Treating Moroccan an Turkish migrants with depression and anxiety disorders (MIDA study).

Since the sixties of the last century, many people from Morocco and Turkey have migrated into the Netherlands. Depressive and anxiety symptoms are very common among these immigrants. In the last decade, Moroccan and Turkish patients have found their way to organizations for mental health care. However, they often drop-out from treatment.


Problems in the communication with the therapists and different expectations regarding treatment seem to be causal factors for the early drop- out from therapy .


The main objective of the study is to optimalize the treatment of Moroccan and Turkish patients with depressive and/or anxiety disorders by increasing the cultural competence of the mental health workers.
A randomized clinical trial will be performed.


Turkish and Moroccan patients (18-65) who are referred to an outpatient clinic for mood and anxiety disorders will be randomly assigned to mental health workers who are trained in the intercultural module and to those who are not. Exclusion criteria: organic brain syndrome, psychotic disorder, bipolar disorder, severe personality disorder, substance abuse as the primary diagnosis.


Intervention: Therapists will be trained in the cultural interview and in techniques bridging the (cultural) gaps between them and their patients.


Dropout is the primary outcome measure.


The study will give an answer to the question whether increasing cultural competence of the therapists reduces drop-out from treatment.

Increasing the intercultural competence of mental health workers will reduce therapy dropout in Moroccan and Turkish patients with depressive and anxiety disorders.

1. T0: baseline measurement;

2. T1: six months follow up;

3. T2: 12 months follow up.

The mental health workers will be trained in using the Cultural Formulation and in techniques bridging the cultural gaps between them en the Turkish and Moroccan patients.