Emotional distress among first-time patients attending outpatient mental health clinics in Israel: an Arab-Jewish comparative study.
BACKGROUND
Few studies have focused specifically on the role of ethnicity in emotional distress and symptoms among first-time psychiatric outpatients.


METHODS
251 first-time patients, aged 18-72 years, attending three outpatient mental health clinics in Israel, were surveyed. Three methods of case detection were used: a GHQ-12 score (equal or >3), self-reported symptoms (using a checklist) and a psychiatrist's provisional ICD-10 diagnosis. In addition, self-efficacy and perceived social support were measured using standardized self-report questionnaires. Univariate and multivariate analyses compared the two ethnic groups: Israeli Arabs and Israeli Jews.


RESULTS
Compared to Jewish patients, Israeli Arab patients had a higher "distress caseness" rate based on GHQ-12 score (70.8% versus 41.2%) and a higher rate of psychiatrist-detected ICD-10 stress-related disorders (46.7% versus 23.3%), but a lower rate of self-reported emotional distress (36% versus 54.3%) and symptoms of mood disturbances (38.7% versus 64.7%). The Israeli Arabs also had lower mean scores on measures of self-efficacy (2.0 versus 2.4) and perceived social support from friends (12.2 versus 17.6) and significant others (16.7 versus 20.0). In a parsimonious regression model, the best predictors of emotional distress had low self-efficacy and social support from significant others, and, being Arab, these variables accounted for 27.1%, 7.2% and 8.8%, respectively, of the total variance in GHQ distress scores.


CONCLUSIONS
The results suggest that the detection of emotional distress and symptoms varies markedly by patients' ethnic background. These variations can be predicted by a lower sense of self-efficacy and social support among Israeli Arabs as compared to Israeli Jews.
Mental Health Services, Ministry of Health, Jerusalem, Israel. alexander.ponizovsky@moh.health.gov.il
Alexander M
AM
Ponizovsky
Nabil
N
Geraisy
Efrat
E
Shoshan
Ilana
I
Kremer
Emma
E
Smetannikov
Alexander
A
Grinshpoon
D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology; D018912:Arabs / Q000523:psychology*; D003155:Community Mental Health Centers; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007557:Israel; D007585:Jews / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000523:psychology; D010555:Personality Inventory; D020377:Self Efficacy; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications*