title: The association of acculturation and depressive and anxiety symptoms in immigrant chronic dialysis patients.
abstract: OBJECTIVE
  Among immigrant chronic dialysis patients, depressive and anxiety symptoms are common. We aimed to examine the association of acculturation, i.e. the adaptation of immigrants to a new cultural context, and depressive and anxiety symptoms in immigrant chronic dialysis patients.
  
  
  METHODS
  The DIVERS study is a prospective cohort study in five urban dialysis centers in the Netherlands. The association of five aspects of acculturation ("Skills", "Social integration", "Traditions", "Values and norms" and "Loss") and the presence of depressive and anxiety symptoms was determined using linear regression analyses, both univariate and multivariate.
  
  
  RESULTS
  A total of 249 immigrant chronic dialysis patients were included in the study. The overall prevalence of depressive and anxiety symptoms was 51% and 47%, respectively. "Skills" and "Loss" were significantly associated with the presence of depressive and anxiety symptoms, respectively ("Skills" β=0.34, CI: 0.11-0.58, and "Loss" β=0.19, CI: 0.01-0.37; "Skills" β=0.49, CI: 0.25-0.73, and "Loss" β=0.33, CI: 0.13-0.53). The associations were comparable after adjustment. No significant associations were found between the other subscales and depressive and anxiety symptoms.
  
  
  CONCLUSIONS
  This study demonstrates that less skills for living in the Dutch society and more feelings of loss are associated with the presence of both depressive and anxiety symptoms in immigrant chronic dialysis patients.
authors.affiliation: Department of Nephrology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands; Department of Psychiatry, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands. Electronic address: G.haverkamp@slaz.nl.
authors.forename: Gertrud L G
authors.initials: GL
authors.lastname: Haverkamp
authors.affiliation: Department of Nephrology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands; Department of Psychiatry, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands.
authors.forename: Wim L
authors.initials: WL
authors.lastname: Loosman
authors.affiliation: Department of Internal Medicine, Amstelland Hospital, Amstelveen, The Netherlands.
authors.forename: Tessa O
authors.initials: TO
authors.lastname: van den Beukel
authors.affiliation: Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Tiny
authors.initials: T
authors.lastname: Hoekstra
authors.affiliation: Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Friedo W
authors.initials: FW
authors.lastname: Dekker
authors.affiliation: Department of Nephrology, Medical Center Haaglanden, The Hague, The Netherlands.
authors.forename: Prataap K
authors.initials: PK
authors.lastname: Chandie Shaw
authors.affiliation: Department of Nephrology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Yves F C
authors.initials: YF
authors.lastname: Smets
authors.affiliation: Department of Nephrology, Haga Hospital, The Hague, The Netherlands.
authors.forename: Louis-Jean
authors.initials: LJ
authors.lastname: Vleming
authors.affiliation: Department of Nephrology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Pieter M
authors.initials: PM
authors.lastname: Ter Wee
authors.affiliation: Department of Psychiatry, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands.
authors.forename: Adriaan
authors.initials: A
authors.lastname: Honig
authors.affiliation: Department of Nephrology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands.
authors.forename: Carl E H
authors.initials: CE
authors.lastname: Siegert
mesh_terms: D000069:Acculturation; D000328:Adult; D017954:Africa South of the Sahara / Q000208:ethnology; D000352:Africa, Northern / Q000208:ethnology; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology*; D001208:Asia / Q000208:ethnology; D017691:Caribbean Region / Q000208:ethnology; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data; D005060:Europe / Q000208:ethnology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D006435:Renal Dialysis / Q000523:psychology*; D013020:South America / Q000208:ethnology; D014505:Urban Population / Q000706:statistics & numerical data
keywords: Acculturation; Anxiety symptoms; Depressive symptoms; Immigrant chronic dialysis patients