Respiratory diseases are a leading cause of morbidity and mortality worldwide, particularly during the COVID-19 pandemic. The aim of this study is to examine respiratory disease-related to morbidity and mortality in Turkey during the COVID-19 pandemic (2020 and 2021).
OBJECTIVES:The evidence remains insufficient and controversial for evaluating modifiable parameters-such as vitamin D, calcium, ferritin, and uric acid-as preclinical biomarkers to contribute to the prevention and early diagnosis of prostate cancer, a disease with a prevalence of up to 10%-20% in men over 50 and strongly associated with environmental factors including diet (high in fat and red meat), obesity, physical inactivity, and carcinogen exposure. This study aims to investigate the potential biomarker role of vitamin D, calcium, ferritin, and uric acids in reducing the risk of prostate cancer (PCa). METHODS:The case-control design was employed, involving 496 PCa cases and 496 controls aged 35 and above. Data collection included sociodemographic details, radiological findings, clinical history, and biochemical markers. RESULTS:Advanced age, cigarette and hookah use, alcohol consumption, processed food intake, chemical exposure, obesity, poor dietary habits, stress, and reduced sleep duration were more prevalent in the PCa group (p < 0.05). Symptoms such as hematuria, anemia, infections, and fatigue were significantly increased (p < 0.001). Hypocalcemia (p < 0.001), vitamin D deficiency (p < 0.001), elevated uric acid levels (p < 0.001), increased ferritin (p = 0.005), and elevated systolic blood pressure (p = 0.004) were identified as key risk factors. CONCLUSION:The current study suggests that vitamin D, calcium, ferritin, and uric acids may serve as promising biomarkers for the detection of PCa. The rising incidence of PCa could be attributed to lifestyle, environmental, and hereditary factors, nutrition, alcohol consumption, hookah use, and cigarette smoking.
OBJECTIVE:This study aims to investigate the determinants of treatment non-compliance among psychiatric patients by exploring related factors. METHODS:This is a cross-sectional study including patients hospitalized for psychiatric disorders and aged between 25 and 70 years in Istanbul, Turkey. 1648 patients were approached and 1310 (79.5 %) agreed to participate. A set of sociodemographic and clinical variables were collected as well as the Turkish Version of the 9-item Patient-Doctor Relationship Questionnaire (PDRQ-9) was administered. Statistical analyses included t-tests, chi-square tests, factor analysis, Confirmatory Factor Analysis, and computation of the Lorenz curve and Gini index. RESULTS:Of 1310 patients, 761 (58.1 %) were compliant with treatments while 549 (41.9 %) were considered as non-compliant. Patients aged above 60 years were significantly less represented in the compliant group of patients (p = 0.008). Non-compliant patients were more like to be obese (p = 0.046), cigarette smokers (p = 0.019), nargileh-hookah users (p = 0.037), and perform less physical exercise (p = 0.044). Patients diagnosed with schizophrenia (p = 0.034), bipolar disorder (p = 0.016), depression (p = 0.008), obsessive-compulsive disorder (p = 0.015) and dementia/Alzheimer's disease (p = 0.003) were more likely to be compliant with treatments whereas patients affected by stress or post-traumatic stress disorder were significantly less complaint (p = 0.015 and p = 0.006, respectively). The main factors contributing to non-compliance included lack of social supervision and family support (p < 0.001), not regular attendance of the mental health services (p = 0.016), lack of insight towards treatments (p = 0.0124), lack of satisfaction with the doctor (p = 0.021), lack of education regarding medications side effects (p < 0.001), and poor perceived improvement with treatment (p = 0.005). Concurrently, the exploratory and confirmatory factor analyses confirmed validity and psychometric characteristics of the Turkish version of the 9-item Patient-Doctor Relationship Questionnaire (PDRQ-9). CONCLUSION:This study reported a high prevalence rate of non-compliance among psychiatric patients. An empathetic patient-doctor approach, shared decision making as well as socially supportive and psychoeducational interventions are potentially useful for improving patients' attitudes toward treatments and their compliance.
