TY - JOUR
T1 - Risk factors for mental disorder development in asylum seekers and refugees resettled in Western Europe and Turkey
T2 - Participant-level analysis of two large prevention studies
AU - Barbui, Corrado
AU - Tedeschi, Federico
AU - Acarturk, Ceren
AU - Anttila, Minna
AU - Au, Teresa
AU - Baumgartner, Josef
AU - Carswell, Ken
AU - Churchill, Rachel
AU - Cuijpers, Pim
AU - Karyotaki, Eirini
AU - Klein, Thomas
AU - Koesters, Markus
AU - Lantta, Tella
AU - Nosè, Michela
AU - Ostuzzi, Giovanni
AU - Pasquini, Massimo
AU - Prina, Eleonora
AU - Sijbrandij, Marit
AU - Tarsitani, Lorenzo
AU - Turrini, Giulia
AU - Uygun, Ersin
AU - Välimäki, Maritta
AU - Walker, Lauren
AU - Wancata, Johannes
AU - White, Ross G.
AU - Purgato, Marianna
N1 - Publisher Copyright:
© The Author(s) 2022.
PY - 2023/5
Y1 - 2023/5
N2 - Background: In asylum seekers and refugees, the frequency of mental disorders, such as depression, anxiety and post-traumatic stress disorder, is higher than the general population, but there is a lack of data on risk factors for the development of mental disorders in this population. Aim: This study investigated the risk factors for mental disorder development in a large group of asylum seekers and refugees resettled in high- and middle-income settings. Methods: Participant-level data from two randomized prevention studies involving asylum seekers and refugees resettled in Western European countries and in Turkey were pooled. The two studies randomized participants with psychological distress, but without a diagnosis of mental disorder, to the Self-Help Plus psychological intervention or enhanced care as usual. At baseline, exposure to potentially traumatic events was measured using the Harvard Trauma Questionnaire-part I, while psychological distress and depressive symptoms were assessed with the General Health Questionnaire and the Patient Health Questionnaire. After 3 and 6 months of follow-up, the proportion of participants who developed a mental disorder was calculated using the Mini International Neuropsychiatric Interview. Results: A total of 1,101 participants were included in the analysis. At 3- and 6-month follow-up the observed frequency of mental disorders was 13.51% (115/851) and 24.30% (207/852), respectively, while the frequency estimates after missing data imputation were 13.95% and 23.78%, respectively. After controlling for confounders, logistic regression analysis showed that participants with a lower education level (p =.034), a shorter duration of journey (p =.057) and arriving from countries with war-related contexts (p =.017), were more at risk of developing mental disorders. Psychological distress (p =.004), depression (p =.001) and exposure to potentially traumatic events (p =.020) were predictors of mental disorder development. Conclusions: This study identified several risk factors for the development of mental disorders in asylum seekers and refugees, some of which may be the target of risk reduction policies. The identification of asylum seekers and refugees at increased risk of mental disorders should guide the implementation of focused preventative psychological interventions.
AB - Background: In asylum seekers and refugees, the frequency of mental disorders, such as depression, anxiety and post-traumatic stress disorder, is higher than the general population, but there is a lack of data on risk factors for the development of mental disorders in this population. Aim: This study investigated the risk factors for mental disorder development in a large group of asylum seekers and refugees resettled in high- and middle-income settings. Methods: Participant-level data from two randomized prevention studies involving asylum seekers and refugees resettled in Western European countries and in Turkey were pooled. The two studies randomized participants with psychological distress, but without a diagnosis of mental disorder, to the Self-Help Plus psychological intervention or enhanced care as usual. At baseline, exposure to potentially traumatic events was measured using the Harvard Trauma Questionnaire-part I, while psychological distress and depressive symptoms were assessed with the General Health Questionnaire and the Patient Health Questionnaire. After 3 and 6 months of follow-up, the proportion of participants who developed a mental disorder was calculated using the Mini International Neuropsychiatric Interview. Results: A total of 1,101 participants were included in the analysis. At 3- and 6-month follow-up the observed frequency of mental disorders was 13.51% (115/851) and 24.30% (207/852), respectively, while the frequency estimates after missing data imputation were 13.95% and 23.78%, respectively. After controlling for confounders, logistic regression analysis showed that participants with a lower education level (p =.034), a shorter duration of journey (p =.057) and arriving from countries with war-related contexts (p =.017), were more at risk of developing mental disorders. Psychological distress (p =.004), depression (p =.001) and exposure to potentially traumatic events (p =.020) were predictors of mental disorder development. Conclusions: This study identified several risk factors for the development of mental disorders in asylum seekers and refugees, some of which may be the target of risk reduction policies. The identification of asylum seekers and refugees at increased risk of mental disorders should guide the implementation of focused preventative psychological interventions.
KW - Asylum seekers
KW - high-income countries
KW - low-income countries
KW - mental disorders
KW - mental health
KW - migrants
KW - refugees
UR - http://www.scopus.com/inward/record.url?scp=85141592154&partnerID=8YFLogxK
U2 - 10.1177/00207640221132430
DO - 10.1177/00207640221132430
M3 - Article
C2 - 36326024
AN - SCOPUS:85141592154
SN - 0020-7640
VL - 69
SP - 664
EP - 674
JO - International journal of social psychiatry
JF - International journal of social psychiatry
IS - 3
ER -