Situation of psychiatric patients with migration background in Germany

Ситуация психиатрических пациентов с миграционным происхождением в Германии Экхардт Кох

Германия

Сегодняшние данные использования стационарных служб психиатрического здравоохранения лицами с иммиграционным происхождением в Германии скудны, несмотря на тот факт, что эта группа составляет почти одну пятую (18,6 %) всего населения, как было показано микропереписью 2005 г.

Current data on the use of inpatient psychiatric healthcare services among persons of immigrant origin in Germany are scarce, despite the fact that this group makes up almost one-fifth (18. 6 %) of the total population, as was shown by the 2005 Microcensus. Previous studies on the utilization of inpatient psychiatric services by migrants had shown that only half of patients percentage of the general population was treated in psychiatric hospitals. The working group on Psychiatry and Migration of the Conference of the Directors of Psychiatric Hospitals in Germany (Bun-desdirektorenkonferenz) conducted a study in 12 psychiatric and psychotherapeutic hospitals and hospital departments (1). In contrast to the previous studies, the proportion of migrants in psychiatric hospitals (17,4 %) equaled that of migrants in the general population. However, there still was a high rate of diagnostic and treatment problems that resulted from cultural differences and, to a lesser extent, from language problems. A high proportion of migrants suffered from delusional and schizophrenic disorders,

Тезисы докладов Международной конференции по психоонкологии «Культура, мозг, тело»

while there were considerable differences in the distribution of diagnoses between different groups of migrants, e. g. from Turkey and from Eastern Europe respectively. Roughly, half of all migrants had German citizenship, among the migrants of Turkish background a high proportion was born in Germany. The number of asylum seekers and refugees was disproportionately high.

This pilot study was followed by a representative nationwide survey about the use of inpatient psychiatric and psychotherapeutic services in Germany by patients of immigrant origin (2). Questionnaires were sent to 350 general hospital psychiatric clinics throughout Germany, and 131 clinics responded. In our study, persons of immigrant origin comprised 17 % of patients in the responding facilities. This indicates that the percentage of inpatient psychiatric services used by patients of immigrant origin is almost proportionate to these patients percentage of the general population. The largest groups of immigrant patients in our study were those of Russian heritage, followed by patients of Turkish, Arabic, or other origin. Almost two-thirds of the immigrant patients were born in Germany and a considerably larger percentage were German citizens (74 %). Sixty-two per cent of all patients of immigrant origin spoke a language other than German (e. g. Russian, Turkish, and Polish) at home. Patients of immigrant origin were significantly more likely to receive an ICD-10 F2 diagnosis and it were precisely patients with this diagnosis who were observed to have trouble in communication with caregivers.

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If we especially look at ethnic German immigrants from former East bloc countries (Aussiedler), we find their number has considerably increased during the past 20 years. However, studies on the frequency of psychiatric disorders or on psychosocial risk factors for psychiatric morbidity in this partially non-homogenous group are remarkably rare. In addition to the above-described data, Kornischka et al. (3) undertook a comprehensive research of the current literature, to gain a systematic review on this issue. They found the most frequent mental disorders among this special group of migrants were depressive disorders, adjustment disorders with brief depressive reactions as well as somatoform disorders, alcoholism and drug dependency. The authors point out ethnic German immigrants as a risk group for mental disorders.