title: The influence of stigma on depression, overall psychological distress, and somatization among female Turkish migrants.
abstract: BACKGROUND
  Even though some studies suggest that in Mediterranean and non-western cultures more somatic and less psychological symptoms are reported, this so-called 'somatization' hypothesis has been challenged. Reviews show that somatic symptoms are a core component of depressive episodes regardless of cultural background. The expression of symptoms might be related to the psychosocial, social and cultural context surrounding the patient rather than 'ethnicity' or related constructs. Also, stigma associated with mental disorders can affect patients'symptom presentation.
  
  
  METHODS
  The interrelationships of perceived stigmatization (Explanatory Model Interview Catalogue - Stigma Scale), depression (Beck Depression Index II), overall psychological distress (Symptom Checklist-90-R), and somatic symptoms (The screening for SOMATOFORM SYMPTOMS II) was assessed in a sample of female patients with Turkish descent with a diagnosis of depression (N=63).
  
  
  RESULTS
  Depression, overall psychological distress, and somatic symptoms were positively and significantly related. Stigma was positively related to depression and overall psychological distress. There was no significant relationship between stigma and somatic symptoms, neither among the severely depressed group (N=39), nor among the less depressed group (N=24).
  
  
  CONCLUSIONS
  The positive relationships between stigma, depression, and overall psychological distress indicate that patients who are more depressed and who have higher levels of overall psychological distress experience their condition as more stigmatizing. Since somatic symptoms and stigma were not related (neither positively, nor negatively), it appears that depressive symptoms and other symptoms of psychological distress affect concerns about stigmatizing attitudes in a way that somatic symptoms do not. This result challenges common assumption of the 'somatization'hypothesis, i.e. that depression is 'somatized'because of concern about stigmatizing attitudes.
authors.affiliation: Department of Psychiatry and Psychotherapy at St Hedwig Hospital, Charité - University Medicine Berlin, Germany. Grosse Hamburger Straße 5-11, 10115 Berlin, Germany. amanda.heredia- montesinos@charite.de
authors.forename: A
authors.initials: A
authors.lastname: Heredia Montesinos
authors.forename: M A
authors.initials: MA
authors.lastname: Rapp
authors.forename: S
authors.initials: S
authors.lastname: Temur-Erman
authors.forename: A
authors.initials: A
authors.lastname: Heinz
authors.forename: U
authors.initials: U
authors.lastname: Hegerl
authors.forename: M
authors.initials: M
authors.lastname: Schouler-Ocak
mesh_terms: D000328:Adult; D000368:Aged; D003469:Culture; D003866:Depressive Disorder / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D005858:Germany; D006801:Humans; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D057545:Social Stigma; D013001:Somatoform Disorders / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology; D013315:Stress, Psychological / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014421:Turkey / Q000208:ethnology; D014930:Women / Q000523:psychology