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Social Psychiatry and Psychiatric Epidemiology

, Volume 45, Issue 10, pp 931–939 | Cite as

Depression among Arabs and Jews in Israel: a population-based study

  • Giora Kaplan
  • Saralee GlasserEmail author
  • Havi Murad
  • Ahmed Atamna
  • Gershon Alpert
  • Uri Goldbourt
  • Ofra Kalter-Leibovici
Original Paper

Abstract

Introduction

Depression is the second most common chronic disorder seen by primary care physicians. Risk factors associated with depression include medical and psychosocial factors. While in Israel, the rate and risk factors for depression are considered similar to those in other Western countries, population-based data are limited. The present study aims to estimate the prevalence of depression among Jews and Muslim Arabs, and to consider possible associations with demographic, socioeconomic, and health factors.

Methods

The study group (N = 872) was equally divided according to ethnicity, gender, and age group. Depression was measured by the Harvard Department of Psychiatry National Depression Screening Day Scale (HANDS).

Results

The rate of depression scores in the likely/very likely range was 2.5 times higher among Arabs than among Jews (24.9 vs. 10.6%; P < 0.001). Women were more likely to express symptoms of depressive episode than were men (22.0 vs. 13.6%; P = 0.001), and the depression rate increased with age, from 11.0% in the youngest group (26–35) to 25.0% in the oldest (P = 0.001). The rate of increase in depression by age was different for the genders, rising more steeply for women than for men. However, the age–gender differential was not identical for the two ethnic groups. The differences in depression prevalence between Arabs and Jews were maintained after controlling for confounding variables, except that when controlling for education, the difference between the ethnic groups was no longer significant. After adjusting for all variables in the analysis, no significant association remained between ethnicity and depression (OR = 0.80; 95% CI = 0.45–1.40).

Keywords

Depression Primary care Arabs Israel 

Notes

Acknowledgments

This study was partially supported by the Israel National Institute for Health Policy and Health Services Research, the Israeli Association for the Study of Diabetes and the Israel Heart Fund. The funding sources had no involvement in the study design, the data collection, analysis and interpretation. The authors wish to thank Flora Lubin, Daphna Gopher, Valentina Boyko, Esther Polak and Alex Zibenber for their valuable professional assistance.