INTRODUCTION:This study aimed to navigate the relationship between cigarette smoking, alcohol consumption, sleeping disorder, mental health and hearing loss in stroke patients. METHODS:This was a cross-sectional study that involved 1040 male and female patients aged 25-65 years. The research utilized physical examinations, radiological assessments, biochemical tests, and pure-tone audiometry (PTA) to evaluate hearing function. RESULTS:Among the 1040 stroke patients, 219 cigarette smokers (21.6%) were found to have hearing loss. Remarkable dissimilarities were observed in three categories: cigarette smokers with hearing loss, cigarette smokers without hearing loss, and non-smokers without hearing loss. These differences were noted in BMI (p<0.001), physical activity (p=0.002), hypertension (p<0.001), MP3 use (p<0.001), tinnitus (p<0.001), vertigo (p<0.001), dizziness (p<0.001), and headaches/migraines (p<0.001). Similarly, significant differences were identified among cigarette smokers with hearing loss, cigarette smokers without hearing loss, and non-smokers in relation to age (p<0.001), BMI (p<0.001), MP3 use (p=0.004), hypertension (p=0.028), ATP III metabolic syndrome (p<0.001), IDF metabolic syndrome (p<0.001), tinnitus (p<0.001), vertigo (p<0.001), dizziness (p=0.012), headaches/migraines (p<0.001), vitamin D (p<0.001), calcium (p<0.001), magnesium (p<0.001), potassium (p=0.019), fasting glucose (p<0.001), hemoglobin A1c (p<0.001), high blood pressure (p<0.001), microalbuminuria (p<0.001), and sleepiness (p=0.014). Multivariate stepwise regression analysis of cigarette smokers among stroke patients showed that vertigo (p<0.001), obesity (p<0.001), vitamin D deficiency (p<0.001), ATP III metabolic syndrome (p<0.001), IDF metabolic syndrome (p=0.004), calcium levels (p=0.008), headaches/migraines (p=0.039), and hypertension (p=0.025) could predict hearing loss. CONCLUSIONS:This study puts forward that smoking cigarettes along with factors like hypertension, obesity, vitamin D deficiency, and sleepiness, serve as notable danger element for loosing hearing ability among stroke patients. There is increasing evidence linking cigarette tobacco smoking to lung cancer and various adverse health effects.
Aim: The aim to investigate and assess role of COVID-19 on Coronary Heart Disease (CHD) mortality using Bayesian Lorenz Curve and associated Gini Index Statistical Method: Bayesian estimation was applied to analyze CHD mortality rates, focusing on both gender and age group differences. Application: A total of 341,467 patients were treated during 2-year period from 2020 to 2021during COVID-19 in Turkey. 195,413 females and 146,054 males were diagnosed and 155,211 deaths where 88,824 were males and 66,387 were females with CHD, and hence were studied to evaluate whether female gender was an independent predictor for poor prognosis. Results: Mortality rates increase with age for females compared to males. The model suggests that males have higher risks or proportions across all groups compared to females, particularly in older age categories. The Lorenz curves for both genders show that a significant portion of deaths is concentrated in a relatively small subset of age groups, particularly older adults. The Gini Index regarding mortality for males is found to be 0.123 compared to value of 0.384 associated with female's age distribution. Meanwhile, the Gini Index regarding morbidity for males (0.146) and females (0.394) are very similar, suggesting that the patterns of inequality in morbidity distribution are comparable across genders. Conclusion: The study highlights the effectiveness of empirical Bayesian techniques in estimating CHD-related COVID-19 mortality rates across Turkey. It suggests that such statistical methods can help allocate resources more efficiently to high-risk areas and to ensure fair resource distribution and healthcare interventions.
