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Antidepressant prescriptions in first and second generation ethnic minorities in Dutch general practice.

Dijk, L. van, Volkers, A.C., Verheij, R.A. Antidepressant prescriptions in first and second generation ethnic minorities in Dutch general practice. European Journal of Public Health: 2007, 17(suppl. 2), p. 111-112. Abstract. 15th Annual EUPHA Meeting: "The future of public health in the Unified Europe", Helsinki, 11-13 oktober 2007.
Background: Ethnic minorities have poor access and different pathways to mental health care as compared to indigenous populations, but less is known about differences in antidepressant treatment in depressed patients among ethnic minorities. This papers studies antidepressant treatment in depressed patients among first and second generation ethnic minorities in general practice. Methods: We tested our hypothesis using data routine electronic medical records from 90 representative general practices in 2003. Ethnicity and generational status of ethnic minorities was
determined by country of birth of subjects and their parents using information from the municipal population registration kept by Statistics Netherlands. Databases were linked on patient basis. Outcome measures were percentage of patients with antidepressant treatment and number of prescriptions in patients receiving antidepressants. The statistical analysis was conducted using multivariate regression models. A total of 2392 Dutch, Moroccan, Turkish, Surinamese and Antillean patients with depression aged 15–55 years among 322 369 matched patients < 55 years were included in the analysis. Results: Moroccan and Surinamese patients with a physician diagnosed depression had lower treatment rates with antidepressants (68.9% and 63.2%) than Dutch patients (72.9%) and all ethnic minorities had lower numbers of prescriptions. Differences in treatment rates were explained by variation in demographic and socioeconomic variables and co-morbidity with anxiety. The second generation was less likely than the indigenous population to receive antidepressant treatment (OR = 0.29) and both first and second generations received a reduced number of prescriptions (B =1.99 and B =2.43, respectively). These findings were independent of age and other background variables. Conclusions: The largest non-western minorities in the Netherlands received less antidepressant treatment for depression in general practice than the indigenous population. The largest difference was found in the second generation, which does not support the acculturation hypothesis. (aut. ref.)