Family functioning and depression among Albanian migrants and Greeks in a rural area in Greece
Background: Albanian immigrants consist a large ethnic minority group in Greece and a significant proportion of local population in many areas of the country, including rural areas, such as in the Cyclades Islands (1). Even though migrants and their families are to various degrees integrated in the life of local communities, the factors associated with family dynamics and their relation to common mental health issues have not been much studied. There is evidence supporting an association between aspects of family dynamics and depression in adults (2-3). The aim of the current study was to explore the relationship between depressive symptomatology and family functioning in Albanian immigrants in a rural area in Greece. A comparison between Albanians and Greek natives was also made, in order to investigate if there were differences between the two ethnic groups, regarding the specific dimensions of family functioning associated with depressive symptomatology.
Methods: The sample consisted of 204 adult service users, 105 (51,5%) Greeks and 99 (48,5%) Albanians, who sought help from the Mental Health Mobile Unit (EPAPSY-NGO) in Paros and Antiparos islands, during the years 2012-2016. The Family Assessment Device (FAD) (4-5) was used to assess perceived family functioning and the Centre for Epidemiologic Studies Depression Scale (CES-D) (6) was used to measure the current level of depressive symptomatology. Additional data was also recorded for every participant, including sociodemographic characteristics and psychiatric diagnosis (assigned by the psychiatrist).
Results: More Greek service users in comparison to Albanians were categorised as perceiving to have healthy family functioning in the domains of ‘Communication’ (25.5% vs 10.1%, p<0.05) and ‘Affective Responsiveness’ (21% vs 6.6%, p<0.05) (according to the cut-off scores of FAD). Irrespective of nationality, better family functioning was related to less depressive symptoms. In Albanians, the specific dimension of family functioning referring to ‘Behaviour Control’ was independently associated with the score in depression scale, while in Greeks the ‘Problem Solving’ dimension was found to be significantly associated with depressive symptomatology.
Conclusions: Differences were detected in certain domains of perceived family functioning between Albanian immigrants and Greek natives, regarding the categorization of healthy/unhealthy functioning. Association of family dynamics with depressive symptomatology was detected in both ethnic groups. Patterns of interaction in Albanian families, as expressed in roles, hierarchy, rules or standards, expectation of behaviour and discipline (Behaviour Control dimension of family functioning) were found to be related, independently of other factors, to depressive symptomatology. When working with migrants, it is important to evaluate different dimensions of family functioning and take them into consideration in order to improve prevention and intervention strategies developed by mental health services.