Background
Methods
Search strategy
Key search terms |
Refugee: refugee, displaced persons, asylum seeker, stateless person, war survivor, conflict survivor, war victim, exile, OR uprooted person |
Mental health: mental health, mental disorders, mental illness, psychiatric symptom, well-being, psychopathology, clinical or psychiatric or psychological outcome, psychiatric morbidity or disability, psychological morbidity or disability, adjustment problem, distress, psychological stress, posttraumatic stress, stress, PTSD, anxiety, depression, depressive disorder, traumatic reaction, psychological reactions OR psychiatric reactions |
Long-term: chronic, enduring, prolonged, persistent, ongoing, continuing, longitudinal OR durable |
Combination operators |
Long-term refugee mental health: Refugee (all terms) AND mental health (all terms) AND long-term (all terms) |
Inclusion and exclusion criteria
Data extraction
Assessment of methodological quality
Data synthesis and analysis
Narrative synthesis of factors associated with mental disorders
Results
Study and baseline characteristics
Author(s) | Refugee population (host) | Displacement duration, yrs. | Sample selection (response rate %) | Measures | Measures reliability and validity | Prevalence | Statistically significant risk factors |
---|---|---|---|---|---|---|---|
Beiser & Hou (2001) | 608 Southeast Asian (Vietnamese Chinese, Vietnamese and Laotians) (Canada) | >10 of residence | random and non-random (95 %; follow-up = 45 %) | Self-report developed for the study | Developed for the study. No data reported. | Depression = 2.3 % | DEPRESSION |
Univariate: depressive symptoms experienced early in the process of resettlement | |||||||
(decreased over 10-year period) | |||||||
-Depression | Multivariate: depressive levels experienced early in the process of resettlement; unemployment or unstable employment (for men); poor English language proficiency (for women and those who did not become engaged in the labour market during the earliest years of resettlement) | ||||||
Bhui et al. (2003) | 180 Somali (UK) | 8 of residence | random (49 %) | SCQ and HSCL | Reported as previously validated in other refugee groups (data not reported). | Anxiety and Depression = 23 % | ANXIETY AND DEPRESSION |
Univariate: separated or widowed, being retired or unemployed, taking medication, not having declared asylum on entry, not having a conflict with immigration on arrival, less time in the UK (<7 yrs), shortage of food, without shelter, being lost, kidnapped, brainwashed | |||||||
Multivariate (controlling for age, gender, conflict with immigration, detention on entry, declaration of seeking asylum on entry, current asylum status, income, current employment status, employment status when in Somalia, accommodation type, cigarette smoking, alcohol use, drug use and number of residence years): number of traumatic events, shortage of food and being lost, having no combat experience | |||||||
Birman & Tran (2008) | 212 Vietnamese (USA) | 11.5 of residence | Non-random (−) | HSCL–25 | Reported as previously validated in this refugee group (data not reported). | Depression = 20.8 % | DEPRESSION |
-Depression | Anxiety = 20.3 % | Univariate: lower satisfaction with social support (by like-ethnic friends and one’s spouse), alienation, lower life satisfaction | |||||
-Anxiety | |||||||
In this sample, Cronbach’s alpha: Anxiety = 0.93 | |||||||
Multivariate: lower satisfaction with social support (by like-ethnic friends and one’s spouse) | |||||||
Depression = 0.94. | |||||||
ANXIETY | |||||||
Univariate: females, poor English language, exhibiting more Vietnamese behaviour | |||||||
Multivariate: females, pre-migration trauma, exhibiting more Vietnamese behaviour | |||||||
