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Depression and Demoralization Among Russian-Jewish Immigrants in Primary Care

Received December 17, 1997; revised July 19, 1998; accepted July 30, 1998. From the Departments of Psychiatry and Medicine, Beth Israel Medical Center, New York. Dr. Gutkovich is currently at Schneider Children's Hospital, Long Island Jewish Medical Center, Division of Child and Adolescent Psychiatry, New York. Address correspondence and reprint requests to Dr. Gutkovich, Schneider Children's Hospital, Long Island Jewish Medical Center, Division of Child and Adolescent Psychiatry, 269–01-76th Ave., New Hyde Park, NY 11040; e-mail: ZGUTKOV{at}aol.com

The purpose of this study was to examine the levels and nature of psychological distress and depression among Russian-Jewish émigrés 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 10), and 43.9% had clinically significant depressive symptoms (Ham-D 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 émigrés 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.

Key Words: Depression • Jews • Russia • Immigration • Primary Care • Depression

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