Immigration status and depression in Spain: analysis of the European Health Interview Surveys of 2014 and 2020

Objective: We examined the association between immigration status and depression in a nationally representative sample of adults in Spain. In addition, we assessed whether this association differed by sex/gender and social support. Method: We used de-identified data from the European Health Interview Survey conducted in Spain in 2014 (n = 21,226) and 2020 (n = 20,136). Our study outcomes were self-reported diagnosis of depression and antidepressant use. We fitted Poisson regression models to quantify the association between immigration status and each outcome, before and after adjusting for age, sex/gender, marital status, educational level, employment status, smoking status, healthcare use, social support, and self-rated health. We obtained prevalence ratios (PR) and 95% confidence intervals (95%CI). We also tested interaction terms to evaluate whether the associations of interest differed by survey year and further by sex/gender and with social support. Results: In 2014 and 2020, we observed a lower prevalence of depression among immigrant adults than among native Spanish adults (adjusted PR2014 = 0.53, 95%CI: 0.40- 0.70; PR2020 = 0.71, 95%CI: 0.55-0.91). However, for antidepressant use, this association was significant only in 2014 (adjusted PR2014 = 0.36, 95%CI: 0.24-0.55). Although the association of immigration status with antidepressant use differed with survey year, these associations did not change with sex/gender or social support. Conclusions: Our findings call attention to depression and mental health-related outcomes in Spain, regardless of immigration status, sex/gender or social support. (c) 2024 SESPAS. Published by Elsevier Espanta, S.L.U. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).