Blair (2000) | 124 Cambodian (USA) | 8.1 of residence | random (83 %) | NIMH DIS | NIMH DIS: Reported as previously validated in other non-refugee cultures (data not reported). | Depression = 51 % | DEPRESSION |
-Depression | GAD =14 % | Univariate: Pre-migration – higher number of war traumas, loss of immediate family member (a parent, a sibling or a child), higher number of problems while trying to escape, being separated from family while in refugee camp; resettlement – higher number of resettlement stressors, financial stress (lower rates of working outside the home, lower income, receiving welfare) | |||||
-Anxiety | Social phobia = 27 % | ||||||
-Social phobia | Panic disorder = 7 % | ||||||
-Panic dis. | PTSD = 45 % | ||||||
Comorbidity: PTSD and Depression = 71 % | |||||||
DICA-R | |||||||
-PTSD | DICA-R: Reported as previously validated in other non-refugee cultures (data not reported). | PTSD and Social Phobia = 32 % | |||||
PTSD | |||||||
Univariate: Pre-migration – higher number of war traumas, loss of immediate family member (a sibling), being separated from family while in a refugee camp, higher number of problems while trying to escape, higher number of incidents of abuse; resettlement – higher number of resettlement stressors | |||||||
Bogic et al. (2012) | 854 refugees from former Yugoslavia (Germany, Italy, and the UK) | 9.3 of residence | random and non–random | MINI | Reported as previously validated in other non-refugee cultures (data not reported). | Depression = 34.3 % | DEPRESSION |
-Depression | PTSD = 33.1 % | Univariate: female, older age, lower education, higher number of war and post-war traumatic events, shorter time since war trauma, more migration stressors, unemployment, not feeling accepted by host country, poor host language fluency, temporary residence status, residing in Germany or the UK compared to Italy | |||||
-PTSD | GAD = 8.7 % | ||||||
-GAD | |||||||
-Social phobia | Social phobia = 6.4 % | ||||||
-Panic disorder | Panic disorder = 10.0 % | ||||||
-Agoraphobia | |||||||
Agoraphobia = 18.6 % | |||||||
-OCD | |||||||
OCD = 4.8 % | |||||||
Comorbidity: | |||||||
PTSD and Depression =65.1 % | |||||||
GAD and PTSD = 43.2 % | |||||||
Social Phobia and PTSD = 15.9 % | |||||||
GAD and depression = 50.7 % | Multivariate: older age, lower education, higher number of war-related traumatic events, shorter time since war trauma, more migration stressors, unemployment, not feeling accepted by host country, temporary residence status, residing in Germany or the UK compared to Italy | ||||||
PTSD | |||||||
Univariate: older age, lower education, higher number of war and post-war traumatic events, longer time since war trauma, more migration stressors, unemployment, not feeling accepted by host country, poor host language fluency, temporary residence status, residing in Germany or the UK compared to Italy | |||||||
Multivariate: older age, lower education, higher number of war and post-war traumatic events, not having a combat experience, more migration stressors, temporary residence status, residing in Germany vs. Italy or the UK | |||||||
ANXIETY (any anxiety disorder) | |||||||
Univariate: female, older age, lower education, higher number of war and post-war traumatic events, not having a combat experience, more migration stressors, unemployment, not feeling accepted by host country, poor host language fluency, temporary residence status, residing in Germany or the UK compared to Italy | |||||||
Multivariate: lower education, higher number of war and post-war traumatic events, not having a combat experience, more migration stressors, not feeling accepted by host country, temporary residence status | |||||||
Buseh et al. (2000) | 50 Liberian males (USA) | 8.6 of residence | non–random (−) | CES–D | Reported as previously validated in other non-refugee cultures (Cronbach’s alpha =0.85). | Depressive Mood =60 % | DEPRESSION |
