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Yıl:2016; Cilt: 53; Sayı: 1>> Özet
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Nöropsikiyatri Arşivi; 2016;53(1):69-76
Psikoterapide Tek Beden Herkese Uymuyor: Avrupa’da Yaşayan Türkiye Kökenli Hastalarda Depresyonu Anlamak
NB Neftçi, S Barnow
Işık Üniversitesi, İstanbul
Son yıllarda Avrupa, yaklaşık olarak 56 milyon uluslararası göçmen barındıran bir göç bölgesi haline gelmiştir. Bunula birlikte, göçün, depresyon ve anksiyete bozuklukları gibi sık görülebilen psikiyatrik bozukluklarda artışa neden olduğunu belirten çalışmalar bulunmaktadır. Avrupa’da yapılan çalışmalar, en kalabalık göçmen gruplarından biri olan Türkiye kökenli göçmenlerde, depresyon ve anksiyete bozukluklarının yaygınlığının, genel nüfusa kıyasla daha yüksek olduğunu göstermektedir. Buna rağmen, yine bu grubun, Avrupalı hastalara kıyasla tedaviye uyum sağlamakta daha çok güçlük çektikleri hatta tedaviyi erken sonlandırma eğiliminde oldukları yapılan araştırmalarla ortaya konmuştur. Batılı olmayan toplumların (ör: Türkiye), ruh sağlığı ve hastalıkları ile ilgili nosyon ve anlayışlarının, batılı toplumlarınkinden farklı olması, göçmen hastaların sağlık hizmetlerinden yararlanmaktan kaçınmalarına yol açabilmektedir. Anlayışlar arasındaki bu farklılıklar ise, göçmen hastalar ve batılı klinisyenler arasındaki iletişimi dolayısıyla tedavinin etkinliğini zayıflatarak tedaviyi bırakma oranlarında açıklanamayan artışlara yol açabilmektedir. Kültüre duyarlı, kaliteli ve kanıta dayalı ruh sağlığı hizmetlerinin sağlanabilmesi adına, hasta ve klinisyenlerin ruh sağlığına ilişkin anlayışları arasındaki sosyokültürel farklılıkları keşfetmeye yönelik araştırmaların artması bir gerekliliktir. Buna yönelik olarak, bu makalede ruh sağlığı ve kültür arasındaki etkileşim ve bu etkileşimin Türk göçmen hastalarda depresyonu tetikleyen ve devam ettiren faktörler ile ilişkileri incelenmiştir. Buradaki amaç, bu hasta grubunun beklentilerine ve ihtiyaçlarına uygun müdahalelerin sunulabilmesi adına, klinisyenlere depresyonun kültürel öğeleri hakkında bilgi sağlamaktır.
One Size Does Not Fit All in Psychotherapy: Understanding Depression Among Patients of Turkish Origin in Europe
Over the last decades, Europe has become an immigration country hosting an estimated 56 million international immigrants. Yet, a large amount of literature suggests that migration is associated with a higher risk of common mental disorders, such as depression and anxiety. As representatives of one of the largest immigrant groups in Europe, various studies have shown that Turkish immigrants exhibit a higher prevalence of depression and anxiety disorders than do the background population. Nevertheless, it is also well demonstrated that this particular patient group is more likely to terminate treatment prematurely and displays lower rates of treatment compliance than their native counterparts. This reluctance for service utilization might be partially because of the fact that people from non-Western ethno-cultural backgrounds (e.g., Turkey) often have a different notion and comprehension of mental health and illness as compared with those of the people from Western societies. Such mismatch often results in discrepancies between the needs and expectations of immigrant patients and clinicians, which attenuate the communication and effectiveness of treatment and lead to unexplained high dropout rates. To provide continued provision of culture-sensitive, high quality, evidence-based mental health care, the advancement of researches exploring such sociocultural differences between the patients’ and the clinicians’ notions of mental health must occur. In response to these problems, the current review aims to explore the interplay between culture and mental processes that associate with the etiology, maintenance, and management of depression among Turkish immigrant patients. This is to inform clinicians regarding culture-specific correlates of depression among Turkish patients to enable them to present interventions that fit the needs and expectations of this particular patient group.

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