title: Mental health in Ecuadorian migrants from a population-based survey: the importance of social determinants and gender roles.
abstract: OBJECTIVE
  To describe the prevalence of and the risk factors for poor mental health in female and male Ecuadorian migrants in Spain compared to Spaniards.
  
  
  METHODS
  Population-based survey. Probabilistic sample was obtained from the council registries. Subjects were interviewed through home visits from September 2006 to January 2007. Possible psychiatric case (PPC) was measured as score of ≥5 on the General Health Questionnaire-28 and analyzed with logistic regression.
  
  
  RESULTS
  Of 1,122 subjects (50% Ecuadorians, and 50% women), PPC prevalence was higher in Ecuadorian (34%, 95% CI 29-40%) and Spanish women (24%, 95% CI 19-29%) compared to Ecuadorian (14%, 95% CI 10-18%) and Spanish men (12%, 95% CI 8-16%). Shared risk factors for PPC between Spanish and Ecuadorian women were: having children (OR 3.1, 95% CI 1.4-6.9), work dissatisfaction (OR 4.1, 95% CI 1.6-10.5), low salaries (OR 2.5, 95% CI 1.1-5.9), no economic support (OR 1.8, 95% CI 0.9-3.4), and no friends (OR 2.2, 95% CI 1.1-4.2). There was an effect modification between the nationality and educational level, having a confidant, and atmosphere at work. Higher education was inversely associated with PPC in Spanish women, but having university studies doubled the odds of being a PPC in Ecuadorians. Shared risk factors for PPC in Ecuadorian and Spanish men were: bad atmosphere at work (OR 2.4, 95% CI 1.3-4.4), no economic support (OR 3.5, 95% CI 1.3-9.5), no friends (OR 2.5, 95% CI 0.9-6.6), and low social support (OR 1.6, 95% CI 0.9-2.9), with effect modification between nationality and partner's emotional support.
  
  
  CONCLUSIONS
  Mental health in Spanish and Ecuadorian women living in Spain is poorer than men. Ecuadorian women are the most disadvantaged group in terms of prevalence of and risk factors for PPC.
authors.affiliation: National Center of Epidemiology, Instituto de Salud Carlos III, Sinesio Delgado 6, 28029, Madrid, Spain. jdamo@isciii.es
authors.forename: Julia
authors.initials: J
authors.lastname: Del Amo
authors.forename: Inma
authors.initials: I
authors.lastname: Jarrín
authors.forename: Ana
authors.initials: A
authors.lastname: García-Fulgueiras
authors.forename: Vicente
authors.initials: V
authors.lastname: Ibáñez-Rojo
authors.forename: Débora
authors.initials: D
authors.lastname: Alvarez
authors.forename: Maria Angeles
authors.initials: MA
authors.lastname: Rodríguez-Arenas
authors.forename: Rocío
authors.initials: R
authors.lastname: García-Pina
authors.forename: Alberto
authors.initials: A
authors.lastname: Fernández-Liria
authors.forename: Visitación
authors.initials: V
authors.lastname: García-Ortúzar
authors.forename: Domingo
authors.initials: D
authors.lastname: Díaz
authors.forename: Lucía
authors.initials: L
authors.lastname: Mazarrasa
authors.forename: Maria Victoria
authors.initials: MV
authors.lastname: Zunzunegui
authors.forename: Alicia
authors.initials: A
authors.lastname: Llácer
mesh_terms: D000328:Adult; D004484:Ecuador / Q000208:ethnology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000208:ethnology; D008603:Mental Health / Q000208:ethnology*; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D012931:Social Environment; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014171:Transients and Migrants / Q000523:psychology*; D055815:Young Adult