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Emotional distress, anxiety, and depression in South Asians with long-term conditions : a qualitative systematic review

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Awan, Hassan, Mughal, Faraz, Kingstone, Tom, Chew-Graham, Carolyn A. and Corp, Nadia (2022) Emotional distress, anxiety, and depression in South Asians with long-term conditions : a qualitative systematic review. British Journal of General Practice, 72 (716). e179-e189. doi:10.3399/bjgp.2021.0345 ISSN 0960-1643.

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Official URL: http://dx.doi.org/10.3399/bjgp.2021.0345

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Abstract

Background People with physical–mental comorbidity have a poorer quality of life, worse clinical outcomes, and increased mortality compared with people with physical conditions alone. People of South Asian (SA) origin are the largest minority group in the UK and are more likely to have long-term conditions (LTCs) such as diabetes and heart disease. People of SA origin are less likely to recognise symptoms that may represent mental health problems.

Aim To explore how people of SA origin with LTCs understand, experience, and seek help for emotional distress, depression, and anxiety.

Design and setting Systematic review of qualitative studies exploring emotional distress in people of SA origin with diabetes or coronary heart disease, within primary and community care settings worldwide.

Method Comprehensive searches of eight electronic databases from inception to 1 September 2021 were undertaken. Data extracted included study characteristics, and understanding, experience, and help-seeking behaviour for emotional distress. Thematic synthesis was undertaken. The Critical Appraisal Skills Programme (CASP) checklist for qualitative studies was used to assess quality of articles, and Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) used to determine the overall strength of evidence.

Results Twenty-one studies from 3165 unique citations were included. Three main themes were identified. Understanding of emotional distress: non-medical terminology used, such as ‘tension’, and a complex relationship between emotional and physical illness. Experiences of emotional distress: multiple forms of inequality, distress at diagnosis of their LTC, cultural factors, and sex differences. Help-seeking behaviour: self-management, support from family, friends, and faith, and inadequate clinical support.

Conclusion This review provides a greater understanding of the conceptualisation of emotional distress in the context of LTCs by people of SA origin, to support improvement in its recognition and management.

Item Type: Journal Article
Subjects: D History General and Old World > DA Great Britain
R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Academic Primary Care
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): South Asians -- Great Britain , South Asians -- Great Britain -- Health and hygiene, South Asians -- Great Britain -- Medical care, South Asians -- Mental health -- Great Britain , Anxiety disorders -- Great Britain , Depression, Mental -- Great Britain , Comorbidity -- Great Britain
Journal or Publication Title: British Journal of General Practice
Publisher: Royal College of General Practitioners
ISSN: 0960-1643
Official Date: March 2022
Dates:
DateEvent
March 2022Published
24 February 2022Available
29 November 2021Accepted
9 June 2021Submitted
Volume: 72
Number: 716
Page Range: e179-e189
DOI: 10.3399/bjgp.2021.0345
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 28 March 2022
Date of first compliant Open Access: 29 March 2022
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
216665/Z/19/ZWellcome Trusthttp://dx.doi.org/10.13039/100010269
216665/Z/19/ZWellcome Trusthttp://dx.doi.org/10.13039/100010269
NIHR300957[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
West Midlands Applied Research CollaborationUniversity of Warwickhttp://dx.doi.org/10.13039/501100000741

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