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In 2019, the global Coronavirus (COVID-19) pandemic and associated prevention measures affected the mental health and psychological well-being of young people with and without a migratory background. The present study aimed to compare the mental health and psychological well-being of migrant and non-migrant young people before and after the COVID-19 vaccination campaign period in two countries which had different policies to deal with the pandemic. The "Psychological General Well-being" of young people and their experiences during the pandemic were investigated using an anonymous online survey during two pandemic waves before the vaccination campaign and 6 months after its start. A majority of the 6154 participants (aged between 15 and 25 years in all study groups) reported a decrease of mental health from the time period before the vaccination (BV) to after the vaccination (AV) campaign (b = 0.27, p < .001). This association was higher in females (b = 0.04, p = 0.008) and in youth with financial problems (b = 0.13, p < .001). Furthermore, this decrease was more pronounced in people ≤17 years old (40% to 62%) than in those >17 years (59% to 67%). Contrary to expectation, vulnerable groups such as the economically disadvantaged, younger, and female participants did not experience a significant easing of the pandemic's psychological burden AV. Vaccination campaigns should continue emphasizing the beneficial effects of COVID-19 vaccination on general well-being, but with an acknowledgement that the road to recovery is still a long one. Concurrently, free access to psychological treatment and financial support should be offered, especially for vulnerable groups. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-023-04366-x.
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While suicide can occur throughout the lifespan, worldwide suicide is the second leading cause of death among young people aged between 15 and 29 years. The aim of this multicentre study, conducted in Austria, Germany and Turkey, is to investigate the transcultural differences of suicide attempts among children and adolescents with and without migration background. The present study is a retrospective analyses of the records of 247 young people, who were admitted after a suicide attempt to Emergency Outpatient Clinics of Departments of Child and Adolescent Psychiatry of the collaborating Universities including Medical University of Vienna, Charité University Medicine Berlin and Cerrahpasa School of Medicine and Bakirkoy Training and Research Hospital for Mental Health in Istanbul over a 3-year period. The results of the present study show significant transcultural differences between minors with and without migration background in regard to triggering reasons, method of suicide attempts and psychiatric diagnosis. The trigger event "intra-familial conflicts" and the use of "low-risk methods" for their suicide attempt were more frequent among patients with migration background. Moreover among native parents living in Vienna and Berlin divorce of parents were more frequent compared to parents living in Istanbul and migrants in Vienna. These results can be partly explained by cultural differences between migrants and host society. Also disadvantages in socio-economic situations of migrants and their poorer access to the healthcare system can mostly lead to acute and delayed treatments. Larger longitudinal studies are needed to understand better the impact of migration on the suicidal behaviour of young people.
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Ideação Suicida , Tentativa de Suicídio , Criança , Adolescente , Humanos , Adulto Jovem , Adulto , Tentativa de Suicídio/psicologia , Estudos Retrospectivos , Berlim , Divórcio , Fatores de RiscoRESUMO
The COVID-19 pandemic has been shown to have impaired the mental health and well-being of young people. This study, for the first time, explores these aspects in young people with and without a migratory background during the extended course of the pandemic and restrictive measures, comparing two countries with a high COVID-19 prevalence: Austria and Turkey. METHODS: The authors used the "Psychological General Well-being" index as part of an anonymous online survey with 3665 participants (ages 15-25), recruited from both countries during the first and the second waves of the pandemic, collecting data on individual experiences and problems encountered during the pandemic. RESULTS: Mental health (b = 0.06, p < 0.023) and general psychological well-being worsened with the progression of the pandemic. Participants with financial problems had the most severe negative effect on mental health (b = 0.12, p < 0.001). Furthermore, females living in Turkey, both natives (b = -0.21, p < 0.001) and migrants (b = 0.25, p < 0.001), reported a more deteriorated mental health status over time. CONCLUSIONS: The extended pandemic duration and resultant "lockdown" restrictions have negatively affected the mental health of young people to varying degrees, depending on country of residence and migration background. A strong "recovery plan" that considers group-specific needs and vulnerabilities is urgently needed.