References

  1. 1.
    Abdel-Khalek AM (1998) Internal consistency of an Arabic adaptation of the Beck Depression Inventory in four Arab countries. Psychol Rep 82:264–266CrossRefPubMedGoogle Scholar
  2. 2.
    Al-Krenawi A, Graham JR (2004) Somatization among Bedouin-Arab women: differentiated by marital status. J Divorce Remarriage 42:131–143CrossRefGoogle Scholar
  3. 3.
    American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders: DSM-IV-TR, 4th edn. American Psychiatric Association, Washington, DC (text rev)Google Scholar
  4. 4.
    Baer L, Jacobs DG, Meszler-Reizes J et al (2000) Development of a brief screening instrument: the HANDS. Psycother Psychosom 69:35–41CrossRefGoogle Scholar
  5. 5.
    Bebbington PE, Dunn G, Jenkins R et al (1998) The influence of age and gender on the prevalence of depressive conditions: report from the National Survey of Psychiatry Morbidity. Psychol Med 28:9–19CrossRefPubMedGoogle Scholar
  6. 6.
    Bener A, Kamal A, Fares A, Sabuncuoglu O (2004) A retrospective study of the relationship between anxiety, depression, stress and hypertension. Arab J Psychiatry 15:131–136Google Scholar
  7. 7.
    Blazer DG, Kessler RC, McGonagle KA, Swartz MS (1994) The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey. Am J Psychiatry 151:979–986PubMedGoogle Scholar
  8. 8.
    Bottomley A (1998) Depression in cancer patients: a literature review. Eur J Cancer Care 7:181–191CrossRefGoogle Scholar
  9. 9.
    Breslau J, Aguilar-Gaxiola S, Kendler KS, Su M, Williams D, Kessler RC (2006) Specifying race-ethnic differences in risk for psychiatric disorder in a USA national sample. Psychol Med 36(1):57–68CrossRefPubMedGoogle Scholar
  10. 10.
    Breslau J, Javaras KN, Blacker D, Murphy JM, Normand SL (2008) Differential item functioning between ethnic groups in the epidemiological assessment of depression. J Nerv Ment Dis 196(4):297–306CrossRefPubMedGoogle Scholar
  11. 11.
    Coulehan JL, Schulberg HC, Block MR, Madonia MJ, Rodriguez E (1997) Treating depressed primary care patients improves their physical, mental, and social functioning. Arch Intern Med 157:1113–1120CrossRefPubMedGoogle Scholar
  12. 12.
    Crabb R, Hunsley J (2006) Utilization of mental health care services among older adults with depression. J Clin Psychol 62:299–312CrossRefPubMedGoogle Scholar
  13. 13.
    Daradkeh TK, Ghubash R, Abou-Saleh MT (2002) Al Ain community survey of psychiatric morbidity. II: sex differences in the prevalence of depressive disorders. J Affect Disord 72:167–176CrossRefPubMedGoogle Scholar
  14. 14.
    Eaton WW, Kessler LG (1981) Rates of symptoms of depression in a national sample. Am J Epidemiol 114:528–538PubMedGoogle Scholar
  15. 15.
    Egede LE (2005) Effect of comorbid chronic diseases on prevalence and odds of depression in adults with diabetes. Psychosom Med 67:46–51CrossRefPubMedGoogle Scholar
  16. 16.
    Elkin I, Shea MT, Watkins JT et al (1989) National Institute of Mental Health Treatment of Depression Collaborative Research Program: general effectiveness of treatments. Arch Gen Psychiatry 46:971–982PubMedGoogle Scholar
  17. 17.
    El-Rufaie OEF, Absood GH (1994) Depression in primary health care. Arab J Psychiatry 5:39–47Google Scholar
  18. 18.
    El-Rufaie OEF, Absood GH (1993) Minor psychiatric morbidity in primary health care: prevalence, nature and severity. Int J Soc Psychiatry 39:159–166CrossRefPubMedGoogle Scholar
  19. 19.
    El-Rufaie OEF, Absood GH (1995) Retesting the validity of the Arabic version of the hospital anxiety and depression scale in primary health care. Soc Psychiatry Psychiatr Epidemiol 30:26–31CrossRefPubMedGoogle Scholar
  20. 20.
    Galea S, Ahern J, Nandi A, Tracy M, Beard J, Vlahov D (2007) Urban neighborhood poverty and the incidence of depression in a population-based cohort study. Ann Epidemiol 17:171–179CrossRefPubMedGoogle Scholar
