Mediterranean Migrants Research Articles

Help-Seeking Behaviour Regarding Mental Health Problems of Mediterranean Migrants in the Netherlands: Familiarity with Care, Consultation Attitude and Use of Services

Ethnic minority groups differ in the pattern of their seeking help, and in their use of and attitude towards mental health systems. To meet the mental health needs of ethnic minority populations, insights into determinants of their help-seeking orientations are of great concern. To investigate help-seeking behaviour regarding mental health problems in terms of familiarity, attitude and service use among Mediterranean migrants in the Netherlands. Samples of Mediterranean citizens in the general population (N = 292) and of Mediterranean (N = 114) and indigenous Dutch outpatients (N = 59) currently treated in mental health care were included. Data were acquired by administering a semi-structured interview. Quantified data were analysed using multivariate techniques. More recently arrived participants were less familiar with mental health services. Moroccan, lower educated and recently arrived respondents reported a more negative attitude towards consulting these agencies. The help-seeking behaviour of the Mediterranean participants was relatively similar to that of the indigenous Dutch subjects. With regard to care-seeking routes and use of mental health services, more inter-ethnic similarities than differences emerged. Sociodemographic variables like age, education and length of residence shape the process of help-seeking and service use.

Summer ichthyoplankton, food supply of fish larvae and impact of invasive ctenophores on the nutrition of fish larvae in the Black Sea during 2000 and 2001

Qualitative composition and abundance of both ichthyoplankton and small forms of zooplankton were evaluated by field studies in the northern (the Crimea near Sevastopol) and southern (Sinop region and TEEZ) Black Sea during the summers 2000 and 2001. A tendency of increasing the species richness, abundance of fish eggs and larvae as well as zooplankton (which is the food for fish larvae) was observed over a period of Mnemiopsis leidyi and Beroe ovata co-existence. The eggs and larvae of the Mediterranean migrants—bonito and bluefish appeared again in the coastal waters near Sevastopol, which testified to favourable conditions for the spawning and nutrition of these fish species and their larvae. Aborigen copepod Oithona nana was found in the Crimean coastal waters although earlier in the 1990s it had completely vanished. Although rare in the 1990s copepods Centropages ponticus and Paracalanus parvus appeared in inshore waters as well as Pontellids species. Observed increases in species number and abundance of both ichthyoplankton and small zooplankton (≤500 μm), which promoted survival and development of fish larvae, were attributed to reduced predatory impact of Mnemiopsis on prey zooplankton after the arrival of Beroe in the late 1990s. However, the influence of Mnemiopsis continued to be significant during the short period of its peak occurrence in late summer. When this period coincided with the appearance of fish larvae, a negative impact on their survival could be predicted due to a low concentration of food items for larvae feeding.