-Depression | Univariate: more acculturative stress; CES–D subscales depressed affect, somatic/retarded activity, and interpersonal affect were positively correlated with all items on acculturative stress; CES–D subscale positive affect less perceived hate, less perceived cultural shock and lower overall acculturative stress | ||||||
In this study, Cronbach’s alpha = 0.91. | |||||||
Carlson & Rosser–Hogan (1994) | 50 Cambodian (USA) | 9.9 since leaving home country (5.4 of residence) | random (100 %) | HSCL–25 | HSCL-25: Reported as previously validated in this refugee culture (test-retest reliability = 0.89; specificity = 0.73 and sensitivity = 0.88). | Depression = 80 % | DEPRESSION, ANXIETY, PTSD, Univariate: higher number of traumatic events |
-Depression | PTSD = 86 % | ||||||
-Anxiety | Anxiety = 88 % | ||||||
PCL–C –amended | |||||||
-PTSD | |||||||
PCL-C: Validated in other cultures (not reported in the study). | |||||||
In this study, test-retest reliability = 0.85. | |||||||
Caspi et al. (1998) | 161 Cambodian (USA) | 7 of residence | random (78 %) | HSCL–25 | HSCL-25 and HTQ validated in this culture (not reported in the study). | Not reported | DEPRESSION, ANXIETY AND PTSD |
-Depression | |||||||
Multivariate: no relationship observed with child loss | |||||||
-Anxiety | |||||||
HTQ | |||||||
-PTSD | |||||||
Chung & Kagawa–Singer (1993) | 2180 Southeast Asian (Cambodian, Laotian, and Vietnamese) (USA) | 5.9 of residence | random (−) | HOS | Reported as previously validated in other non-refugee cultures (data not reported). In this study, Cronbach’s alpha for depression = 0.85 and for anxiety = 0.89. | Not reported | DEPRESSION |
-Depression | Univariate: Cambodians (followed by Lao and Vietnamese) | ||||||
-Anxiety | |||||||
Multivariate (controlling for ethnicity and number of years in the USA): higher number of pre-migration traumatic events and female gender; for the >5 yrs in the USA: female gender, higher number of traumatic events, longer time in refugee camp, longer time in the USA, unemployment, low family income, poor English, being Vietnamese (compared to Cambodians) | |||||||
ANXIETY | |||||||
Univariate: Cambodians (followed by Lao and Vietnamese) | |||||||
Multivariate: Regardless of ethnicity and years in the USA – higher number of traumatic events, female gender, older age, receipt of public assistance, lower family income, poor English, being Lao; for refugees >5 yrs in the USA: female gender, older age, longer in the USA, higher number of traumatic events, longer time in refugee camp, unemployment, receiving public assistance, low family income, low English proficiency, Lao, Cambodian | |||||||
Craig et al. (2008) | 126 Bosnian (USA) | 9 of residence | random (25.2 %) | MHI | MHI and PSDS reported as previously validated in other non-refugee cultures (MHI: Cronbach’s Alpha >0.80, test-retest reliability > 0.58; | Depression = 31.7 % | DEPRESSION |
-Depression | PTSD = 66.6 % | Univariate: females, older age, lower education | |||||
-Anxiety | Anxiety = 40.5 % | ||||||
PSDS | |||||||
-PTSD | PTSD | ||||||
Univariate: older age, lower education | |||||||
ANXIETY | |||||||
Univariate: older age, lower education | |||||||
PSDS Cronbach’s alpha = 0.94–0.98, test-retest reliability 0.69–0.72). | |||||||
In this study, MHI Cronbach’s alpha for anxiety = 0.95 and for depression = 0.96; | |||||||
PSDS Cronbach’s alpha =0.97. | |||||||
D'Avanzo & Barab (1998) | 175 Cambodian females (USA and France) | ≥5 of residence | non–random (−) | HSCL–25 | Reported as previously validated in other non-refugee cultures (test-retest reliability for depression = 0.82, anxiety = 0.84, sensitivity = 0.93 and specificity = 0.76 for either). | Depression = 73.7 % (France = 85.3 %; USA = 65 %) | DEPRESSION |
