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S24 A. Heredia Montesinos et al. / European Psychiatry 27 (2012) / supplement n°2 /S22-S26
socio- demographic data were assessed: age, education level,
income, marital status, number of children, region of origin
(urban vs. rural), and years in Germany.
2.3.2. Explanatory Model Interview Catalogue (EMIC)
Stigma Scale
The Explanatory Model Interview Catalogue (EMIC) [23] is a
catalogue of instruments used to study different cultural and epidemiological
aspects of a health condition. It has been used to measure
attitudes and perceptions regarding a number of health conditions
in different cultural settings. For this study only its Stigma Scale
was used. The EMIC Stigma Scale covers certain areas of life that
may be affected by stigma, namely, concealment, avoidance, pity,
shame, being made fun of, respect and marriage (prospects). It is
composed of 13 statements which are ranked from 0 to 3 (0=no,
1=not sure, 2=maybe, 3=yes). Since there is no German or Turkish
version of the EMIC, the Stigma Scale was translated and translated
back into both languages by professional translators.
2.3.3. Beck Depression Inventory II (BDI)
The Beck Depression Inventory II (BDI) is a self- report screening
instrument for measuring the severity of depression [1].
The inventory is composed of 21 items relating to depressive
symptoms (hopelessness and irritability), cognitions (guilt or
feelings of being punished), and physical symptoms (fatigue,
weight loss, and lack of interest in sex). Statements are marked
which have been true during the past two weeks. Each item
consists of 4 statements that range from mild/neutral (mild=0)
to severe (severe=3). The severity of depression is divided into
four groups: 0–13: minimal depression; 14–19: mild depression;
20–28: moderate depression; and 29–63: severe depression.
Higher total scores indicate more severe depressive symptoms.
2.3.4. The Screening for Somatoform Symptoms II (SOMS- II)
The SOMS II [17] is a self- report screening instrument for
53 physical symptoms. It includes all 33 physical complaints of the
DSM- IV somatization disorder symptom list, the symptoms of ICD-
10 somatization disorder, and the ICD- 10 somatoform autonomic
dysfunction symptom list. It assesses whether the listed physical
symptoms were experienced during the last two years (yes/no).
2.3.5. The Symptom Checklist- 90- Revised (SCL- 90- R)
The Symptom Checklist- 90- Revised (SCL- 90- R) is a self-
report screening measure of general psychiatric symptomatology
with 90 items [3]. It includes subscales measuring somatization,
obsessive- compulsive, depression, anxiety, phobic anxiety,
hostility, interpersonal sensitivity, paranoid ideation, and psychoticism.
The severity of experiences with each symptom over
the past week is rated on a 5- point scale ranging from 0 (not at
all) to 4 (extremely). The SCL- 90- R has three global indices. The
Global Severity Index (GSI) measures the overall psychological
distress, the Positive Symptom Distress Index (PSDI) measures
the intensity of symptoms, and the Positive Symptom Total (PST)
reports the number of self- reported symptoms.
2.4. Data analysis
Statistical analyses were performed with SPSS, Version 19.
Pearson´s correlations were performed to examine the association
between EMIC Stigma Scale, BDI II, SCL- 90, and SOMS- II. To explore
the infl uence of severity of depression on the association between
stigma and somatic symptoms, the sample was divided into two
groups according to the severity of the depression (group 1: BDI>28
vs. group 2: BDI