Prevalence of Major Depression Among Immigrants in Santiago, Chile (STRING)

The Santiago Immigrant Wellbeing Study (STRING): Prevalence of Mood Disorders Among Immigrants in Santiago, Chile

The general aim of this study is to explore the prevalence of major depressive disorder and the use of mental health services in the immigrant populations in the Metropolitan Region of Santiago, Chile.

The hypotheses are:

1. A healthy immigrant effect will be observed in the studied population by which their prevalence of major depressive disorder 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 major depressive disorder.
3. A significant association will be observed between the report of victimization experience(s) in the previous year and a greater probability of major depressive disorder.
4. A significant association will be observed between financial difficulties and a greater probability of major depressive disorder.

The sampling framework of the Chilean National Institute of Statistics (INE) from the 2016 Census will be used for the purpose of this research. The sampling units are as follows:

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 (n=1,100) 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) looking at exploring 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
6. Experience of childhood adversity

Study Overview

• Status: Completed
• Conditions: Major Depressive Disorder

• Study Type: Observational
• Enrollment (Actual): 1092

Contacts and Locations

Study Locations

• Chile
  • RM
    • Santiago, RM, Chile, 7550139
      • Pontificia Universidad Catolica de Chile

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

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 3 months

Description

Inclusion Criteria:

• Country of birth other than Chile
• Time since arrival to Chile: 3 months

Exclusion Criteria:

• Unable to understand Spanish

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Major Depressive Disorder	Assessed using the World Health Organisation Composite International Diagnostic Interview (WHO-CIDI)	baseline
Any affective/mood disorder	Assessed using the WHO-CIDI	baseline
Suicidal ideation, plans and attempts	Assessed using the WHO-CIDI	baseline
Depressive symptoms	Assessed using the nine-item Patient Health Questionnaire (PHQ-9). The PHQ-9 score can range from 0 to 27, with the following severity scores: 0-4 None; 5-9 Mild; 10-14 Moderate; 15-19 Moderate to Severe; 20-27 Severe.	baseline
Anxiety symptoms	Assessed using the Generalized Anxiety Disorder 7-item scale (GAD-7). The GAD-7 score can range from 0 to 21, with the following severity scores: 0-4 None; 5-9 Mild; 10-14 Moderate; 15-21 Severe.	baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mental wellbeing	Assessed using the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS). The 14 Items are scored on a range from 1 to 5, providing a total score between 14 and 70 with higher values indicating higher mental well-being.	baseline
Mental health service use	Assessed using items of the Services Module of the WHO-CIDI	baseline
Hazardous/harmful drinking	Assessed using the Alcohol Use Disorders Identification Test (AUDIT)	baseline

Collaborators and Investigators

• Sponsor: Pontificia Universidad Catolica de Chile
• Collaborators: Fondo Nacional de Desarrollo Científico y Tecnológico, Chile

Publications and helpful links

Helpful Links

• ISRCTN registry

Study record dates

Study Major Dates

• Study Start (Actual): July 29, 2019
• Primary Completion (Actual): November 30, 2019
• Study Completion (Actual): June 30, 2020

Study Registration Dates

• First Submitted: September 30, 2019
• First Submitted That Met QC Criteria: October 2, 2019
• First Posted (Actual): October 3, 2019

Study Record Updates

• Last Update Posted (Actual): July 31, 2020
• Last Update Submitted That Met QC Criteria: July 29, 2020
• Last Verified: July 1, 2020

More Information

Terms related to this study

• Keywords: major depressive disorder; prevalence; mood disorders; affective disorders; global mental health; service use; migration health
• Additional Relevant MeSH Terms: Behavioral Symptoms; Mental Disorders; Mood Disorders; Depression; Depressive Disorder; Depressive Disorder, Major
• Other Study ID Numbers: 17051004; 96875479 (Registry Identifier: ISRCTN)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: IPD (database, dictionary) will be made available to researchers upon request.
• IPD Sharing Time Frame: 3 years after data collection ends
• IPD Sharing Access Criteria: Researchers with interest in mental health, particularly migration mental health
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No