AimThis study explores the predictors and associated risk factors of sleep quality, quality of life, fatigue, and mental health among the Turkish population during the COVID-19 post-pandemic period.Materials and methodsA cross-sectional survey using multi-stage, stratified random sampling was employed. In total, 3,200 persons were approached. Of these, 2,624 (82%) completed the questionnaire package consisting of socio-demographic information, Pittsburgh Sleep Quality Index (PSQI), the WHO Quality of Life Brief Version (WHOQOL-BREF), Fatigue Assessment Scale (FAS), Patients Health Questionnaire (PHQ-15), GAD-7 anxiety scale, and the 21-item Depression, Anxiety, Stress Scale (DASS-21).ResultsSignificant differences between genders were found regarding socio-demographic characteristics (p < 0.01). Using PHQ-15 for depressive disorders, significant differences were found between normal and high severity scores (≥ 10), regarding age group (p < 0.001), gender (p = 0.049), educational level (p < 0.001), occupational status (p = 0.019), cigarette smoking (p = 0.002), waterpipe-narghile smoking (p = 0.039), and co-morbidity (p = 0.003). The WHOQOL-BREF indicated strong correlations between public health, physical health, psychological status, social relationships, environmental conditions, and sleep disorders (p < 0.01). Furthermore, comparisons of the prevalence of mental health symptoms and sleeping with PHQ-15 scores ≥ 10 (p = 0.039), fatigue (p = 0.012), depression (p = 0.009), anxiety (p = 0.032), stress (p = 0.045), and GAD-7 (p < 0.001), were significantly higher among the mental health condition according to sleeping disorder status. Multiple regression analysis revealed that DASS21 stress (p < 0.001), DASS21 depression (p < 0.001), DASS21 anxiety (p = 0.002), physical health (WHOQOL-BREF) (p = 0.007), patient health depression-PHQ-15 (p = 0.011), psychological health (WHOQOL-BREF) (p = 0.012), fatigue (p = 0.017), and environmental factors (WHOQOL-BREF) (p = 0.041) were the main predictor risk factors associated with sleep when adjusted for gender and age.ConclusionThe current study has shown that sleep quality was associated with the mental health symptoms of depression, anxiety, stress, and fatigue. In addition, insufficient sleep duration and unsatisfactory sleep quality seemed to affect physical and mental health functioning.
Background: The aim of this study is to investigate whether vitamin D, calcium, ferritin, and uric acids play a beneficial biomarker role in the prevention of colorectal cancer (CRC) risk. Methods: The case-control design was employed, including 650 CRC cases and 650 controls aged 35 to 70 years, comprising both men and women. The study encompasses sociodemographic data, clinical information, radiological diagnoses, and biochemical measurements. Results: Statistically significant differences were observed between CRC and controls in terms of age, diagnostic radiology, tomography, positron emission tomography/computed tomography (PET/CT), colonoscopy, CRC awareness, risk factors, age, genetics, exposure to chemicals, inadequate nutrition, smoking, hookah and alcohol use. Significant differences were also identified in intestinal inflammations, obesity, processed foods (P < 0.001), abdominal pain and cramps, diarrhea, constipation, blood in stool, bloating (gas), irritable bowel, nausea/vomiting, anemia, stress, fatigue, weakness, and weight loss. Regarding biochemical parameters, statistically significant differences were found between CRC and controls in terms of hemoglobin, glycated hemoglobin (HbA1c), fasting blood glucose (FBG), vitamin D, neutrophil level, red blood cell (RBC), white blood cell (WBC), platelet level, platelet count, hematocrit, potassium, sodium (Na), calcium, creatinine, cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), bilirubin, uric acid, iron (Fe), ferritin, C-reactive protein (CRP), total protein, systolic blood pressure (SBP), and diastolic blood pressure (DBP) parameters (P < 0.001). Multivariate stepwise regression analysis was performed to find the best risk factors for the diagnosis of CRC as the dependent variable. As a result of the analysis, intestinal inflammation (P < 0.001), nausea/vomiting (P < 0.001), stomach pain (P = 0.003), hookah-smoking (P = 0.034), uric acid (P < 0.001), bilirubin (P < 0.001), cigarette smoke exposure (P = 0.033), processed food consumption (P = 0.002), calcium levels (P = 0.029), vitamin D deficiency (P < 0.001), and ferritin (P < 0.001) levels were identified as significant determinants for CRC. Conclusions: The current study demonstrated that vitamin D, calcium, ferritin, and uric acids play a beneficial biomarker role in reducing the risk of CRC prevention. The increase in CRC rates may be associated with lifestyle, environmental and hereditary factors, nutrition, alcohol consumption, hookah use, and cigarette smoking.
Modern psychiatry aims to adopt precision models and promote personalized treatment within mental health care. However, the complexity of factors underpinning mental disorders and the variety of expressions of clinical conditions make this task arduous for clinicians. Globally, major depression is a common mental disorder and encompasses a constellation of clinical manifestations and a variety of etiological factors. In this context, the use of Artificial Intelligence might help clinicians in the screening and diagnosis of depression on a wider scale and could also facilitate their task in predicting disease outcomes by considering complex interactions between prodromal and clinical symptoms, neuroimaging data, genetics, or biomarkers. In this narrative review, we report on the most significant evidence from current international literature regarding the use of Artificial Intelligence in the diagnosis and treatment of major depression, specifically focusing on the use of Natural Language Processing, Chatbots, Machine Learning, and Deep Learning.