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COVID-19 , Pandemias , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Saúde Mental , SARS-CoV-2 , Adulto JovemRESUMO
Little is known about the impact of the COVID-19 pandemic on the mental health and psychological well-being of young people. The aim of this study is to investigate the psychological well-being and changes in the mental-health state of young people living in Austria and Turkey. By using an anonymous online survey, we recruited 1240 people aged 15-25 years from these two countries. We used the "Psychological General Well-being" and a self-created questionnaire to capture individual experiences during the COVID-19 pandemic and quarantine period. The native Turks indicated higher "anxiety" (ps < 0.010), lower "vitality" (ps < 0.011), and lower "general health" (ps < 0.011) than native Austrians or Austrian migrants and increased "depression" (p = 0.005) and lower "self-control" (p = 0.022), than Austrian migrants. Moreover, 50.9% of native Turks reported a decrease in their mental health status, compared to 31.1% of native Austrians and 23.7% of Austrian migrants. Participants with financial problems (OR = 1.68) and prior mental health problems (i.e., already in treatment by the time of COVID-19, OR = 5.83) reported a higher probability for a worsening in their mental health status. Our results show that the COVID-19 pandemic impaired the psychological well-being and mental health of young people. Especially people in Turkey were most affected, probably due to the stringent policies to fight COVID-19.
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COVID-19/psicologia , Saúde Mental , Pandemias , Adolescente , Adulto , Ansiedade/epidemiologia , Áustria , Depressão/epidemiologia , Emigrantes e Imigrantes/psicologia , Humanos , Inquéritos e Questionários , Turquia/epidemiologia , Adulto JovemRESUMO
Minors with and without migration background can have different risk factors and triggering reasons for self-harming and suicidal behaviour. We retrospectively analysed the data of 192 children and adolescents to investigate the transcultural differences in self-harming, as well as suicidal behaviour in Austrian, Turkish, and Bosnian/Croatian/Serbian (BCS)-speaking patients, who were treated in an emergency out-patient clinic in Vienna. Our results showed transcultural differences in both behaviours. In all groups, females had higher rates of suicide attempts and self-harming behaviour than males. While Turkish-speaking patients received treatment more often, after attempted suicide, Austrians and BCS-speaking patients needed treatment more often for acute stress disorder. Suicide attempts and self-harming behaviours were triggered most frequently by intrafamilial problems, but more frequently in migrant patients. Turkish-speaking patients were at a more than 2 times (OR = 2.21, 95%CI: 1.408-3.477) higher risk for suicide attempts, and were triggered almost 3 times (OR = 2.94, 95%CI: 1.632-5.304) more often by interfamilial conflicts. The suicide attempts of BCS-speaking minors were more often caused by relationship and separation crises (OR = 2.56, 95%CI: 1.148-5.705). These transcultural differences in suicidal and self-harming behaviour of minors, demand an increase of transcultural competence to provide optimal treatment of migrant children.