-Depression | Univariate: refugee women in France were more likely to be symptomatic of depression | ||||||
-Anxiety | |||||||
Anxiety = 81.3 % (France = 85 %; USA = 79 %) | |||||||
In this study, Cronbach’s alpha for depression = 0.86 and anxiety = 0.86. | |||||||
Delic-Ovcina (2010) | 637 Bosnian males (USA) | 6–16 (97.7 % ≥ 8 years) of residence | non–random (−) | IES | Reported as previously validated in this refugee culture (data not reported). | PTSD = 76.5 % | PTSD |
-PTSD | Univariate: older age, married, lower education, perceived poor general health, recentness of dental visit, higher frequency of smoking, lack of physical activity, no health care coverage and insufficient funds for health care services | ||||||
In this study, Cronbach’s alpha = 0.96. | |||||||
Gerritsen et al. (2006) | 178 Afghan, Iranian and Somali (Netherlands) | 8.8 of residence | random (59 %) | HSCL–25 | Reported as previously validated in other refugee cultures (data not reported). | Depression = 29.3 % | (sample includes 232 recently arrived refugees (M = 5.6 yrs.) |
-Depression | |||||||
-Anxiety | |||||||
HTQ | PTSD = 10.6 % | PTSD AND DEPRESSION/ANXIETY | |||||
-PTSD | |||||||
Anxiety = 27.7 % | Multivariate: asylum seeker (but not for PTSD) being from Iran or Afghanistan; female, higher number of traumatic events, higher post-migration stress, less social support | ||||||
Hinton et al. (1998) | 3401 Vietnamese males (USA) | 8–11 of residence | random (85–96 %) | HSCL–D | Reported as previously validated in this refugee culture (sensitivity = 0.86 and specificity = 0.96). | Depression = 8.8 % | DEPRESSION |
-Depression | (San Francisco = 9.8 % | Univariate: older age and veteran (in particular for those at the San Francisco and Santa Clara sites), less educated, poorer English proficiency, more recently arrived, poorer, unemployed or disabled, re-education camp survivors | |||||
Santa Clara = 8.2 % | |||||||
Houston = 8.6 %) | |||||||
Multivariate: unemployed or disabled, veterans, poorer English proficiency, income below poverty line, living in Houston | |||||||
Hollifield et al. (2006) | 252 Kurdish and Vietnamese (USA) | Kurds = 7.0 and Vietnamese 7.8 of residence | non–random (−) | HSCL–25 | HSCL-25: Reported as previously validated in other refugee cultures (data not reported).PSS-SR: Reported as previously validated in other non-refugee cultures (Cronbach’s alpha = 0.91, test-retest reliability = 0.74). In this study, Cronbach’s alpha =0.95. | Depression = 38.9 % | DEPRESSION, PTSD, ANXIETY |
-Depression | PTSD = 31.3 % | ||||||
-Anxiety | Anxiety = 25.0 % | Univariate: higher number of war-related traumatic events | |||||
PSS-SR | |||||||
-PTSD | |||||||
Multivariate: higher number of war-related traumatic events | |||||||
Hunt & Gakenyi (2005) | 69 Bosnian (UK) | 5–8 since war trauma | non–random (69 %) | IES–R | Validated in this culture (not reported in this study). In this study, Cronbach’s alpha =0.83 | PTSD = 77 % | Not reported |
-PTSD | (IES–R > 45) | ||||||
Jaranson et al. (2004) | 1134 Ethiopian (Oromo and Somali) (USA) | 7.5 since leaving home country (3.4 of residence) | non–random (97 %) | PCL–C | Reported as previously validated in other non-refugee cultures (data not reported).In this study, Cronbach’s alpha =0.93. | PTSD = 13 % | PTSD |
-PTSD | Univariate: being exposed to torture | ||||||
Multivariate: male, being Oromo, change in religious practices since migration, higher number of traumatic events, exposure to torture | |||||||
Kolassa et al. (2010) | 444 Rwandans (refugee camp in Uganda) | ~13 since war trauma | random (−) | PDS | Reported as previously validated in this refugee culture (test-retest reliability = 0.93). In this study, test-retest reliability = 0.87, | PTSD = 49.5 % | PTSD |
-PTSD | Multivariate: higher number of traumatic events | ||||||
sensitivity = 0.87 and specificity = 0.86. | |||||||