Objective: The aim of this study was to test the hypothesis that the duration of breastfeeding in infancy reduces the risk of childhood leukemia or lymphoma, and modifies the risk of developing functional gastrointestinal disorders (FGIDs). Subjects and Methods: This case-control study involved the recruitment of children with lymphoid malignancy and functional gastrointestinal symptoms with healthy children as controls. Focused questionnaires were used to collect data on breastfeeding history and other key risk factors. Univariate and multivariate analyses were undertaken. Results: Of the 334 children with lymphoid malignancy, 65% were male. The control group included 334 age- and sex-matched participants. Most (n = 189; 56.6%) of the children with leukemia were <10 years of age. Differences between cases and controls included the duration of breastfeeding (p < 0.0001), mean birthweight (p < 0.001), maternal age (p < 0.001), paternal age (p < 0.001), birth order (p < 0.001), mean number of children (p < 0.001), BMI percentile (p = 0.042), and maternal smoking (p = 0.012). Breastfeeding duration of up to 6 months' duration, when compared with feeding of longer than 6 months, was associated with increased odds ratios (OR) for acute lymphoblastic leukemia (OR = 3.43, 95% confidence interval [CI] 2.37-4.98; p < 0.001), Hodgkin's lymphoma (OR = 1.58, 95% CI: 0.88-2.84, p = 0.120), Non-Hodgkin's lymphoma (OR = 2.14, 95% CI: 1.25-3.65, p = 0.005), and overall (OR = 1.95, 95% CI: 1.40-2.71, p < 0.001). Cases also differed from controls with regard to FGIDs, such as stomach ache (p < 0.001), dyspepsia (p < 0.001), early satiety (p = 0.017), bowel satisfaction (p < 0.001), bloating (p < 0.001), nausea (p = 0.005), vomiting (p = 0.039), constipation (p = 0.003), diarrhea (p = 0.010), gastrointestinal canal congestion (p =0.039), muscle aches pains (p = 0.008), fecal incontinence (p = 0.021), and indigestion (p = 0.003). A multivariate stepwise regression analysis revealed that maternal smoking (p < 0.001), formula feeding (p < 0.001), duration of breastfeeding (p < 0.001), birth order (p = 0.002), mother's age (p = 0.004) and the child's birthweight (p = 0.009) were predictors for leukemia. Further analysis showed that dyspepsia (p < 0.001), gastrointestinal tract canal congestion (p < 0.001), constipation (p = 0.009), diarrhea (p = 0.013), bowel satisfaction (p = 0.021), bloating (p = 0.022), duration of breastfeeding (p < 0.001), and stomach ache (p = 0.025) were significant predictors for developing FGID symptoms after adjusting for age, gender, and other confounding variables. Conclusion: This study confirmed that breastfeeding has some effect on reducing possible risk of childhood lymphoma and leukemia and FGID symptoms compared with healthy control children.
Purpose: Low back pain (LBP), Gonarthrosis, knee, and Carpal Tunnel Syndrome have been regarded as affecting more than three-quarters’ of individuals in their lifetime. The aim of this study was conducted to determine and compare the effects of topical patients with sand compared with control related to Gonarthrosis, LBP, knee, and Carpal Tunnel Syndrome pain. Methods: This is a prospective case and control designed study based on 101 pain case with Sand and 101 control subjects. The interventional groups in addition either topical sand or without sand 2 months after the intervention were assessed. We assessed tolerability of an established pain perception scale by the Numeric Rating Scale (NRS). Categorical variables were compared using the chi-square (χ2) test. The paired t-test was used to compare the two groups before and after the intervention. One-way analysis of variance (ANOVA) was employed for comparison of several group means. Results: The study was based on 202 patients, 41 males (20.3%) and 161 females (79.7%). There were statistically significant differences between subjects with and without Sand in term of Gonarthrosis, Rheumatoid Arthritis LBP, knee, and Carpal Tunnel Syndrome pain (p = 0.033). Majority of patients were over age 55 years old (55%) and females 78 (77.2%). The mean score of total pain experience before and after the intervention was 7.41 ± 1.1 for black sand, and 4.24 ± 2.38 for without sand as control group. The mean scores of these 5 groups were highly significant before and after the intervention (p There was statistically highly significant in regarding subjects with Sand as compared with those before Sand after treatment mean score specifically with gonarthrosis before pain 7.23 ± 1.86 vs after treatment 4.54 ± 2.18 p Conclusion: The current study has revealed that the topical treatments with sand could have a significant effect on the perception of pain compared to those in the control group with respect of gonarthrosis, rheumatoid arthritis, LBP, knee, and Carpal Tunnel Syndrome pain .