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Características Culturais , Comportamento Autodestrutivo , Ideação Suicida , Adolescente , Áustria , Criança , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Comportamento Autodestrutivo/epidemiologiaRESUMO
BACKGROUND: Social anxiety disorder (SAD) in adolescents may be associated with the use of maladaptive emotion regulation (ER) strategies. The present study examined the use of maladaptive and adaptive ER strategies in adolescents with SAD. METHODS: 30 adolescents with SAD (CLIN) and 36 healthy adolescents for the control group (CON) aged between 11 and 16 years were assessed with the standardized questionnaires PHOKI (Phobiefragebogen für Kinder und Jugendliche) for self-reported fears as well as FEEL-KJ (Fragebogen zur Erhebung der Emotionsregulation bei Kindern und Jugendlichen) for different emotion regulation strategies. RESULTS: Compared to controls, adolescents with SAD used adaptive ER strategies significantly less often, but made use of maladaptive ER strategies significantly more often. There was a significant positive correlation between maladaptive ER and social anxiety in adolescents. Examining group differences of single ER strategy use, the CLIN and CON differed significantly in the use of the adaptive ER strategy reappraisal with CLIN reporting less use of reappraisal than CON. Group differences regarding the maladaptive ER strategies withdrawal and rumination, as well as the adaptive ER strategy problem-solving were found present, with CLIN reporting more use of withdrawal and rumination and less use of problem-solving than CON. CONCLUSIONS: Promoting adaptive emotion regulation should be a central component of psychotherapy (cognitive behavioral therapy-CBT) for social anxiety in adolescents from the beginning of the therapy process. These findings provide rationale for special therapy programs concentrating on the establishment of different adaptive ER strategies (including reappraisal). As an increased use of maladaptive ER may be associated with SAD in adolescents, it may be paramount to focus on reduction of maladaptive ER (for example withdrawal and rumination) from the beginning of the psychotherapy process. Incorporating more ER components into psychotherapy (CBT) could increase the treatment efficacy. Further investigations of the patterns of emotion regulation in specific anxiety groups like SAD in adolescents is needed to continue to optimize the psychotherapy (CBT) concept.
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BACKGROUND: Compared to their indigenous peers, migrant children and adolescents are at increased risk for mental health problems. The aim of our study was to compare psychological disorders of children and adolescents with Turkish migration background and their native Austrian peers. METHODS: We analysed 302 children and adolescents aged between 7 and 18 years. The sample consisted of 100 Austrian and 100 Turkish outpatients with mental health problems, and 102 healthy controls, 52 with Austrian and 50 with Turkish background, recruited from various Viennese local child and youth centres. RESULTS: Native patients had more frequently externalizing problems (42.1%) compared to the Turkish-speaking sample (28%). However, in the control group, Turkish-speaking children and adolescents had higher levels of internalizing, depressive and anxiety symptoms compared to their native peers. CONCLUSIONS: We found noticeable differences in psychological problems among children and adolescents with and without migration background. We assume that migration-related stress factors are responsible for these differences. Also, children and adolescents with migration background seek for psychological help less frequently than their indigenous peers.
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Objective: Attention-deficit/hyperactivity disorder (ADHD) may have a lasting effect on the quality of life (QoL) of children and their parents. Children with ADHD as well as their parents report a lower QoL compared with healthy children and children with chronic diseases such as bronchial asthma. The primary objective of this study was to investigate the changes of QoL of children with ADHD and their parents' subjective well-being before and after starting pharmacotherapy. We used the appropriate KINDL questionnaire for assessing the children's QoL and the World Health Organization (WHO) Big Five Questionnaire for assessing parental well-being. Methods: We assessed the QoL and the parental well-being in 60 children and adolescents with ADHD between the ages of 6 and 12 years [mean age 8.7 years, (standard deviation = 1.8)], treated at the Department of Child and Adolescent Psychiatry of the Medical University of Vienna. QoL was rated using the KINDL questionnaires, and parental well-being was assessed using the WHO Big Five Questionnaire (WHO-5) before and after starting pharmacotherapy. We used t-tests and three-way GLM-ANOVA (SPSS, version 22; IBM Corp.) for evaluating the statistical significance of pre-post differences. Results: The QoL of the children with ADHD and the subjective well-being of the parents improved significantly after introducing pharmacotherapy. Conclusions: Pharmacotherapy is recommended in children with clinically significant ADHD not only because it helps to improve the symptoms of ADHD, but also their QoL and the well-being of their parents.
