Adverse social circumstances and depression in people of Pakistani origin in the UK

Background The social origins of depression in people of Pakistani origin in the UK are not fully understood; they may not be the same as for the indigenous White population. Method Patients attending a GP's surgery were screened with the Personal Health Questionnaire to detect depressive illness, which was confirmed using the Psychiatric Assessment Schedule; the estimated prevalence of major depression was 42%. Forty-four people with depression and 33 non-depressed comparison subjects were successfully interviewed using the Life Event and Difficulty Schedule, either in Urdu or English. Results Seventy-five percent of the sample were Pakistani born; 57% of cases and 33% of non-cases spoke English with difficulty. Seventy-five per cent of the cases and 36% of the non-cases had experienced an independent severe event and/or a major difficulty (P = 0.0015). Difficulties associated with depression were most commonly in the marital, health and housing categories; overt racial harassment and discrimination were rare. Conclusions This is a preliminary study because of the small sample of GP attenders. The somatic presentation of depression in this population is clear Acceptable forms of social support and help with marital, housing and employment problems will be needed to help relieve the depression in this population.