title: A prospective study of social difficulties, acculturation and persistent depression in Pakistani women living in the UK.
abstract: BACKGROUND
  The reasons for the high prevalence of depressive disorders in women of Pakistani origin living in the UK are not clear. The aim of this study was to determine the relative importance of life events, chronic social difficulties and acculturation in a population-based sample of British Pakistani women.
  
  
  METHODS
  A cross-sectional and prospective cohort study of 18- to 65-year-old Pakistani women in UK was carried out. The Schedule for Clinical Assessment in Neuropsychiatry for diagnosis, the Life Events and Difficulties Schedule for social stress and an acculturation questionnaire were used.
  
  
  RESULTS
  Depressive disorder at baseline was associated with older age, social isolation and marked difficulties involving health and close relationships. Depressive disorder at follow-up was associated with severity of depression at baseline, difficulties in close relationships and two aspects of acculturation, especially less acculturation in relation to use of the English language.
  
  
  CONCLUSIONS
  Lack of acculturation, especially less familiarity with the English language, is an independent predictor of persistence of depression in Pakistani women in UK. This needs to be taken into consideration when planning treatment, which also needs to address the personal difficulties associated with persistent depression. The implication of this work is that women of Pakistani origin with depression should be encouraged to receive help in the use of English as one part of treatment that may prevent relapse.
authors: University of Manchester, Manchester, UK. nasim.chaudhry@manchester.ac.uk
authors: N
authors: N
authors: Chaudhry
authors: N
authors: N
authors: Husain
authors: B
authors: B
authors: Tomenson
authors: F
authors: F
authors: Creed
mesh_terms: D000069:Acculturation; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002908:Chronic Disease; D003866:Depressive Disorder / Q000208:ethnology* / Q000523:psychology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007802:Language; D008016:Life Change Events; D008875:Middle Aged; D010154:Pakistan / Q000208:ethnology; D012917:Social Adjustment; D012923:Social Class; D012934:Social Isolation / Q000523:psychology; D013315:Stress, Psychological / Q000208:ethnology*; D006113:United Kingdom / Q000453:epidemiology; D014930:Women / Q000523:psychology*; D055815:Young Adult