The aim of this study was to assess the rates of depression, anxiety, and stress and quality of sleeping among COVID-19 patients with and without type 2 diabetes mellitus (T2DM). A case and control design has been employed, involving patients affected by COVID-19 infection (884 with T2DM vs. 884 controls without T2DM) and hospitalized in Istanbul (Turkey) from January to December 2021. A multivariate stepwise regression approach was used to test the associations between sociodemographic, metabolic, serum markers, mental health scores, and T2DM/COVID-19 patients’ clinical presentation. A statistically significant difference between T2DM and non-T2DM was found with respect to age, gender, BMI (body mass index), smoking, physical exercise, and physical comorbidities as well as levels of depression, anxiety, stress, and sleeping disorders (0.0003 ≤ all p = 0.025). With regard to serum biomarkers, vitamin D and ferritin were identified as useful parameters of reduction of glycated hemoglobin as well as COVID-19 infection among T2DM patients. This study detected that 25% of patients with COVID-19 and T2DM experienced mental distress, with sleeping disturbances and lifestyle changes markedly impacting their clinical outcome alongside metabolic and serum parameters.
Objective: This study's objective was to identify the factors and impact of serums calcium 25-Hydroxy vitamin D, ferritin, uric acid, and sleeping disorders on benign paroxysmal positional vertigo (BPPV) patients. Methods: This is a case and control design study. The consecutive patients' visits (age, older than 25 years) with idiopathic BPPV were recruited in the present study. For each patient, 3:1 sex and age-matched healthy people were assigned as the control. The study comprised 177 patients with BPPV and 656 controls. The study included biochemical, clinical, physical examinations, PSQI sleep quality, supine roll test, and Dix-Hallpike test for the diagnosis of all patients, and pure-tone audiometry (PTA) was used to assess hearing. Univariate and multivariate stepwise regression analyses were used for statistical analysis. Results: The study comprised 833 patients with 295 males (35.4%) and 538 females (64.6%) who were between 25 and 70 years old. Of a total of 833 participants, 177 were BPPV patients, and 656 subject were normal. The results shown that there were significant differences between the BPPV and the normal group in terms of BMI (p = 0.039), physical activity (p = 0.003), cigarette smoking (p = 0.035), nargile-waterpipe use (p < 0.001), diabetes (p < 0.001), hypertension (p < 0.001), congestive heart failure (CHF) (p < 0.001), neurology (p < 0.001), tinnitus (p < 0.001), dizziness (p < 0.001), headache (p < 0.001), vitamin D (p = 0.004), calcium (p = 0.004), magnesium (p < 0.001), potassium (p = 0.019), phosphorus (p < 0.001), haemoglobin (p < 0.001), serum glucose (p < 0.001), HbA1c (p < 0.001), triglyceride (p < 0.001), systolic BP (p = 0.004), diastolic BP (p = 0.008), and microalbuminuria (p = 0.005); ATP III metabolic syndrome (p = 0.038), IDF metabolic syndrome (p = 0.034), and poor sleep (p = 0.033). In terms of the type of BPPV, the posterior canal was the most commonly affected (n = 126, 71.2%), followed by the horizontal (n = 43, 24.3%) and anterior canal (n = 8, 4.5%). The analysis indicated that serum ferritin (p < 0.001), uric acid (p < 0.001), blood pressure (p < 0.001), dizziness (p < 0.001), cigarette-water-pipe smokers (p = 0.004), headaches/migraines (p = 0.005), calcium (p = 0.007), vitamin D deficiency (p = 0.008), sleepiness (p = 0.016), physical activity (p = 0.022), CHF (p = 0.024), and tinnitus (p = 0.025) were considered as risk predictors for BPPV. Conclusions: The results revealed that the serum levels of vitamin D, ferritin, uric acid, and calcium are low among the study population and supplementation could be considered as prevention in BPPV patients.
