Depressive Symptoms among Urban Kurdish Refugees and Immigrants

Purpose: Being elderly and having refugee or migrant status pose a dual risk for depression. Members of this population are often isolated, physically or linguistically, with limited opportunities for culturally appropriate activities. Thus, the purpose of this study was to explore the prevalence of depressive symptoms among the elderly Kurdish immigrant and refugee population living in Nashville, Tennessee. Nashville has the largest population of Kurds living outside of Kurdistan, but as is the case for many immigrant and refugee groups, little empirical research exists to aid practitioners in addressing the unique needs of this population.

Method: The study utilized an exploratory design consisting of face-to-face interviews, with a nonrandom sample of Kurds aged 50 or over using a snowball sampling technique. Interviews were conducted at the Kurdistan Cultural Institute or participants' homes by trained bi-lingual interviewers. The questionnaire included the Geriatric Depression Scale (GDS) and the Migratory Grief and Loss Questionnaire (MGLQ).

A total of 70 Kurdish immigrants and refugees (47% male and 53% female) between 50 – 79 years of age (M=59, SD=7.0) agreed to participate in the study. Length of residency in the U.S. ranged from 9 - 30 years (M=12.6, SD = 3.5), and 71% reported having refugee status, 23% asylum, and only 6% reported immigrant status. All participants (100%) reported Islam as their religion. Only 1% of subjects cited English as a secondary language, but many more reported varying levels of proficiency in reading, speaking and understanding some English.

Results: The mean GDS score was 13.5 (SD = 7.4). One-third of participants (32.9 %) scored in the normal/average range, 41.4% had scores indicating mild depression, and 25.7% had scores placing them in the range for severe depression. There was a significant but limited correlation between GDS scores and total scores on the MGLQ. Further analysis, however, revealed a slightly stronger correlation between GDS scores and the MGLQ subscale of disorganization. Female participants' scores were consistently higher than males, regardless of the scale or subscale used.

Conclusions and Implications: Due to the nonrandom sample, it would be inappropriate to generalize beyond the sample group. The information gathered, however, serves as a glimpse into the needs of this unique population. This study revealed that depression is a considerable concern for this sample. Compared to current statistics from the NIH (2007), this sample reported severe depression at a rate of four times greater than the general U.S. population. In planning for changes in policy and practice, it is important to remember that depressive symptoms may develop many years after resettlement and that long-term monitoring for symptoms is recommended. The present study revealed depressive symptoms among participants 10, 20 and 30 years after arrival in the U.S. Professionals who work with this population beyond the initial resettlement period should be trained to identify the early signs of depression among their elderly clients and administer a brief depression assessment in routine examinations, as overburdened multicultural practitioners often overlook depressive symptoms.