  21. 21.
    Gelkopf M, Solomon Z, Berger R, Bleich A (2008) The mental health impact of terrorism on the Arab minority in Israel. A repeat cross-sectional study of Arabs and Jews. Acta Psychiatr Scand 117:269–380CrossRefGoogle Scholar
  22. 22.
    Ghubash R, Daradkey TK, Al-Naseri KS, Al-Bloushi N, Al-Daheri AM (2000) The performance of the Center for Epidemiologic Study Depression Scales (CES-D) in an Arab female community. Int J Soc Psychiatry 46:241–249CrossRefPubMedGoogle Scholar
  23. 23.
    Gutiérrez-Lobos K, Scherer M, Anderer P, Katschnig H (2002) The influence of age on the female/male ratio of treated incidence rates in depression. BMC Psychiatry 2:3CrossRefPubMedGoogle Scholar
  24. 24.
    Hamdi E, Amin Y, Abou-Saleh MT (1997) Performance of the Hamilton depression rating scale in depressed patients in the United Arab Emirates. Acta Psychiatr Scand 96:416–423CrossRefPubMedGoogle Scholar
  25. 25.
    Harvard Department of Psychiatry and the National Mental Illness Screening Project (1998) HANDS: National depression screening day scale manual. Harvard Department of Psychiatry, Wellesley HillsGoogle Scholar
  26. 26.
    Hays RD, Wells KB, Sherbourne CD, Rogers W, Spritzer K (1995) Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Arch Gen Psychiatry 52:11–19PubMedGoogle Scholar
  27. 27.
    Iancu I, Horesh N, Lepkifker E, Drory Y (2003) An epidemiological study of depressive symptomology among Israeli adults: prevalence of depressive symptoms and demographic risk factors. Isr J Psychiatry Relat Sci 40:82–89PubMedGoogle Scholar
  28. 28.
    Israel Center for Disease Control (2006) Israeli National Health Interview Survey (INHIS-1): selected findings. ICDC, Ramat Gan. Publication 249Google Scholar
  29. 29.
    Jackson-Triche ME, Greer Sullivan JG, Wells KB, Rogers W, Camp P, Mazel R (2000) Depression and health-related quality of life in ethnic minorities seeking care in general medical settings. J Affect Disord 58:89–97CrossRefPubMedGoogle Scholar
  30. 30.
    Jorm AF (1987) Gender and age differences in depression: a quantitative synthesis of published research. ANZ J Psychiatry 21:46–53Google Scholar
  31. 31.
    Kalter-Leibovici O, Atamna A, Lubin F et al (2007) Obesity among Arabs and Jews in Israel: population based study. Isr Med Assoc J 9:525–530PubMedGoogle Scholar
  32. 32.
    Katon W, Schulberg H (1992) Epidemiology of depression in primary care. Gen Hosp Psychiatry 14:237–247CrossRefPubMedGoogle Scholar
  33. 33.
    Kessler RC, McGonagle KA, Swartz M, Blazer DG, Nelson C (1993) Gender and depression in the National Comorbidity Survey I: lifetime prevalence, chronicity and recurrence. J Aff Dis 29:85–96CrossRefGoogle Scholar
  34. 34.
    Kessler RC, Berglund P, Demier O, Jin R, Koretz D, Merikangas KR, Rush AJ, Walters EE, Wang PS (2003) National Comorbidity Survey Replication. The epidemiology of major depressive disorder. JAMA 289:3095–3105CrossRefPubMedGoogle Scholar
  35. 35.
    Knight RG, Waal-Manning HJ, Spears GF (1983) Some norms and reliability data for the state-trait anxiety inventory and the Zung self-rating depression scale. Br J Clin Psychol 22:245–249PubMedGoogle Scholar
  36. 36.
    Knight RG (1984) Some general population norms for the short form of Beck Depression Inventory. J Clin Psychol 40:751–753CrossRefPubMedGoogle Scholar
  37. 37.
    Levav I, Al-Krenawi A, Ifrach A et al (2007) Common mental disorders among Arab-Israelis: findings from the Israel National Health Survey. Isr J Psychiatry Relat Sci 44:104–113PubMedGoogle Scholar
  38. 38.
    Lorant V, Ch Croux, Weich S, Deliege D, Mackenbach J, Ansseau M (2007) Depression and socio-economic risk factors: 7-year longitudinal population study. Br J Psychiatry 190:293–298CrossRefPubMedGoogle Scholar