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Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Pais/psicologia , Qualidade de Vida , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Inquéritos e QuestionáriosRESUMO
BACKGROUND: The symptoms following a traumatic event as well as the coping strategies can be culture specific. The objective of the present study was to analyse the transcultural differences of psychologically traumatized children and adolescents with and without migration background. METHODS: The medical files of 199 psychologically traumatized children and adolescents (99 native Austrian, 100 Turkish-speaking) who were treated at the Department of Child and Adolescent Psychiatry in Vienna were retrospectively analysed. RESULTS: The most frequently observed causes of trauma in patients with Turkish migration background were intra-familial conflicts, forced separation from parent(s), and conforming to a new environment. In native Austrian patients, forced separation from parent(s) and divorce or separation of parents were the leading causes of trauma. Trauma-related symptoms like changed mood, cognitive and perceptual disturbance, social withdrawal, sleeping problems, somatisation and behavioural problems were similarly observed in both groups; "sleeping problems" were more often observed in Austrian patients, and "behavioural problems" were more often observed in Turkish patients. More Austrian patients (32.7%) obtained psychiatric and psychotherapeutic treatment. Turkish-speaking patients mostly obtained psychiatric treatment only. Patients with migration background were more compliant compared to indigenous patients. CONCLUSIONS: Both study groups differed in type, causes and symptoms of trauma, and in preferred therapy. Turkish-speaking patients were more compliant with therapy, as they received culture and language-sensitive medical advice and treatment in their mother tongue. Considering the cultural background of patients can optimize service delivery and therapy outcomes among children and adolescents with stressful and traumatic experiences.
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Psiquiatria do Adolescente , Psiquiatria Infantil , Comparação Transcultural , Trauma Psicológico/psicologia , Trauma Psicológico/terapia , Adolescente , Ansiedade de Separação , Áustria , Criança , Divórcio/psicologia , Humanos , Pais , Trauma Psicológico/etiologia , Psicoterapia , Estudos Retrospectivos , TurquiaRESUMO
BACKGROUND: Associations of social anxiety disorder (SAD) with various somatic symptoms have been already reported in the literature several times. The present study investigated somatic complaints in children and adolescents with SAD compared to controls and evaluated the relationship between social anxiety and somatic symptom severity. METHODS: Thirty children and adolescents with SAD were compared with 36 healthy age-matched controls. Self-reported fears were assessed using the Phobiefragebogen für Kinder und Jugendliche (PHOKI); emotional and behavioral problems were assessed using the Child Behavior Checklist (CBCL/4-18); and the Gießener Beschwerdebogen für Kinder und Jugendliche (GBB-KJ) was used to assess 59 somatic symptoms. RESULTS: Parents and youth with SAD reported higher somatic symptom severity compared to controls. Youth with SAD more frequently reported stomach pain, circulatory complaints, and fatigue than controls. Specific group differences between SAD and control youth were found for the following single somatic symptoms: faintness, quickly exhausted, sensation of heat, stomachache, nausea, dizziness, and sudden heart complaints. Parents of girls with SAD reported higher somatic symptom severity than parents of boys with SAD. CONCLUSIONS: The results demonstrated a significant positive association between somatic symptoms and social anxiety in youth. The results of the present study can help to develop improved screening measurements, which increase the proportion of children and adolescents with SAD receiving proper treatment.
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Medo , Fobia Social/psicologia , Adolescente , Estudos de Casos e Controles , Criança , Feminino , Humanos , Masculino , Pais/psicologia , AutorrelatoRESUMO
OBJECTIVE: Suicidal behavior of young people is a topic of utmost importance because suicide is irreversible, and should be prevented. Knowing about the psychosocial background and the triggering events could help in preventing suicidal behavior. We therefore aimed at identifying psychosocial factors that may trigger suicidal behavior in youth. METHODS: We analyzed retrospectively the standardized records of 2232 youths aged ≤25 years, who were treated after a suicide attempt at emergency units of public hospitals in Istanbul, Turkey during a period of 1 year. We describe this population according to sex and socio-economic conditions, like educational, occupational, relationship status and link them with their reported reasons for suicide attempts. RESULTS: The majority of patients were female (81.6%, N = 1822 females, 18.4%, N = 410 males). Independent of their educational and occupational background, patients indicated most frequently intra-familial problems (females 45.8%, males 30.5%), intrapersonal problems (females 19.9%, males 18.5%), and relationship problems (females 11.3%, males 23.9%) as triggering reasons. CONCLUSIONS: Because intra-familial problems were the most frequently reported triggers of suicide attempts, preventive measures should focus on handling intra-familial conflicts. As sex differences were observed for the second-most common trigger-reasons, prevention should also focus on differentially handling intrapersonal and relationship conflicts better.
