title: Depression, anxiety and suicidal ideation among 1(st) and 2(nd) generation migrants - results from the Gutenberg health study.
abstract: Even though migrants constitute a large proportion of the German population, there is a lack of representative studies on their mental health. Hence, the present study explored mental health characteristics and suicidal ideation comparing 1(st) and 2(nd) generation migrants to non-migrants and subgroups within 1(st) generation migrants.
  
  
  
  We investigated cross-sectional data of 14,943 participants of the Gutenberg Health Study (GHS), a population-based, prospective, single-center cohort study in Mid-Germany (age 35 to 74 years). Migration status was assessed according to the German microcensus criteria. Depression and anxiety were measured by the PHQ (PHQ-8, GAD-2, Panic module), social anxiety by the Mini SPIN and Distressed Personality (Type D) by the DS-14. Suicidal ideation was assessed by the single item of the PHQ-9.
  
  
  
  A total of n = 3,525 participants had a migration background; the proportion of 1(st) generation (immigrated after 1949) migrants was 10.6 % (2(nd) generation 13 %). Among the 1(st) generation migrants those with Polish (N = 295) and Turkish (N = 141) origins were the largest groups from single countries. Controlling for sex, age and socioeconomic status, 1(st) generation migrants reported significantly more depression (OR 1.24; CI 1.01-1.52), generalized anxiety (OR 1.38; CI 1.13-1.68), panic attacks in the past 4 weeks (OR 1.43; CI 1.16-1.77); Type D (OR 1.28; CI 1.13-1.45) and suicidal ideation (1.44; CI 1.19-1.74) compared to non-migrants. The mental health of 2(nd) generation migrants did not differ from native Germans; they had the highest socioeconomic status of the three groups. Compared to native Germans, Turkish migrants of both sexes reported more depression and panic, particularly a strongly increased suicidal ideation (OR 3.02; CI 1.80-5.04) after taking sex, age, and socioeconomic status into account. Polish migrants only reported an increased rate of suicidal ideation and Type D. Turkish migrants exceeded Polish migrants regarding depression (OR = 2.61; 95 % CI 1.21-5.67), and panic attacks (OR=3.38; 95 % CI 1.45-7.85). In the subgroup analyses years lived in Germany was not significant.
  
  
  
  One of few representative community studies shows that compared to native Germans depression, anxiety and suicidal ideation were more frequently reported by 1(st) generation migrants, particularly of Turkish origin. Overall, 2(nd) generation migrants appear to have adjusted successfully. Limitations refer to a lack of data for persons without German language skills and missing mental health data in the Turkish sample. Further analyses need to address causes of mental strains and health care needs and provision.
authors: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Str. 8, D-55131, Mainz, Germany.
authors: Manfred E
authors: ME
authors: Beutel
authors: Medical Clinic for Cardiology, Angiology and Intensive Care Medicine, University Medical Center Mainz, Mainz, Germany.
authors: Claus
authors: C
authors: Jünger
authors: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Str. 8, D-55131, Mainz, Germany. Eva.Klein@unimedizin-mainz.de.
authors: Eva M
authors: EM
authors: Klein
authors: Preventive Cardiology and Preventive Medicine, Department of Medicine 2, University Medical Center Mainz, Mainz, Germany.|Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany.|German Center for Cardiovascular Research (DZHK), partner site Rhine Main, University Medical Center Mainz, Mainz, Germany.
authors: Philipp
authors: P
authors: Wild
authors: Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center Mainz, Mainz, Germany.
authors: Karl J
authors: KJ
authors: Lackner
authors: Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany.
authors: Maria
authors: M
authors: Blettner
authors: Department of English and Linguistics, American Studies, Center for Comparative Native and Indigenous Studies, Mainz, Germany.
authors: Mita
authors: M
authors: Banerjee
authors: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Str. 8, D-55131, Mainz, Germany.
authors: Matthias
authors: M
authors: Michal
authors: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Str. 8, D-55131, Mainz, Germany.
authors: Jörg
authors: J
authors: Wiltink
authors: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Str. 8, D-55131, Mainz, Germany.
authors: Elmar
authors: E
authors: Brähler
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D054242:Emigrants and Immigrants / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D010551:Personality; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D059020:Suicidal Ideation
keywords: Mental health; Migration; Polish; Suicidal ideation; Turkish