Marshall et al. (2005) | 490 Cambodian (USA) | 20–22 of residence | random (87 %) | CIDI | Reported as previously validated in other non-refugee cultures (data not reported). | Depression = 51 % | DEPRESSION |
-Depression | PTSD = 62 % | Univariate: poor English language, retired or disabled, unemployed, below federal poverty level, older age, higher number of pre–and post-migration traumatic events | |||||
-PTSD | Comorbidity of PTSD and depression = 71 % | ||||||
Comorbidity of depression and PTSD = 86 % | |||||||
Multivariate: (adjusted for age, gender, year of immigration, and pre- and post-migration trauma exposure): older age, higher number of pre- and post–migration traumatic events | |||||||
PTSD | |||||||
Univariate: older age, males, poor English language, retired or disabled, unemployed, below federal poverty level, higher number of pre–and post–migration traumatic events | |||||||
Multivariate (adjusted for age, gender, year of immigration, and pre- and post-migration trauma exposure): older age, higher number of pre and post–migration traumatic events | |||||||
Matheson et al. (2008) | 90 Somali (Canada) | ≥9 (90 % sample) of residence | non–random (−) | IES-R | IES-R: Reported as previously validated in other non-refugee cultures (data not reported). | Depression 22.5 % | DEPRESSION |
-PTSD | PTSD = 22.2 % | Univariate: higher number of traumatic events, assault from a stranger or familiar other, coping strategies involving engagement with emotions and avoidant coping efforts | |||||
BDI | |||||||
-Depression | |||||||
In this study, Cronbach’s alpha =0.96. | |||||||
BDI: Validated in other cultures (not reported in the study). | Multivariate: the relation between trauma experiences and depression was fully 9confounded by endorsement of emotion-focused coping strategies in relation to acculturation stressors | ||||||
In this study, Cronbach’s alpha = 0.90. | |||||||
PTSD | |||||||
Univariate: higher number of traumatic events, collective trauma, threat to other, assault from a stranger or familiar other, coping strategies involving engagement with emotions and avoidant coping efforts | |||||||
Multivariate: higher number of traumatic events | |||||||
Mollica et al. (1998) | 993 Cambodian (refugee camp on Thailand–Cambodia border) | ≥5 of residence | random (98 %) | HSCL–25 | HTQ and HSCL-25: Reported as validated in this culture (data not reported). | Depression 55 % | DEPRESSION, PTSD, PTSD SUB–SCALES (except avoidance, which had no dose–effect relationship), ANXIETY |
-Depression | PTSD = 14.7 % | ||||||
-Anxiety | |||||||
HTQ | |||||||
-PTSD | |||||||
Multivariate (covariates: gender, age, marital status, education, trauma exposure, and one of the symptom scale or sub-scales): dose–response relationship between cumulative trauma and symptoms – recent trauma had a more potent effect except for emotional numbing (roughly equally 'potent') | |||||||
Nicholson (1997) | 447 Southeast Asian (Vietnamese, Cambodians, Laotians and Hmong) (USA) | 9.2 of residence | non–random (−) | HTQ | HTQ: Reported as validated in this culture (data not reported). | Depression = 40 % | PTSD, ANXIETY, DEPRESSION |
-PTSD | PTSD = 14 %, | ||||||
HSCL–25 | Anxiety = 35 % | Multivariate: degree of current stress was the strongest predictor, self–perceived poor health status, greater number of experienced traumatic events (in particular for PTSD), while greater number of witnessed events and rural background (confounded through current stress), and female gender (confounded through lower income) had indirect effects on all mental health. In addition, low income and being unmarried predicted depression; greater number of witnessed events predicted PTSD; and female gender predicted anxiety | |||||
-Depression | |||||||
-Anxiety | In this study, Cronbach’s alpha =0.95. | ||||||
