpha reliability
a relationship between depression and of the depression scale was .92.
adverse clinical outcomes. 3 Another —A self-report checklist of health prob-
study found that self-reports of depres- lems.
sive symptoms were greater among in-
dividuals who also reported digestive
system disorders, respiratory problems, RESULTS
and heart problems.4 The current study
explored the relationships between de- Table 1 shows that there were sig-
pressive manifestations and physical or niﬁcant differences on the depression
medical complaints in a group of Arab- scale between women who have diag-
American women. nosed medical problems and women
who do not have medical problems.
These problems included heart disease,
METHODS fatigue, headaches, weight gain, and ap-
pitite and sleep irregularities.
The study included 100 Arab-Amer-
ican women who came to ACCESS for DISCUSSION
different services. They consented to
participate in the study after receiving The results of this study showed sig-
an explanation that non-participation niﬁcant differences between women
would not have any negative conse- with or without physical complaints.
quences. Participants’ ages ranged from These ﬁndings are consistent with re-
18 to 70 years, with a mean of 34.94 search on the role of depression in the
From the Arab Community Center for and a standard deviation of 11.86. In incidence, and negative effects on med-
Economic and Social Services, Dearborn, the sample, 46% were from Lebanon, ical problems. Recent research found
Michigan. 14% from Iraq, and 14% from Yemen. depressed individuals appear to have in-
S1-106 Ethnicity & Disease, Volume 15, Winter 2005
MENTAL HEALTH - Aboumediene et al
pic medications, cognitive behavior
Means, standard deviations, and t test of differences on the depression scale
Problem No Problem
Mean SD Mean SD t Test Signiﬁcance REFERENCES
1. Farrag M. Needs and problems of Arab-Amer-
Heart disease 23.17 13.48 15.60 12.24 2.33 .02 ican mental health clients. Paper presented at:
(N 18) (N 82) First Biennial National Conference on the
Fatigue 21.75 11.54 11.55 11.93 4.34 .00 Health of Arab Americans; 1999.
(N 53) (N 47) 2. National Institute of Mental Health (NIMH).
Headaches 18.64 12.39 13.23 12.91 1.99 .05 The number count. 1999. NIH Publication
(N 69) (N 31) No. NIH 99–4584. Available at: http://
Appetite problems 20.97 12.67 14.39 12.20 2.592 .01 www.NIMH.NIH.gov/publicat/number. Feb-
(N 39) (N 61) ruary 9, 2004.
Weight gain 23.40 11.69 15.35 12.54 2.60 .01 3. Lett HS, Blumenthal JA, Babyak MA, et al.
(N 20) (N 80) Depression as a risk factor for coronary artery
Sleep problems 22.04 12.21 10.23 10.12 5.14 .00 disease: evidence, mechanisms, and treatment.
(N 57) (N 43) Psychosom Med. 2004;66(3):305–315.
4. Unutzer J, Katon W, Williams JW, et al. Im-
proving primary care for depression in late life:
the design of a multicenter randomized trial.
creased cortisol levels in response to sive care that takes into consideration Med Care. 2001:29(8):785–799.
stress, a ﬁnding that may explain the the important role of psychological fac- 5. Mollica RF, Wyshak G, deMameffe D, Khuon
link between depression and osteopo- tors. With this in mind, the restructur- F, Lavelle J. Indochinese versions of the Hop-
kins Symptom Checklist-25. A screening in-
rosis.7 Depression also may worsen the ing of primary care and family medical strument for psychiatric care of refugees. Am J
outcome of treatment for cardiovascular care is warranted. The authors recom- Psychiatry. 1987;144:497–500.
patients. Depression was such an im- mend that, at the very least, every per- 6. Netterbladt P, Hansson L, Borgoquist L. Test
portant risk factor in one study that the son served in primary care and every characteristics of the HSCL-25 in Sweden, us-
ing the Present State Examination (PSE-9) as
ability of elevated C-reactive protein person with severe medical problems a caseness criterion. Soc Psychiatry Psychiatr Ep-
(CRP) to predict cardiovascular events will beneﬁt from a brief psychological idemiol. 1993;28(3):130–133.
lost its statistical signiﬁcance when the screening to assess problems of anxiety 7. Wachter K. Cortisol may mediate effect of de-
analysis was restricted to men without and depression. Once a problem is iden- pression on osteoporosis. Clin Psychiatry News.
signs of depression.8 tiﬁed, an appropriate referral for treat- 8. Tucker M. Depression trumps high CRP level
The ﬁndings of the current study ment should be recommended and in cardiac risk. Clin Psychiatry News. 2004;
call for more integrated and comprehen- would likely include, besides psychotro- 32(4):91.
Ethnicity & Disease, Volume 15, Winter 2005 S1-107