Prevalence of Major Depression Among Immigrants in Santiago, Chile

Study Overview
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Brief Summary
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The general aim of this study is to explore the prevalence of major depressive disorder and the use of mental health services in the immigrant populations in the Metropolitan Region of Santiago, Chile. The hypotheses are: A healthy immigrant effect will be observed in the studied population by which their prevalence of major depressive disorder will be lower than the prevalence in the general Chilean population. A significant association will be observed between the loss of socio-economic position after migration and a greater probability of major depressive disorder. A significant association will be observed between the report of victimization experience(s) in the previous year and a greater probability of major depressive disorder. A significant association will be observed between financial difficulties and a greater probability of major depressive disorder. The sampling framework of the Chilean National Institute of Statistics (INE) from the 2016 Census will be used for the purpose of this research. The sampling units are as follows: Primary sampling units (PSUs): conglomerates or groups of adjoining houses, organized in spatial blocks (200 households on average) Secondary sampling units (SSUs): individual households within each of the conglomerates selected in the first stage Final sampling units: persons meeting the study's inclusion criteria Multi-stage random probability sampling involving a 3-stage sampling design will be used - first, the sampling of the primary sampling units (PSUs); second, the sampling of households within the selected PSUs and finally, the random sampling of a household member. Participants (n=1,100) will then take part in a 45-minute interview. This interview will be a household survey using the modular version of the Composite International Diagnostic Interview (WHO-CIDI) looking at exploring a broad spectrum of factors traditionally associated with increased risk of affective disorders: Sociodemographics Finance Variation in socioeconomic position Experience of victimization Discrimination Experience of childhood adversity

Official Title
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The Santiago Immigrant Wellbeing Study (STRING): Prevalence of Mood Disorders Among Immigrants in Santiago, Chile

Conditions
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Major Depressive Disorder

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Country of birth other than Chile Time since arrival to Chile: 3 months Exclusion Criteria: Unable to understand Spanish

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Major Depressive Disorder | Assessed using the World Health Organisation Composite International Diagnostic Interview (WHO-CIDI) | baseline | 
| Any affective/mood disorder | Assessed using the WHO-CIDI | baseline | 
| Suicidal ideation, plans and attempts | Assessed using the WHO-CIDI | baseline | 
| Depressive symptoms | Assessed using the nine-item Patient Health Questionnaire (PHQ-9). The PHQ-9 score can range from 0 to 27, with the following severity scores: 0-4 None; 5-9 Mild; 10-14 Moderate; 15-19 Moderate to Severe; 20-27 Severe. | baseline | 
| Anxiety symptoms | Assessed using the Generalized Anxiety Disorder 7-item scale (GAD-7). The GAD-7 score can range from 0 to 21, with the following severity scores: 0-4 None; 5-9 Mild; 10-14 Moderate; 15-21 Severe. | baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mental wellbeing | Assessed using the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS). The 14 Items are scored on a range from 1 to 5, providing a total score between 14 and 70 with higher values indicating higher mental well-being. | baseline | 
| Mental health service use | Assessed using items of the Services Module of the WHO-CIDI | baseline | 
| Hazardous/harmful drinking | Assessed using the Alcohol Use Disorders Identification Test (AUDIT) | baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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prevalence, mood disorders, affective disorders, major depressive disorder, service use, migration health, global mental health