Clinical Methods in Transcultural Psychiatry

Back to table of contents Previous article Next article Book ReviewFull AccessClinical Methods in Transcultural PsychiatryCarl C. Bell, M.D.Carl C. BellSearch for more papers by this author, M.D.Published Online:1 Dec 1998https://doi.org/10.1176/ps.49.12.1630AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail This book has a global perspective on transcultural psychiatry. It does not focus just on major U.S. minority populations. Accordingly, I recommend it. As human migration increases and international business continues to grow, American psychiatrists will need to become more versed in transcultural psychiatry.The text is chock-full of useful pearls and illuminating examples of how culture affects behavior and the treatment of mental illness. It includes meaningful paradigms that are easy-to-remember guideposts for transcultural psychiatric efforts. The book embodies the goals of transcultural psychiatry by seeking to explore the epidemiology of mental illness in different cultures, identifying cultural factors facilitating the development of mental illness, describing forms of treatment practiced in different cultures, and comparing different attitudes toward mentally ill persons in different cultures.The book's first section provides an overview of transcultural psychiatry, explores the relationships between personality and culture, and addresses mental health aspects of voluntary and forced immigration. Given the large numbers of refugees who are at risk because of traumatic experiences, clinicians need to know how to assess, formulate, and treat patients who are culturally different from themselves.Section 2 recommends, among other considerations, that practitioners attend to the cultural aspects of the spiritual realm. An outstanding chapter addresses mental health professionals' attitudes toward traditional healing. Curanderismo, espiritismo, santeria, umbanda, vodou, obeah, and Southern black rootwork are thoroughly explained. Further, the conceptual bases of alternative healing systems, covering natural, mystical, animistic, and magical causation, are discussed.Also in this section is a unique, exemplary chapter on how New Zealand Maori adapt to mainstream Western medicine. Another commendable original chapter, focusing on psychiatry in an English inner-city community, gives some poignant examples of how the culture of poverty and religion influences behavior. A third novel chapter focuses on psychiatry in Arabian Gulf communities. These contributions illuminate the stark contrasts between American culture and other cultural contexts. They heighten our awareness of our own culture and how culture influences behavior and the practice of psychiatry in various contexts. Another outstanding chapter points out how different ethnic groups respond to various medications. The section concludes with a chapter by authors who are appropriately critical of Western psychiatry's disdain for religion as a negative influence on mental health.Section 3 highlights the role of culture in psychiatric assessments and advises that the "patient's explanatory model" of the psychiatric problem be explored. Useful treatment approaches range from interpreting somatic symptoms using several different levels of meaning to establishing a therapeutic alliance across cultures. Section 4 has distinctive chapters on somatization patterns among Mediterranean migrants and on religion and magic in Italy.The following section, on education and training, presents curricula for transcultural training of mental health professionals. DSM-IV cultural formulations are highlighted in hopes they will provide leadership for psychiatric residency education in transcultural psychiatry. Section 6 explains how children and families in cultural transition are influenced by differential rates of acculturation, culture clashes, culture-bound developmental myths, cultural adaptation, and a culture's impact on identity. A model of transcultural family therapy is provided.The bottom line is that there is a lot to learn from this book.Dr. Bell is clinical professor of psychiatry at the University of Illinois and president and chief executive officer of the Community Mental Health Council in Chicago.edited by Samuel O. Okpaku, M.D., Ph.D.; Washington, D.C., American Psychiatric Press, 1998, 458 pages, $65 FiguresReferencesCited byDetailsCited byNone Volume 49Issue 12 December 1998Pages 1630-1630 Metrics History Published online 1 December 1998 Published in print 1 December 1998

Occupational and economic mobility and social integration of Mediterranean migrants in Germany.

Foreigners of Mediterranean immigrant origin still occupy the lowerpositions in the German labour market. The employment profile is clearlydifferent from that of German wage earners and salaried employees. Resultsfrom the German Socio-Economic Panel Study show that 60% of this foreignpopulation was employed as unskilled or semi-skilled workers in 1993. Between1984 and 1993 their occupational mobility was relatively low. The situationof the second generation has clearly improved. To a small degree they evenfound access to attractive jobs in the service sector. But compared withGermans of the same age group their occupational success is limited. Thesocial situation of foreigners is characterised by increasing segregation.

Naissance d'une colonie : un comptoir commercial à Marseille

Birth of a Colony: a Trading Company in Marseille Alain TARRIUS The Belsunce neighborhood, in the historic center of Marseille, has since the 19th century received diasporas of Mediterranean migrants (Italians, Armenians, Sephardic Jews, North Africans) who develop economic activities in the neighborhood which contribute to their insertion into French society. Until 1987, Algerians dominated the North African representation, perpetuating the historic role of this neighborhood. Since, Tunisian and Moroccan entrepreneurs, whose profile fits that of the international nomad, have caused a profound change in the economy from being local and community-centered to worldwide and underground, closely related in character to a colonial trading post. Moroccan entrepreneurs who have lived in Brussels and Madrid do business with Turks; Tunisians who have lived in Libya, Spain, and Italy deal with Italians and Lebanese. The neighborhood has changed from being a social space favorable to an entry into French identity to being a place where initiatives tending towards alterity, or otherness, are asserted. The author analyzes the complexity ofthis social and economic transformation and its effects on the urban device which is Belsunce.

Uptake of preventive health care among Mediterranean migrants in Belgium.