  39. 39.
    Mayou RA, Gill D, Thompson DR et al (2000) Depression and anxiety as predictors of outcome after myocardial infarction. Psychosom Med 62:212–219PubMedGoogle Scholar
  40. 40.
    Meltzer H, Gill B, Petticrew M, Hinds K (1995) The prevalence of psychiatric morbidity among adults living in private households. OPCS Survey of Psychiatric Morbidity in Great Britain. Report 1. HMSO, LondonGoogle Scholar
  41. 41.
    Mirowsky J (1996) Age and the gender gap in depression. J Health Soc Behav 37:362–380CrossRefPubMedGoogle Scholar
  42. 42.
    Mosalum LMJ (1999) Psychological health and well-being in a community sample of Bahraini adults. Diss Int Sci Eng 59(9-B):4723Google Scholar
  43. 43.
    Murphy JM, Laird NM, Monson RR, Sobol AM, Leighton AH (2000) A 40-year perspective on the prevalence of depression: the Stirling County Study. Arch Gen Psychiatry 57:209–215CrossRefPubMedGoogle Scholar
  44. 44.
    Peyrot M, Rubin RR (1997) Levels and risks of depression and anxiety symptomology among diabetic adults. Diabetes Care 20:585–590CrossRefPubMedGoogle Scholar
  45. 45.
    Plant EA, Sachs-Ericson N (2004) Racial and ethnic differences in depression: the roles of social support and meeting basic needs. J Consult Clinl Psychol 72:41–52CrossRefGoogle Scholar
  46. 46.
    Robins LN, Regier DA (1991) Psychiatric Disorders in America: the Epidemiologic Catchment Area Study. Free Press, New YorkGoogle Scholar
  47. 47.
    Smith KLW, Matheson FI, Moineddin R, Glazier RH (2007) Gender, income and immigration differences in depression in Canadian urban centres. Can J Public Health 98:149–153PubMedGoogle Scholar
  48. 48.
    Spitzer RL, Kroenke K, Williams JB (1999) Patient Health Questionnaire Primary Care Study Group. Validation and utility of a self-report version of PRIMEMD: the PHQ Primary Care Study. JAMA 282:1737–1744CrossRefPubMedGoogle Scholar
  49. 49.
    Tracy M, Hobfoll SE, Canetti-Nisim D, Galea S (2008) Predictors of depressive symptoms among Israeli Jews and Arabs during the Al Aqsa Intifada: a population-based cohort study. Ann Epidemiol 18:447–457CrossRefPubMedGoogle Scholar
  50. 50.
    US Dept. of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research (1993) Depression in primary care, vol 1. Detection and diagnosis. Government Printing Office, Rockville, AHCPR publication no. 93-0550/1Google Scholar
  51. 51.
    Weissman MM, Bland RC, Canino GJ et al (1996) Cross-national epidemiology of major depression and bipolar disorder. JAMA 276:293–299CrossRefPubMedGoogle Scholar
  52. 52.
    Wells KB (1996) Caring for depression. Harvard University Press, CambridgeGoogle Scholar
  53. 53.
    Wilhelm K, Parker G, Hadzi-Pavlovic D (1997) Fifteen years on: evolving ideas in researching gender differences in depression. Psychol Med 27:875–883CrossRefPubMedGoogle Scholar
  54. 54.
    Williams DR, Gonzalez HM, Neighbors H, Nesse R, Abelson JM, Sweetman J, Jackson JS (2007) Arch Gen Psychiatry 64:305–315CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Giora Kaplan
    • 1
  • Saralee Glasser
    • 1
    Email author
  • Havi Murad
    • 2
  • Ahmed Atamna
    • 3
  • Gershon Alpert
    • 3
  • Uri Goldbourt
    • 4
  • Ofra Kalter-Leibovici
    • 4
    • 5
  1. 1.Unit for Mental Health Epidemiology and Research on the Psychosocial Aspects of IllnessGertner Institute for Epidemiology and Health Policy ResearchTel HashomerIsrael
  2. 2.Biostatistics UnitGertner Institute for Epidemiology and Health Policy ResearchTel HashomerIsrael
  3. 3.Clalit Health ServicesHaderaIsrael
  4. 4.Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  5. 5.Unit of Cardiovascular EpidemiologyGertner Institute for Epidemiology and Health Policy ResearchTel HashomerIsrael

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