Abstract
Background: Migrant women represent a particularly vulnerable group in psychosomatic rehabilitation, often reporting higher psychological distress and poorer treatment outcomes compared with male or non-migrant patients. Women of Turkish and Kurdish origin in Germany face persistent sociocultural and socioeconomic stressors that shape their mental health burden and rehabilitation experiences even after decades of residence.
Objective: This study examined sociodemographic, cultural, and clinical predictors of psychosomatic rehabilitation outcomes among long-term migrant patients of Turkish and Kurdish origin in Germany, focusing on depression, embitterment, and overall symptom severity.
Methods: A total of 80 inpatients (40 women, 40 men) of Turkish or Kurdish origin, all of whom had lived in Germany for at least 20 years, participated in this cross-sectional study. None had refugee backgrounds. Participants completed standardized instruments including the Berne Embitterment Inventory (BVI), Beck Depression Inventory I (BDI-I), ICD-10 Symptom Rating (ISR), and Personal Belief in a Just World Scale (PBJW). Descriptive statistics, group comparisons, and correlation analyses were conducted.
Results: Women demonstrated significantly higher embitterment, depressive symptoms, and overall symptom severity than men, while reporting lower just-world beliefs (p<0.01). Cultural and socioeconomic stressors such as arranged or forced marriages (42.5% vs. 15%), low educational attainment (67.5% vs. 52.5%), and unemployment (72.5% vs. 47.5%) were strongly associated with elevated psychological burden. Embitterment correlated positively with depression (r =0.62, p<0.001) and symptom severity (r =0.58, p<0.001). Patients with a stated retirement wish reported significantly higher embitterment levels (p=0.008).
Conclusions: Long-term migrant women of Turkish and Kurdish origin exhibit greater psychological distress than men, reflecting the cumulative impact of gendered social roles, economic disadvantage, and perceived injustice rather than recent migration or trauma. Psychosomatic rehabilitation should therefore integrate gender- and culture-sensitive approaches, such as empowerment-based psychoeducation, motivational interventions, and intercultural competence training, to improve treatment equity and outcomes.
Keywords
Psychosomatic rehabilitation, Migrant women, Embitterment, Depression, Cultural stressors, Gender differences, Germany