Plain English Summary
Background and study aims
Evidence suggests that a personal or family history of migration is a psychologically stressful life event and a risk factor for developing psychotic disorders and schizophrenia in some ethnic minorities and/or immigrant populations. However, research on the potential influence of immigration on the prevalence of affective disorders (i.e. depression, bipolar disorder) is more limited and the evidence is more ambiguous. The general aim of this study is to explore the prevalence of affective disorders and use of mental health services on immigrant populations in the Metropolitan Region of Santiago in Chile.
Who can participate?
Adults residing in private households in the Metropolitan Region of Santiago, Chile who were born outside of Chile and have lived in the country for at least 6 months
What does the study involve?
A 45 minute face to face interview covering socioeconomic situation, immigration history, experience of victimization, discrimination, alcohol use, social support, mental wellbeing, affective disorders, depressive and anxiety symptoms and experience of childhood adversity.
What are the possible benefits and risks of participating?
There are no known benefits or risks of participating in this study.
Where is the study run from?
Department of Psychiatry, School of Medicine, Pontifical Catholic University of Chile (Chile)
When is the study starting and how long is it expected to run for?
October 2017 to October 2019
Who is funding the study?
Chilean National Commission for Scientific and Technological Research (CONICYT) (Chile)
Who is the main contact?
Antonia Errázuriz
anerrazuriz@uc.cl
Trial website
Contact information
Type
Scientific
Primary contact
Dr Antonia Errazuriz
ORCID ID
Contact details
Departamento de Psiquiatría
Escuela de Medicina
Pontificia Universidad Católica de Chile
Diagonal Paraguay 362 piso 5
Santiago
8330077
Chile
+56953631333
anerrazuriz@uc.cl
Additional identifiers
EudraCT number
ClinicalTrials.gov number
Protocol/serial number
Fondecyt 11170828
Study information
Scientific title
Prevalence of mood disorders and mental health service use among immigrants of the Metropolitan Region of Chile
Acronym
STRING
Study hypothesis
1. A healthy immigrant effect will be observed in the studied population by which their prevalence of Affective Disorders (AD) will be lower than the prevalence in the general Chilean population.
2. A significant association will be observed between the loss of socio-economic position after migration and a greater probability of AD in immigrants.
3. A significant association will be observed between the report of victimization experience(s) in the previous year and a greater probability of AD in immigrants.
4. A significant association will be observed between financial difficulties and a greater probability of AD in immigrants.
Ethics approval
1. Ethical Scientific Committee of the Social Sciences of the Pontifical Catholic University of Chile, 06/12/2017, ref: 170519004
2. Ethical Scientific Committee of the South Metropolitan Health Service of the Chilean Ministry of Health, 04/04/2018, ref: 145/2018
Study design
Observational epidemiological cross-sectional study
Primary study design
Observational
Secondary study design
Epidemiological study
Trial setting
Community
Trial type
Other
Patient information sheet
Not available in web format, please use the contact details to request a patient information sheet
Condition
Affective/Mood Disorders
Intervention
The sampling framework of the Chilean National Institute of Statistics (INE) from the 2016 Census will be used in MRS and for the purpose of this research it included the following sampling units:
1. Primary sampling units (PSUs): conglomerates or groups of adjoining houses, organized in spatial blocks (200 households on average)
2. Secondary sampling units (SSUs): individual households within each of the conglomerates selected in the first stage
3. Final sampling units: persons meeting the study’s inclusion criteria
Multi-stage random probability sampling involving a 3-stage sampling design will be used - first, the sampling of the primary sampling units (PSUs); second, the sampling of households within the selected PSUs and finally, the random sampling of a household member.
Participants will then take part in a 45-minute interview. This interview will be a household survey using the modular version of the Composite International Diagnostic Interview (WHO-CIDI) will be conducted to explore a broad spectrum of factors traditionally associated with increased risk of affective disorders:
1. Sociodemographics
2. Finance
3. Variation in socioeconomic position
4. Experience of victimization
5. Discrimination
Added 09/08/2019: 6. Experience of childhood adversity
Intervention type
Other
Phase
Drug names
Primary outcome measure
Major depressive episodes, assessed using the World Health Organisation Composite International Diagnostic Interview (WHO-CIDI) at the study interview
Secondary outcome measures
The following are assessed at the study interview:
1. Any affective disorder, assessed using the World Health Organisation Composite International Diagnostic Interview (WHO-CIDI)
2. Bipolar disorder, assessed using the WHO-CIDI
3. Suicidal ideation, plans and attempts, assessed using the WHO-CIDI
4. Mental health service use, assessed using items SR27, SR37, SR47, SR57, SR133, SR139, SR143 and SR149 of the Services Module of the WHO-CIDI
5. Discrimination, assessed using the Spanish-validated version of the Everyday Discrimination Scale (EDS)
6. Mental wellbeing, assessed using the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS)
7. Depressive symptoms, assessed using the nine-item Patient Health Questionnaire (PHQ-9)
8. Hazardous/harmful drinking, assessed using the Alcohol Use Disorders Identification Test (AUDIT)
9. Functional social support, assessed using the 11-item Duke-UNC Functional Social Support Questionnaire (FSSQ)
Added 09/08/2019:
10. Resilience assessed using the Connor-Davidson Resilience Scale (CD-RISC)
11. Childhood adversity using ítems from the Adverse Childhood Experience (ACE) Questionnaire
12. Anxiety symptoms assessed using the Generalized Anxiety Disorder 7-item (GAD-7) scale
Overall trial start date
01/10/2017
Overall trial end date
31/10/2019
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
1. Residents of the Metropolitan Area of Santiago (MAS), Chile
2. Born outside of Chile
3. Aged 18 or over
4. Lived in Chile for at least 3 months (updated 09/0/2019: for at least 6 months)
Added 09/08/2019: 5. Be able to provide informed consent (participants unable to understand Spanish will not be recruited)
Participant type
All
Age group
Adult
Gender
Both
Target number of participants
1100
Total final enrolment
1098
Participant exclusion criteria
1. Inability to read and write
2. Suffering from disability or condition which makes participation in survey difficult
3. Both parents Chilean-born
Recruitment start date
01/08/2019
Recruitment end date
18/10/2019
Locations
Countries of recruitment
Chile
Trial participating centre
Department of Psychiatry, School of Medicine of the Pontifical Catholic University of Chile
Av Libertador Bernardo O'Higgins 340
Santiago
8331150
Chile
Sponsor information
Organisation
Pontifical Catholic University of Chile (Pontificia Universidad Catolica de Chile)
Sponsor details
Av Libertador Bernardo O'Higgins 340
Santiago
8331150
Chile
+5622 354 8170
didemuc@med.puc.cl
Sponsor type
University/education
Website
Funders
Funder type
Government
Funder name
Comisión Nacional de Investigación Científica y Tecnológica
Alternative name(s)
National Commission for Scientific and Technological Research, CONICYT
Funding Body Type
government organisation
Funding Body Subtype
National government
Location
Chile
Results and Publications
Publication and dissemination plan
We intend to publish:
1. The study protocol in 2019
2. Cohort profile and prevalence estimates in 2019
3. Risk factors for affective disorders among immigrants in 2020
IPD sharing statement:
The datasets generated during and/or analysed during the current study are/will be available upon request from Dr. Antonia Errazuriz (anerrazuriz@uc.cl). The anonymized database will be made available from 01/01/2022 to researchers from known research centers based upon the quality of the research proposal brought forward. Participants will give consent to this.
Intention to publish date
01/11/2020
Participant level data
Available on request
Basic results (scientific)
Publication list