REPORTS : MENTAL HEALTH FACTORS ASSOCIATED WITH SELF-REPORTED DEPRESSION IN ARAB , CHALDEAN , AND AFRICAN AMERICANS

Somatic or psychological symptoms of depression and the ability of health professionals to detect it in ethnic minorities vary worldwide. Histories of trauma and stress exposure have been linked to depression in both African Americans and Arab Americans and may account for some of the variance in depression that is typically observed within and across primary care settings in urban communities. The Arab American population is growing because of war and political unrest in the Middle East. At least 3.5 million Arabic-speaking people, including Chaldeans, reside in the United States, and 490,000 Arab Americans live in Michigan alone. As the Arab American population grows, we need to better comprehend the epidemiology of common medical conditions affecting immigrants, such as depression, so that culturally appropriate interventions can be designed and implemented. In the Arab world, depression has been historically stigmatized. Persons suffering from depression relied on those in their immediate social network for help. Only after the failure of these efforts would the family seek outside professional assistance. However, resistance may persist even today because of the associated stigma of potentially heritable mental illness. Recent reports of depression in clinical samples of Arab Americans have varied from 22.4% to 49%. Research on non-Arab refugees worldwide has shown that non-Arab refugees often suffer from more symptoms of depression, anxiety, and posttraumatic stress disorder and have more health problems than do those who immigrate for educational, economic, and family reunification reasons. As refugees from the Arab world assimilate to the United States, whether their health patterns and risk factors, including those associated with depression, eventually mirror those of non-African Americans should be ascertained. For example, the most common factors associated with depression are chronic illness, type 2 diabetes, heart failure, age, sex, and race. Patients with poorly controlled hypertension are more than six times as likely to suffer depression than are nonhypertensive patients. Similarly, African Americans with depression and obesity are significantly more likely to have such chronic diseases as hypertension and diabetes than their non-Hispanic European American counterparts. The objectives of this study were to determine the overall and ethnicityspecific prevalence of self-reported depression (SR-depression) in an urban sample of African Americans, Arab Americans, and Chaldeans and to evaluate associations between potential risk factors and the presence of SRdepression. Address correspondence and reprint requests to: Hikmet Jamil, MD, PhD; Wayne State University; 3800 Woodward Ave, Ste 808; Detroit, MI 48201; 313-5772048; hjamil@med.wayne. edu From the Department of Family Medicine and Public Health Sciences, Division of Occupation and Environmental Health (HJ), Department of Emergency Medicine (MG), Wayne State University School of Medicine, Detroit; Arab American and Chaldean Council, Southfield (HJ, MF, RK, HF); MPRO, Farmington Hills (JS), Michigan; University of Windsor, Department of Psychology, Windsor, Canada (JHL).