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are listed by Turkish immigrants in Berlin, for example the most
frequent listing of the term “depression”, listing of “fears” and
“schizophrenia” (see table 1). In contrast they do not appear
among the most frequently listed terms of the Turkish group
in Istanbul.
Another interesting result is that both Turkish groups use
specifi c Turkish terms for which there is no equivalent expression
in the German or English language, as for example”rahatsızlık”
which comes close to the meaning of “not feeling well” or
„sıkıntı” that might be translated as “distress/annoyance”.
Regarding the meaning of psychological problems (Table 2),
the terms “exclusion” and “restrained life” were only mentioned
by the two groups in Germany. Additionally, the native Germans
named some categories that do not appear among the most mentioned
terms in the other groups, as “anxiety, fears”, “problems
in dealing with other people”, “problems in coping with daily
life”, “family and friends suffer as well”, “somatic complaints”
and “low self- esteem”. Both Turkish groups list the categories
“being sad/unhappy” and “bad thing”.
Also the categories concerning causes for mental disorders
or psychological problems vary between the different groups.
Native Germans as well as Turkish immigrants list “childhood/
upbringing”, “stress” and “loss of a beloved person” often as
cause, but the other terms named by these two groups differ
from each other. The native Germans list categories like
“trauma”, “genetic”, “severe experiences”, “work” and “drugs”
while these categories do not seem to be equally important for
Turkish immigrants. The latter list “family problems” relatively
often as well as “pressure”, which were listed by Turks in Istanbul
as well. Turks in Istanbul list also “genetic” causes relatively
often, in which they resemble the German group.
With regard to possible advice or help (Table 4) differences
between the groups are not as strong as for the other questions.
The categories resemble each other in the three included groups.
Only two German answers are not found in the other groups:
“psychotherapy/ psychotherapist” and “counselling offi ces”. The
answers of both groups in Germany resemble each other in the
terms “doctor”, “psychologist”, “talk”, “friends” and “to distract
yourself”. Turkish people in Istanbul put an emphasis on professional
help like “psychiatrist” and “psychiatry”, “psychologist”
and “doctor” which are terms that appear only partly in the
other groups. Terms that are connected to traditional healers
are missing in both Turkish groups.
Although there are similarities between the groups, the results
suggest that the differences are linked to cultural background.
However, when evaluating the data in each group in more detail
and aggregating them by educational background, the variations
within a group turn out to be as big as the intra- group differences
observed so far. We will exemplify this fact with the answers of
the two groups in Germany to question 3 (causes of psychological
problems/mental disorders) (Table 5 and 6).
In the German group the categories “trauma”, “genetic” und
“severe experiences” are named by university graduates as well
as non- graduates, but the university graduates most frequently
mention “work”, “experience of violence” and “drugs” while the
non- graduates list “diffi cult childhood/problems in upbringing”,
“loss of a beloved person” and “stress”.
In the group of Turkish immigrants, the categories differed
substantially according to university degree. Only the terms
A. Vardar et al. / European Psychiatry 27 (2012) / supplement n°2 / S50-S55 S53
Table 5
Most mentioned categories regarding causes of psychological problems/
mental disorders in the German group.
German university graduates German non- graduates
Trauma (35%)
Genetic (35%)
Work (e.g. stress, discontent,
hierarchies) (29%)
Severe experiences (e.g. accidents,
shock situations) (27%)
Experience of violence
(e.g. domestic violence,
war, rape) (21%)
Drugs (21%)
“pressure” and “anxiety, fears” is mentioned by both sub- groups.
Besides that, university graduates mention “childhood/upbringing”,
“problems with environment”, “genetic” and “fi nancial
problems poverty” while non- graduates mentioned “family
problems”, “problems with partner”, “stress” and “loss of a
beloved person” most often. Especially the categories “family
problems” and “problems with partner” are thus put into perspective
as it becomes obvious that these terms are more relevant
for the sub- group of non- graduates with Turkish immigration
background and not for the Turkish group in Germany as a whole.
In summary, the data show that some of the listed terms are
specifi c to cultural background or immigration status. At the
same time there are similar differences in terms according to
subgroups, shown by the example of persons with and without
a university degree. In general the inventory of knowledge
about mental health issues appears to be very broad in all the
groups and it is barely possible to identify a “cultural” consensus
concerning certain categories as even the most mentioned terms
were named by not more than half of the interviewees.
Proofs
4. Discussion
Diffi cult childhood,
problems in upbringing (41%)
Loss of a beloved person (27%)
Genetic (24%)
Severe experiences (e.g. accidents,
shock situations) (21%)
Trauma (21%)
Stress (21%)
Table 6
Most mentioned categories regarding causes of psychological problems/
mental disorders in the Turkish immigrant group.
University graduates with Turkish
immigration background
Pressure (43%)
Childhood/upbringing (29%)
Problems with environment (25%)
Genetic (24%)
Anxiety, fears (19%)
Financial problems poverty (19%)
Non- graduates with Turkish
immigration background
Family problems (49%)
Problems with partner (22%)
Stress (18%)
Loss of a beloved person (16%)
Anxiety, fears (13%)
Pressure (13%)
The main fi ndings are that the answers in each group are very
heterogeneous and thus it is diffi cult to name specifi c vocabulary
that is unique for one group. The analysis of listed categories thus
shows diverse results as the differences between the groups are
as big as the differences within one group.
Concerning the answers of the group of Turkish immigrants
with lower education degrees, the question is raised if for this group
psychic stress results from family problems and is expressed in
social terms. However, counselling institutions (social institutions
where social workers work) were not named spontaneously as a
help possibility although these answer the needs of people with
family problems in the German psycho- social health care system.
Concerning resources in handling mental health problems
it can be stated that all three groups name professional help,