HSCL-25: Reported as validated in this culture (data not reported). | |||||||
In this study, Cronbach’s alpha for depression = 0.89 and anxiety = 0.89. | |||||||
Onyut et al. (2009) | 1422 Somalis and Rwandans (refugee camp in Uganda) | ≥9 (80 % sample) of residence | random (<90 %) | PDS | PDS: Reported as previously validated in other non-refugee cultures (data not reported). | PTSD = 37.8 % | DEPRESSION |
-PTSD | Univariate: male gender (only for Rwandese), being Somali, higher number of traumatic events, functioning deficits, physical health deficits | ||||||
HSCL-25 | |||||||
-Depression | |||||||
-Anxiety | |||||||
In this study, sensitivity = 0.86 and specificity = 0.88 | |||||||
PTSD | |||||||
Univariate: male gender (only for Rwandese), being Somali, higher number of traumatic events, functioning deficits, physical health deficits | |||||||
HSCL-25: Validated in other refugee cultures (not reported in the study). | |||||||
In this study, for depression subscale sensitivity = 0.67 and | ANXIETY | ||||||
Univariate: female gender (only for Somali), being Somali, higher number of traumatic events, functioning deficits, physical health deficits | |||||||
specificity = 0.73. | |||||||
Sabin et al. (2003) | 170 Guatemalan (refugee camp in Mexico) | 20 of residence | random (93 %) | HSCL–25 | HSCL-25 and HTQ: Reported as previously validated in other refugee cultures (data not reported). | Depression = 38.8 % | DEPRESSION |
-Depression | |||||||
PTSD = 11.8 % | Univariate: female, widowed, witnessing disappearance of others, torture, mutilation, higher number of traumatic events | ||||||
-Anxiety | Anxiety = 54.4 % | ||||||
HTQ | |||||||
-PTSD | |||||||
In this study, HTQ Cronbach’s alpha =0.87; HSCL-25 Cronbach’s alpha =0.95. | |||||||
Multivariate: female, widowed, witnessing disappearance of others, higher number of traumatic events | |||||||
PTSD | |||||||
Univariate: older age, being close to death, witnessed assassination or massacre, disappearance of others, larger household size, lived in 3 or more camps, not having experienced lack of food | |||||||
Multivariate: disappearance of others, being close to death, larger household size, and not having experienced lack of food | |||||||
ANXIETY | |||||||
Univariate: older age, higher number of traumatic events, sexual abuse or rape, witnessing massacre, witnessing disappearance of others, torture | |||||||
Multivariate: witnessing a massacre, higher number of traumatic events | |||||||
Schweitzer et al. (2006) | 63 Sudanese (Australia) | 9 since leaving home country (2 of residence) | non–random (−) | HSCL-37 | HSCL-25 and HTQ: Reported as previously validated in other refugee cultures (data not reported). | Depression =16 % | DEPRESSION |
-Depression | PTSD = 13 % | Univariate: female, higher number of traumas experienced by family, longer time in transit, family separation, less of ethnic community support | |||||
-Anxiety | |||||||
HTQ | |||||||
-PTSD | |||||||
In this study, HTQ Cronbach’s alpha =0.87; HSCL-25 Cronbach’s alpha for depression = 0.89 and for anxiety = 0.82 | |||||||
Multivariate: female, higher number of trauma experienced by family, longer time in transit, longer residence, family separation, unemployment | |||||||
PTSD | |||||||
Univariate: female, higher number of trauma experienced by the individual, higher number of trauma experienced by family, less of ethnic community support, more post-migration living difficulties | |||||||
Multivariate: female, higher number of trauma experienced by the individual, higher number of trauma experienced by family, less of ethnic community support | |||||||
ANXIETY | |||||||
Univariate: female, higher number of trauma experienced by the individual, number of trauma experienced by family, less of ethnic | |||||||
