Comorbidity of anxiety and depressive disorders: A comparative population study in Western and non-Western inhabitants in the Netherlands

Background: Overlap of depressive and anxiety symptoms is supposedly more common in non-Western populations. This can lead to diagnostic uncertainity and undertreatment. Aims: The aim of this study was to assess cross-cultural differences regarding the comorbidity of anxiety and depressive disorders in a comparative population study. Methods: In a random urban population sample, stratified for descent, in Amsterdam, the Netherlands, diagnostic interviews were held by bilingual interviewers. Diagnoses of anxiety and depressive disorders, based on the Composite International Diagnostic Interview, were obtained for 307 native Dutch subjects, 205 Turkish-Dutch subjects and 186 Moroccan-Dutch subjects. Results: The prevalence rate of comorbid anxiety and depressive disorders was higher in Turkish-Dutch (9.8%) and Moroccan-Dutch (3.8%) subjects compared to native Dutch subjects (2.3%). However, this could be explained by differences in baseline prevalence rate and level of severity of the separate disorders. The onset order of anxiety disorders and depressive disorders was comparable in each ethnic group. Conclusions: The high prevalence rate of comorbid anxiety and depressive diorders in non-Western immigrants in the Netherlands necessitates assesssment and treatment of both disorders. There was no indication of a - culturally influenced - stronger overlap between anxiety and depressive disorders in non-Western immigrants in the Netherlands.