Skip to main content
Erschienen in: European Journal of Pediatrics 2/2018

10.11.2017 | Original Article

Psychiatric screening and interventions for minor refugees in Europe: an overview of approaches and tools

verfasst von: Annerieke Horlings, Irma Hein

Erschienen in: European Journal of Pediatrics | Ausgabe 2/2018

Einloggen, um Zugang zu erhalten

Abstract

Currently hundreds of thousands of minor refugees entered Europe. This group has been exposed to traumatic events pre-, during, and post-migration and is at increased risk of developing psychiatric disorders. In this article, we describe the results of our literature search on screening and interventions for post-traumatic stress disorder (PTSD) in minor refugees, in order to make recommendations for clinical practice. Results show that studies on diagnostic accuracy of assessment instruments and efficacy of mental healthcare interventions in this population are lacking. Traumatic experiences pre-flight, during the flight and at resettlement, superimposed by parental PTSD, and other contextual factors, might lead to more than 25% of minor refugees developing PTSD.
Conclusion: To enhance the number of minor refugees recognized with PTSD, we recommend the use of a brief screening instrument. A public health approach, focusing on environmental supportive factors is the first step in treatment for this group, followed by short-term psychological group interventions focusing on psycho-education and stress reduction. Minor refugees with no improvement in PTSD symptoms by these interventions need referral to specialized mental health care services. Mental health providers should be culturally competent.
What is Known:
Post-traumatic stress disorder, anxiety, sleeping problems, and depression are the most common psychiatric disorders in minor refugees.
Evidence based methods on screening and interventions in minor refugees with psychiatric disorders are lacking.
What is New:
In the absence of validated screening tools a best practice reliable, quick and child-friendly tool is presented.
A layered system for mental health care and psychosocial support in minor refugees is explained.
Literatur
1.
Zurück zum Zitat Alisic E, Zalta AK, Wesel F Van, Larsen SE, Hafstad GS, Hassanpour K et al (2014) Rates of posttraumatic stress disorder in trauma-exposed children and adolescents: meta-analysis. Br J Psychiatry 204; 335–340.CrossRef Alisic E, Zalta AK, Wesel F Van, Larsen SE, Hafstad GS, Hassanpour K et al (2014) Rates of posttraumatic stress disorder in trauma-exposed children and adolescents: meta-analysis. Br J Psychiatry 204; 335–340.CrossRef
6.
Zurück zum Zitat Brymer M, Steinberg A, Sornborger J, Layne C, Pynoos R (2008) Acute interventions for refugee children and families. Child Adolesc Psychiatr Clin N Am 17(3):625–640CrossRef Brymer M, Steinberg A, Sornborger J, Layne C, Pynoos R (2008) Acute interventions for refugee children and families. Child Adolesc Psychiatr Clin N Am 17(3):625–640CrossRef
9.
Zurück zum Zitat Derluyn I, Broekaert E, Schuyten G (2008) Emotional and behavioural problems in migrant adolescents in Belgium. European Child and Adolescence Psychiatry 54–62.CrossRef Derluyn I, Broekaert E, Schuyten G (2008) Emotional and behavioural problems in migrant adolescents in Belgium. European Child and Adolescence Psychiatry 54–62.CrossRef
10.
Zurück zum Zitat Derluyn I, Broekaert E, Schuyten G, Temmerman DE (2004) Post-traumatic stress in former Ugandan child. Soldiers 363:861–863 Derluyn I, Broekaert E, Schuyten G, Temmerman DE (2004) Post-traumatic stress in former Ugandan child. Soldiers 363:861–863
11.
Zurück zum Zitat Diehle J, Opmeer BC, Boer F, Mannarino AP, Lindauer RJL (2015) Trauma-focused cognitive behavioral therapy or eye movement desensitization and reprocessing: what works in children with posttraumatic stress symptoms? A randomized controlled trial. Eur Child Adolesc Psychiatry 24(2):227–236CrossRef Diehle J, Opmeer BC, Boer F, Mannarino AP, Lindauer RJL (2015) Trauma-focused cognitive behavioral therapy or eye movement desensitization and reprocessing: what works in children with posttraumatic stress symptoms? A randomized controlled trial. Eur Child Adolesc Psychiatry 24(2):227–236CrossRef