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Conflito Familiar , Relações Interpessoais , Fatores Socioeconômicos , Tentativa de Suicídio/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores Sexuais , Turquia/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Seasonal changes and climatic factors like ambient temperature, sunlight duration and rainfall can influence suicidal behavior. METHODS: This study analyses the relationship between seasonal changes and climatic variations and suicide attempts in 2131 young patients in Istanbul, Turkey. RESULTS: In our study sample, there was an association between suicide attempts in youths and seasonal changes, as suicide attempts occurred most frequently during summer in females as well as in males. Furthermore, there was a positive correlation between the mean temperature over the past 10 days and temperature at the index day and suicide attempts in females. After seasonality effects were mathematically removed, the mean temperature 10 days before a suicide attempt remained significant in males only, indicating a possible short-term influence of temperature on suicide attempts. CONCLUSIONS: This study shows an association between suicide attempts of young people and climatic changes, in particular temperature changes as well as seasonal changes. Therefore, the influence of seasonal changes and climatic factors on young suicide attempters should get more attention in research to understand the biopsychosocial mechanisms playing a role in suicide attempts of young people. As suicide attempts most frequently occur in young people, further research is of considerable clinical importance.
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Estações do Ano , Tentativa de Suicídio/estatística & dados numéricos , Adolescente , Serviços de Saúde do Adolescente , Adulto , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Ideação Suicida , Tentativa de Suicídio/psicologia , Luz Solar , Turquia/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Different psychosocial factors might have an impact on suicidal behaviour and evidence shows that there may be an association between monthly, diurnal and circadian changes and suicidal behaviours. METHODS: In the present study we analysed retrospectively records of 2232 youth, who were treated in emergency units of state hospitals in Istanbul/Turkey after attempting suicide. RESULTS: The majority of the suicide attempters were females (81.6%). In both sexes, suicide attempts most frequently occurred at the beginning of the calendar week and between evening and midnight. CONCLUSIONS: This study shows that suicide attempts in youth follow diurnal and circadian changes. As suicide attempts of youth most frequently occurred at the beginning of the calendar week and between evening and midnight, health services such as specialized counselling for youth should especially be available during this time.
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OBJECTIVE: Despite the growing number of young second-generation immigrant (SGI) children and adolescents, studies about their mental health are rare. The objective of this study was to investigate the mental health problems of SGI children and adolescents in Istanbul, Turkey. METHODS: In a clinical sample the mental health of 54 SGIs and 50 native children and adolescents were examined using the Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime Version (K-SADS-PL) and Children's Global Assessment Scale. The assessments were carried out by a blinded rater. RESULTS: SGI children had higher rates of psychiatric disorders such as depression (p = 0.001), post-traumatic stress disorder (PTSD) (p = 0.011) and anxiety disorders (p = 0.013), more comorbid disorders and lower functionality scores compared to their native counterparts (p = 0.001). CONCLUSIONS: SGI children seem to have higher rates of psychiatric disorders most probably due to migration-induced burdens. The professionals treating SGI children should have more awareness for these problems to be able to approach them in a culture and language sensitive way.