community support, more post-migration living difficulties | |||||||
Multivariate: female, higher number of trauma experienced by family, longer residence, less of ethnic community support, unemployment, more post-migration living difficulties | |||||||
Steel et al. (2002) | 1161 Vietnamese (Australia) | 11.4 of residence | random (82 %) | CIDI, PVPS | PVPS: Developed in this culture (data not reported) | Depression =3 % | ANXIETY DISORDERS |
PTSD = 4 % | Univariate: females | ||||||
-Depression | GAD = 0.7 % | ||||||
Social Phobia = 0.3 % | |||||||
-PTSD | |||||||
-GAD | Panic disorder = 0.6 % | ||||||
-Social phobia | |||||||
OCD = 0.5 % | |||||||
-Panic | PVPS: similar results | ||||||
disorder | |||||||
-OCD | |||||||
Stige & Sveaass (2010) | 142 Sri Lankan Tamils & Aceh from Indonesia (Norway) | 6.7 of residence | combination of random (10 %) and non-random | PTSS | Validated in other non-refugee cultures (not reported in the study). | PTSD = 75.4 % | Not reported |
-PTSD | |||||||
In this study, Cronbach’s alpha = 0.98 | |||||||
von Lersner et al. (2008) | 100 refugees from former Yugoslavia (85 %), Turkey (8 %) and Iraq (5 %) (Germany) | 10.8 of residence | non–random (−) | MINI | MINI: Reported as previously validated in other non-refugee cultures (data not reported). | Depression = 42.0 % | Not reported |
-Depression | |||||||
PTSD = 44.2 % | |||||||
-Anxiety | GAD = 2 % | ||||||
-Social phobia | Social phobia = 9.6 % | ||||||
PDS: Validated in other refugee cultures (not reported in the study). | Panic disorder = 8 % | ||||||
-Panic disorder | |||||||
Agoraphobia = 9 % | |||||||
-Agoraphobia | OCD = 0 % | ||||||
PDS | |||||||
-PTSD | |||||||
Westermeyer (1988) | 97 Hmong from Laos (USA) | 7–9 since leaving home country (6–8 of residence) | random (95 %; 96 % at the follow–up assessment) | NIMH DIS | Validated in other non-refugee cultures (not reported in the study). | Axis 1 disorder = 44 % | Not reported |
-Depression | |||||||
Depression = 6.2 % | |||||||
-GAD | GAD = 1 % | ||||||
-OCD | OCD = 0.4 % |
Data synthesis of prevalence rates of depression and anxiety disorders
Depression
Anxiety disorders
Unspecified anxiety
Posttraumatic Stress Disorder (PTSD)
Other anxiety disorders
Comorbidity of mental disorders
Publication bias
Factors associated with mental disorders - a narrative review
Depression | PTSD | Unspecified anxiety | ||||
---|---|---|---|---|---|---|
Factor | Univariate | Multivariate | Univariate | Multivariate | Univariate | Multivariate |
Demographics | ||||||
older age | + (4/11; 36 %) | + (2/9; 22 %) | + (5/8; 63 %) | + (2/6; 33 %) | + (2/5; 40 %) | + (1/5; 20 %) |
female gender | + (3/9; 33 %) | + (4/9; 44 %) | + (1/6; 17 %)/–(1/6; 17 %) | + (2/6; 33 %)/–(1/6; 17 %) | + (2/7; 29 %) | + (5/7; 71 %) |
lower education | + (3/5; 60 %) | + (1/7; 14 %) | + (3/4; 75 %) | + (1/4; 25 %) | 0 (0/1; 0 %) | 0 (0/3; 0 %) |
War context | ||||||
number of war traumatic events | + (7/9; 78 %) | + (9/12; 73 %) | + (9/10; 90 %) | + (9/9; 100 %) | + (5/5; 100 %) | + (8/9; 89 %) |
combat experience | + (1/3; 33 %) | + (1/3; 33 %)/–(1/3; 33 %) | NA | NA | NA | NA |
Post–migratin context | ||||||
longer duration in exile | – (2/10; 20 %) | + (2/7; 29 %) | 0 (0/7; 0 %) | 0 (0/4; 0 %) | – (1/3; 33 %) | + (2/3; 67 %) |
post-migration stress | + (3/4; 75 %) | + (3/3; 100 %) | + (3/3; 100 %) | + (3/4; 75 %) | + (1/1; 100 %) | + (3/3; 100 %) |
unemploymet | + (5/6; 83 %) | + (5/6; 83 %) | + (2/4; 50 %) | 0 (0/3; 0 %) | + (1/2; 50 %) | + (2/3; 67 %) |
low income | + (3/4; 75 %) | + (3/4; 75 %) | NA | NA | NA | NA |
poor host language proficiency | + (3/4; 75 %) | + (3/5; 60 %) | NA | NA | NA | NA |
lack of social support | + (2/2; 100 %) | + (3/3; 100 %) | NA | NA | NA | NA |
unmarrid | + (2/4; 50 %) | + (2/4; 50 %) | + (1/3; 33 %) | 0 (0/4; 0 %) | + (1/1; 100 %) | 0 (0/3; 0 %) |