12.
Zurück zum Zitat Dyregrov A, Kuterovac G, Baráth Á (1996) Factor analysis of the Impact of Event Scale with children in war. Scand J Psychol 37:339–350CrossRef Dyregrov A, Kuterovac G, Baráth Á (1996) Factor analysis of the Impact of Event Scale with children in war. Scand J Psychol 37:339–350CrossRef
13.
Zurück zum Zitat Ee van E, Hein I, Bala J, Mooren T (2014) Multi Family Therapy met vluchtelingengezinnen: van oorlog naar veiligheid. Kind Adolesc 35(3):205–2015CrossRef Ee van E, Hein I, Bala J, Mooren T (2014) Multi Family Therapy met vluchtelingengezinnen: van oorlog naar veiligheid. Kind Adolesc 35(3):205–2015CrossRef
17.
Zurück zum Zitat Gadeberg AK, Montgomery E, Frederiksen HW, Norredam M. (2016) Assessing trauma and mental health in refugee children and youth: a systematic review of validated screening and measurement tools. European Journal of Public Health 27(3): 439–446CrossRef Gadeberg AK, Montgomery E, Frederiksen HW, Norredam M. (2016) Assessing trauma and mental health in refugee children and youth: a systematic review of validated screening and measurement tools. European Journal of Public Health 27(3): 439–446CrossRef
18.
Zurück zum Zitat Goosen S, Stronks K, Kunst AE (2014) Frequent relocations between asylum-seeker centres are associated with mental distress in asylum-seeking children: a longitudinal medical record study. Int J Epidemiol 43(1):94–104CrossRef Goosen S, Stronks K, Kunst AE (2014) Frequent relocations between asylum-seeker centres are associated with mental distress in asylum-seeking children: a longitudinal medical record study. Int J Epidemiol 43(1):94–104CrossRef
19.
Zurück zum Zitat Hebebrand J, Anagnostopoulos D, Eliez S, Linse H, Pejovic-Milovancevic M, Klasen H (2016) A first assessment of the needs of young refugees arriving in Europe: what mental health professionals need to know. Eur Child Adolesc Psychiatry 25(1):1–6CrossRef Hebebrand J, Anagnostopoulos D, Eliez S, Linse H, Pejovic-Milovancevic M, Klasen H (2016) A first assessment of the needs of young refugees arriving in Europe: what mental health professionals need to know. Eur Child Adolesc Psychiatry 25(1):1–6CrossRef
23.
Zurück zum Zitat Laban CJ, Komproe IH, Gernaat HBPE, Jong JTVM (2008) The impact of a long asylum procedure on quality of life, disability and physical health in Iraqi asylum seekers in the Netherlands. Soc Psychiatry Psychiatr Epidemiol 43(7):507–515CrossRef Laban CJ, Komproe IH, Gernaat HBPE, Jong JTVM (2008) The impact of a long asylum procedure on quality of life, disability and physical health in Iraqi asylum seekers in the Netherlands. Soc Psychiatry Psychiatr Epidemiol 43(7):507–515CrossRef
26.
Zurück zum Zitat Malmusi D (2015) Immigrants’ health and health inequality by type of integration policies in European countries. Eur J Pub Health 25(2):293–299CrossRef Malmusi D (2015) Immigrants’ health and health inequality by type of integration policies in European countries. Eur J Pub Health 25(2):293–299CrossRef
27.
Zurück zum Zitat Montgomery E (2011) Trauma, exile and mental health in young refugees. Acta Psychiatr Scand 124(SUPPL. S440):1–46CrossRef Montgomery E (2011) Trauma, exile and mental health in young refugees. Acta Psychiatr Scand 124(SUPPL. S440):1–46CrossRef
30.
Zurück zum Zitat National Institute for Health and Care Excellence (2005) Post-traumatic stress disorder: management. Clinical guideline National Institute for Health and Care Excellence (2005) Post-traumatic stress disorder: management. Clinical guideline
31.