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Transtornos de Ansiedade/epidemiologia , Depressão/epidemiologia , Emigrantes e Imigrantes/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adolescente , Criança , Comorbidade , Feminino , Humanos , Masculino , Turquia/epidemiologiaRESUMO
BACKGROUND: The conditions of children and adolescents with migration background receiving emergency psychiatric care in Europe are not well known. Migrants usually attend regular psychiatric care less frequently than the autochthonous population. We therefore speculated that, being undertreated, they would be overrepresented among psychiatric emergency care patients. METHODS: We retrospectively analyzed the records of 1093 minors aged 418 years treated during a period of three years at the psychiatric emergency outpatient clinic of the Department of Child and Adolescent Psychiatry at the Medical University of Vienna. RESULTS: More minors with migration background than natives consulted our emergency clinic. Most frequent reasons for referral were suicide attempts by Turkish patients, acute stress disorder in Serbian/Croatian/Bosnian and in Austrian patients. Psychiatric diagnoses like eating and personality disorders were mostly diagnosed in natives. We found gender specific differences between the groups. CONCLUSIONS: The reasons for these differences possibly relate to deficits of adequate mental health-care in Austria, to intercultural and intrafamiliar conflicts related to acculturation distress in the migrant population. Prospective longitudinal studies focusing on the utilization of mental health care by the migrant children and the impact of the migration background on their mental health are needed for improving adequate culture-sensitive mental-health care for this population.
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Serviços de Emergência Psiquiátrica/estatística & dados numéricos , Emigrantes e Imigrantes/psicologia , Transtornos Mentais/etnologia , Transtornos Mentais/terapia , Menores de Idade/psicologia , Adolescente , Áustria , Bósnia e Herzegóvina/etnologia , Criança , Pré-Escolar , Croácia/etnologia , Comparação Transcultural , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Grupos Populacionais/psicologia , Grupos Populacionais/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , Sérvia/etnologia , Fatores Sexuais , Transtornos de Estresse Traumático Agudo/epidemiologia , Transtornos de Estresse Traumático Agudo/etnologia , Transtornos de Estresse Traumático Agudo/psicologia , Transtornos de Estresse Traumático Agudo/terapia , Tentativa de Suicídio/etnologia , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos , Turquia/etnologiaRESUMO
BACKGROUND: The aim of the present study was to evaluate psychiatric problems and disorders among Yazidi Kurd refugee children and adolescents, who were assessed immediately after their forced migration following life-threatening attacks by ISIS terrorists. METHODS: We retrospectively analyzed the psychiatric assessments of 38 Yazidi children and adolescents (age 2-18, mean 12 years, m:f = 16:22), which were performed upon their arrival at the refugee camp. RESULTS: All children and adolescents exhibited psychiatric problems and disorders, 50 % had one, and 50 % had more than one. The most relevant problems were disturbed sleeping (71 % of children), followed by depression (36.8 %), conversion disorders (28.9 %), adjustment (21.8 %), acute (18.4 %) and posttraumatic stress (PTSD, 10.5 %) disorders, and non-organic enuresis (18.4 %). CONCLUSION: Our study confirms the results of previous studies, asserting that refugee children and adolescents do not just suffer from PTSD but from various other problems that are already present in the first days of resettlement. Children and adolescents living in refugee camps urgently need psychosocial support.
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Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Refugiados/psicologia , Refugiados/estatística & dados numéricos , Terrorismo/psicologia , Terrorismo/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Comorbidade , Feminino , Humanos , Iraque , Masculino , Determinação da Personalidade , Estudos Retrospectivos , SíriaRESUMO
BACKGROUND: Suicidal behaviour is related to psychosocial and biological factors. Although suicide is strictly forbidden by the Islamic faith, there are non-confirmed observations of increased suicidality on religious feast days. The objective of the present study was to find out if suicide attempts of youths living in Istanbul increase on religious feast days compared to ordinary and non-religious holidays. METHODS: We retrospectively analyzed all suicide attempts (N = 2,232) of young people up to 25 years of age seeking support at various hospitals in Istanbul in 2010. The main hypothesis was that the number of suicide attempts would increase during religious feast days. RESULTS: The number of suicide attempts was higher on religious feast days and non-religious holidays except for New Year's Day and International Labour Day than the daily average number of the actual months. Like on ordinary days, more female than male youth (84.9% vs. 15.1%) attempted suicide on feast days. CONCLUSION: We speculate that changes of the daily rhythm and increased family interaction on feast days and non-religious holidays could lead to unexpected confrontations and disputes instead of the expected positive family climate. This "Broken-Promise Effect" and changes of the daily rhythm could contribute to the observed increased suicidal behaviour.