BACKGROUND:The shortage of physicians in Turkey is a highly critical emergency. In fact, physicians' migration to developing or high-income countries, defined as brain drain, threatens the sustainability of the national healthcare system. AIMS:This study explored the driving factors associated with Turkish Physicians' brain drain, including high-economic inflation, social-politics, poor-living, equity, violence, and the desire to practice medical activity abroad. METHODS:A cross-sectional survey of 1,861 Turkish physicians aged 25 to 65 years old was conducted employing the Brain Drain questionnaire, the Depression Anxiety Stress Scale (DASS-21), the Patient Health Questionnaire 9 (PHQ-9), and the Fatigue Assessment Scale (FAS). RESULTS:Significant differences were observed among physicians staying in Turkey versus considering migration to Western countries, regarding their age, gender, marital status, educational level, occupational status, work years, hospital night shifts, income, and cigarette/nargileh smoking habits (all p ⩽ .018). The main reasons for brain drain included transport problems, harassment, low salary, malpractice, bad environment, job insecurity, workload, burnout, treating difficult patients, inadequate postgraduate systems, peer-pressure, health safety concerns, and favoritism in the workplace, as well as stress and depression caused by work overload. In fact, depression, anxiety, stress, fatigue, and burnout varied significantly among the different groups of physicians (all p ⩽ .013). Additionally, key predictors of brain drain were better job opportunities, poor hospital management (in Turkey), job-related stress, dealing with difficult patients, research deficiencies, workload, burnout, transportation issues, short consultation time, low salary, and fatigue. Among the general factors contributing to the brain drain in the Turkish Health System, we identified significant issues related to research deficiencies, compulsory working duties, poor quality of postgraduate, inadequate medical-schools, poor hospital management, and shortage of consultants. CONCLUSION:Physicians' migration is a major global public health concern, leading to substantial risks for healthcare services, especially in Turkey. Many physicians decide to migrate to work in Western countries.
AimThis study aimed to investigate the causes and risk factors of colorectal cancer (CRC) in a Turkish population, focusing on various modifiable and non-modifiable risk factors.MethodsA hospital-based case-control design was employed to compare individuals with CRC (cases) to individuals without CRC (controls). Male and female participants were recruited from the surgery, internal medicine, and out-patient departments. The study encompassed socio-demographic data, clinical information, radiological diagnoses, and biochemical measurements. Univariable and multivariable logistic regressions were used to determine associated risk factors of CRC.ResultsThe study included 704 individuals with CRC and 704 controls. Significant socio-demographic disparities were observed between the groups, with over 30% of the cases having lower levels of education and income compared to the controls. Lifestyle factors such as obesity, higher rates of smoking (cigarettes and hookah) and alcohol consumption were more prevalent among cases than controls. Further significant associations were identified with intestinal inflammation, obesity, processed food consumption, and symptoms such as abdominal pain, cramps, diarrhea, constipation, blood in stool, bloating, irritable bowel syndrome, nausea/vomiting, anemia, stress, fatigue, weakness, and weight loss. Diet analysis revealed that individuals with CRC consumed more red meat, processed and fast foods along with less pulses and vegetables. Genetic predispositions and exposure to chemicals also correlated strongly with increased CRC risk. Multivariable regression analysis identified, nausea/vomiting, constipation, intestinal disease, genetics factor, hookah-nargileh use, history of any cancer, family history of bowel cancer, constipation, cigarette smoking, stress, milk-yogurt consumption, obesity and red meat consumption as significant determinants for CRC.ConclusionCRC risk is influenced by dietary, lifestyle, and genetic factors. Awareness of hereditary risk and participation in screening are crucial. Lifestyle changes, such as avoiding smoking, hookah, and alcohol use, and adopting a healthy diet, are essential for prevention.
Racism and racial discrimination heavily impact on health and mental health of ethnic minorities. In this conceptual paper and narrative review, we aim to report on relevant evidence from the international literature describing the prevalence and the qualitative aspects of mental illness due to racism and ethnic- discrimination in different settings and populations. Some variables related to racism, such as cultural, institutional, interpersonal factors, as well as the concepts of perceived and internalised racism will be described and discussed. These are relevant characteristics in the explanatory model of the relationship between racism and mental health. Epidemiological data on the prevalence of depressive and psychotic symptoms as well as substance abuse/misuse among ethnic minorities in large catchment areas, such as United States and United Kingdom, will be represented. We conclude that anti-racism policies are essential in order to address racism and racial discrimination around the world. Pluralistic societies should be promoted in order to understand mental illnesses among ethnic and cultural minorities. Also, anti-racism programs should be delivered in the educational and health-care settings and their impact evaluated.
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