Zurück zum Zitat Onyut LP, Neuner F, Schauer E, Ertl V, Odenwald M, Schauer M et al (2005) Narrative Exposure Therapy as a treatment for child war survivors with posttraumatic stress disorder: two case reports and a pilot study in an African refugee settlement. BMC Psychiatry 5:7CrossRef Onyut LP, Neuner F, Schauer E, Ertl V, Odenwald M, Schauer M et al (2005) Narrative Exposure Therapy as a treatment for child war survivors with posttraumatic stress disorder: two case reports and a pilot study in an African refugee settlement. BMC Psychiatry 5:7CrossRef
32.
Zurück zum Zitat Oras R, de Ezpeleta SC, Ahmad A (2004) Treatment of traumatized refugee children with eye movement desensitization and reprocessing in a psychodynamic context. Nord J Psychiatry 58(3):199–203CrossRef Oras R, de Ezpeleta SC, Ahmad A (2004) Treatment of traumatized refugee children with eye movement desensitization and reprocessing in a psychodynamic context. Nord J Psychiatry 58(3):199–203CrossRef
33.
Zurück zum Zitat Pacione L, Measham T, Rousseau C (2013) Refugee children: Mental health and effective interventions. Curr Psychiatry Rep 15:341 Pacione L, Measham T, Rousseau C (2013) Refugee children: Mental health and effective interventions. Curr Psychiatry Rep 15:341
35.
Zurück zum Zitat Crosby SS (2013) Primary Care Management of non–english-speaking refugees who have experienced trauma: a clinical review. JAMA 310(5):519–528CrossRef Crosby SS (2013) Primary Care Management of non–english-speaking refugees who have experienced trauma: a clinical review. JAMA 310(5):519–528CrossRef
36.
Zurück zum Zitat Sack W, Seeley J, Him C, Clarke G (1998) Psychometric properties of the Impact of Event Scale in traumatized Cambodian refugee youth. Personal Individ Differ 25:57–67CrossRef Sack W, Seeley J, Him C, Clarke G (1998) Psychometric properties of the Impact of Event Scale in traumatized Cambodian refugee youth. Personal Individ Differ 25:57–67CrossRef
37.
Zurück zum Zitat Silove D, Steel Z, Watters C (2000) Policies of deterrence and the mental health of asylum seekers. JAMA 284(5):604–611CrossRef Silove D, Steel Z, Watters C (2000) Policies of deterrence and the mental health of asylum seekers. JAMA 284(5):604–611CrossRef
40.
Zurück zum Zitat Slobodin O, de Jong JT (2015) Family interventions in traumatized immigrants and refugees: a systematic review. Transcult Psychiatry 52(6):723–742CrossRef Slobodin O, de Jong JT (2015) Family interventions in traumatized immigrants and refugees: a systematic review. Transcult Psychiatry 52(6):723–742CrossRef
41.
Zurück zum Zitat Smith P, Perrin S, Dyregrov A, Yule W (2003) Principal components analysis of the impact of event scale with children in war. Personal Individ Differ 34(2):315–322CrossRef Smith P, Perrin S, Dyregrov A, Yule W (2003) Principal components analysis of the impact of event scale with children in war. Personal Individ Differ 34(2):315–322CrossRef
44.
Zurück zum Zitat Verlinden E, Lindauer RJL (2015) Trauma bij kinderen en adolescenten: screening, diagnostiek en behandeling. Tijdschr Psychiatr 57(12):912–916PubMed Verlinden E, Lindauer RJL (2015) Trauma bij kinderen en adolescenten: screening, diagnostiek en behandeling. Tijdschr Psychiatr 57(12):912–916PubMed
47.
Zurück zum Zitat Zurek G, Schedlich C, Bering R (2006) Manual for trauma-based psychoeducation for victims of disasters. European Network for Psychosocial Aftercare in Case of Disaster. Target Group Intervention Programme Manual III Zurek G, Schedlich C, Bering R (2006) Manual for trauma-based psychoeducation for victims of disasters. European Network for Psychosocial Aftercare in Case of Disaster. Target Group Intervention Programme Manual III
Metadaten
Titel
Psychiatric screening and interventions for minor refugees in Europe: an overview of approaches and tools
verfasst von
Annerieke Horlings
Irma Hein
Publikationsdatum
10.11.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Pediatrics / Ausgabe 2/2018
Print ISSN: 0340-6199
Elektronische ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-017-3027-4

Weitere Artikel der Ausgabe 2/2018

European Journal of Pediatrics 2/2018 Zur Ausgabe

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.