Physical inactivity is strongly associated with anxiety and depression in Iraqi immigrants to Sweden: a cross-sectional studyReport as inadecuate

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BMC Public Health

, 14:502

Chronic Disease epidemiology


BackgroundIncreasing evidence on associations between mental health and chronic diseases like cardio-vascular disease and diabetes together with the fact that little is known about the prevalence of anxiety-depression and associated risk factors among Iraqi immigrants to Sweden, warrants a study in this group. The aim was to study the prevalence of anxiety and depression in immigrants from Iraq compared to native Swedes and compare socioeconomic and lifestyle-related factors associated with these conditions.

MethodA population-based, cross-sectional study of residents of Malmö, Sweden, aged 30–75 years, born in Iraq or Sweden. The overall response rate was 49% for Iraqis and 32% for Swedes. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Associations were studied using multivariate logistic regression models. The outcome was odds of depression and-or anxiety.

ResultsCompared to Swedes n = 634, anxiety was three times as prevalent 52.6 vs. 16.3%, p < 0.001 and depression five times as prevalent 16.3 vs. 3.1%, p < 0.001 in Iraqi immigrants n = 1255. Iraqis were three times more likely to be anxious and-or depressed compared to Swedes odds ratio OR 3.02, 95% confidence interval CI 2.06-4.41. Among Iraqis, physical inactivity <150 min-week OR 2.00, 95% CI 1.49-2.69, economic insecurity OR 2.16, 95% CI 1.56-3.01, inability to trust people OR 1.75, 95% CI 1.28-2.39 and smoking OR 1.43, 95% CI 1.02-2.01, were strongly associated with anxiety-depression. Among Swedes, living alone OR 2.10, 95% CI 1.36-3.25 and economic insecurity OR 2.38, 95% CI 1.38-4.12 showed the strongest associations with anxiety-depression. Country of birth modified the effect of physical inactivity Pinteraction =0.058 as well as of marital status Pinteraction =0.001.

ConclusionOur study indicates that economic insecurity has a major impact on poor mental health irrespective of ethnic background but that physical inactivity may be more strongly associated with anxiety-depression in immigrants from the Middle East compared to native Swedes. Preventive actions emphasizing increased physical activity may reduce the risk of poor mental health in immigrants from the Middle East, however intervention studies are warranted to test this hypothesis.

KeywordsAnxiety Depression Physical activity Immigrants Middle East Sweden AbbreviationsBMIBody mass index

CIConfidence interval

HADSHospital anxiety and depression scale

OROdds ratio

WHOWorld Health Organization.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2458-14-502 contains supplementary material, which is available to authorized users.

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Author: Faiza Siddiqui - Ulf Lindblad - Louise Bennet



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