Depression and demoralization among Russian-Jewish immigrants in primary care

The purpose of this study was to examine the levels and nature of psychological distress and depression among Russian-Jewish emigres in primary care. Fifty-seven consecutive patients at the primary care clinic were assessed with the Hamilton Depression Scale (Ham-D). The subjects completed self-rating scales, including the Beck Depression Inventory (BDI), Life Orientation Test, Beck Hopelessness Scale, Attributional Style Questionnaire, and Snaith-Hamilton pleasure Scale. Data on demographics and physical complaints were collected and analyzed. Of the patients studied, 82.5% experienced psychological distress (BDI greater than or equal to 10), and 43.9% had clinically significant depressive symptoms (Ham-D greater than or equal to 17). BDI and Ham-D scores were significantly correlated with the number of psychosomatic complaints, hopelessness, lack of optimism, anhedonia, and dysfunctional attributional style. The distressed;but not depressed, patients had preservation of hedonic capacity. The authors found a high rate of depression based upon Ham-D scores among the Russian-Jewish emigres in primary care. The authors suggest that this high rate is attributable to a culturally specific tendency to express distress in somatic terms, The nature of distress was phenomenologically similar to demoralization.