The aim was to investigate the influence of ethnicity on the demand for preventive care by Mediterranean migrants in Belgium. This was a survey of patient contacts with general practitioners. 33 general practitioners working in Belgian localities with the highest migrant density collaborated in the study. During two months they recorded information on consultations with an estimated 72,600 clients. Participation was obtained from all subjects attending for preventive care or for a new episode of illness (n = 6256). An average of 30% of the patients sought preventive care, but multivariate analysis showed ethnicity to be a strong independent predictor of this type of demand. The higher primary preventive uptake by female Moroccans and Turks and the higher secondary preventive uptake by males from the same ethnic groups, as compared with the Belgian reference population, contrasted with a lower demand for tertiary prevention in migrants of either gender. The relative demand for preventive care by the more acculturated migrants was, however, quite similar to the demand of the Belgian population. The differential uptake of primary preventive care could be partly explained by the higher fertility rates of immigrant women, and the differential secondary uptake by a lower incidence of tuberculosis in the indigenous population. The meagre demand for tertiary prevention by Moroccan and Turkish migrants could be due to weaker compliance with treatments for chronic disorders, which is related to the perceptions of illness in these ethnic groups. The establishment of cross cultural mechanisms of dialogue should enhance compliance and improve the access of immigrants to the benefits of tertiary preventive care.

Somatization of psychiatric illness in Mediterranean migrants in Belgium.

Mediterranean migrants with acute psychiatric problems show a predominance of dramatic somatization in their symptom patterns, when compared with Belgian patients with similar psychiatric problems and admitted after identical recruiting and referral procedures. D.S.M. III diagnoses of the Mediterranean patients, however, reveal neither a correspondingly high incidence of somatoform disorders nor histrionic personalities. Adult and adolescent Mediterranean migrants appear to convey psychological problems through contrasting forms of somatization. Adolescents somatize mainly through self-inflicted symptoms, whereas adults express somatization in a more 'natural' way--insubjective bodily sensations, psychophysiological symptoms or psychosomatic syndromes. The main reason for acute psychiatric admission among Belgian adolescents is outward aggressive behaviour. In Mediterranean adolescents in Belgium it is a combination of somatization and aggression in self-inflicted physical symptoms.

More maladies in Mediterranean migrants stomatocytosis and macrothrombocytopenia.

More maladies in Mediterranean migrants stomatocytosis and macrothrombocytopenia.

Mediterranean stomatocytosis: A possible red cell membrane defect

Stomatocytes are red cells in which the usual central pale area becomes elongated, so that the cell has the appearance of a pair of lips forming a mouth. In cases referred to as showing 'stomatocytosis' more than 10% of the red cells are stomatocytes. The authors searched for such cases over 18 mth., after one of them had gained the impression that stomatocytosis was frequently seen in Mediterranean migrants to Australia. The haematological investigation of 50 such cases was described and included family studies which suggested its inheritance as an autosomal dominant. Thirty-five had haemoglobin concentrations within the normal range, the remainder having mild to moderate anaemia, the lowest haemoglobin being 8g./100 ml. The anaemia appeared to be haemolytic in type. Thrombocytopenia was observed in 20 of 30 cases where platelet counts were performed, varying from 38- to 130,000mm.³. Reticulocytes varied from 2.2 to 7.4% in 19 of 26 cases, and slight splenomegaly in 10 out of 13 cases examined. Splenectomy was undertaken in one anaemia case with good result. Most patients presented to their doctors with a variety of complaints, none of which were clearly haematological. Acyltransferase activity was measured in 3 cases and significant reduction observed. It is possible that stomatocytosis may be caused by an abnormal red cell lipid partem resulting at least in part from a lowered level of acyltransferase. However, incubation of normal compatible red cells for 24hr. with plasma from patients with stomatocytosis did not induce stomatocyte formation and conversely stomatocytosis was not reversed when incubated for 24hr. at 37° in normal plasma. The plasma and red cells of 6 cases were analysed for sodium and potassium concentration and no evidence was found of the increased potassium/sodium flux across the red cell membrane such as has been described in two previously published studies of stomatocytosis.