[Psychodiagnostics in Psychosocial Centers for Refugees]. / Psychodiagnostik in den psychosozialen Zentren für geflüchtete Menschen.

OBJECTIVE: Accurate psychodiagnostics is crucial for diagnosing and ensuring quality treatment for individuals with mental health disorders. However, there is limited understanding of psychodiagnostic practices within Psychosocial Centers (PSZ) when dealing with refugees, particularly in the presence of language and cultural barriers and resource constraints. This study aims to evaluate the current status and potential pathways for enhancing culturally sensitive diagnostics in this context. METHODS: We conducted an online survey using a self-developed questionnaire with representatives from 32 PSZ to examine psychodiagnostic practices, barriers, and perceived development potentials, and analyzed the data descriptively. RESULTS: Most centers prefer individual case assessments over standardized diagnostics. Key barriers to using standardized questionnaires and interviews include communication difficulties (unfamiliarity with question formats, reading and writing difficulties) and resource limitations (time, translation). When conducting diagnostics, time constraints and prioritizing complex cases are the primary challenges. Additional assessments are needed for several disorders and languages. Employees are interested in receiving training in the field of culturally sensitive diagnostics. DISCUSSION: Diagnostic practice in the PSZs is characterized by numerous challenges that differ from the challenges in standard care. In order to ensure appropriate standardized diagnostics and care for mentally distressed people with a refugee or migrant background, further expansion of the linguistic and cultural adaptation of established diagnostic instruments is essential. CONCLUSION: In the care of psychologically distressed refugees, culturally sensitive standardized diagnostics offer critical benefits for both practitioners and affected individuals. Existing resources are being referred to.

Temporal stability of optimism and pessimism (LOT-R) over 6 years in the general population.

Objective: The aims of this study were to examine changes in habitual optimism over a six-year period and to analyze the relationship between changes in optimism and changes in other quality of life-related variables. Method: A randomly selected community sample of the German adult general population (N = 4,965) was surveyed twice, with a time interval of 6.04 years. Results: During the course of the 6 years, the mean score of the LOT-R total scale improved (effect size d = 0.11). The temporal stability in terms of the test-retest correlation was r = 0.61 for the total sample. There were only marginal gender differences in this temporal stability, however, the stability in the oldest age group ≥70 years (r = 0.50) was lower than the stability of the other age groups. The cross-sectional correlations showed clear relationships between optimism on the one hand and quality of life, life satisfaction, social support, and low levels of anxiety and physical complaints on the other. The corresponding longitudinal correlations between changes in optimism and changes in the other variables were less pronounced, but in the same direction. Conclusion: The study confirmed the applicability of the LOT-R in longitudinal studies. In samples with participants of 70 years and above, the limited stability in the optimism assessments needs to be considered in clinical practice and epidemiologic research.

[Frequency Of Psychological Stress And Barriers To Accessing Mental Health Services For Leipzig Citizens Of Afghan And Iraqi Citizenship]. / Zugangshürden zu psychosozialen Versorgungsangeboten Leipziger Bürger*innen afghanischer und irakischer Staatsangehörigkeit.

OBJECTIVE: Aim of the study was to report evidence on mental health needs and access to mental health and psychosocial support for Leipzig citizens of Afghan and Iraqi citizenship in the presence of mental stress and, above all, to identify barriers to access to care. METHODS: All adults in Leipzig with Iraqi or Afghan citizenship, who were not born in Germany were contacted. Various instruments (PHQ-9, GAD-7, SSS-8, PCL-5/LEC-5) to screen for symptoms of depression, anxiety, somatization disorder or PTSD and one item for self-reported emotional problems were used. Questions on health care utilization and barriers to care followed. RESULTS: 51.4% screened positive in at least one of the tests and self-reported emotional problems. 38.2% of those in need of treatment did not seek help. Frequent reasons for not seeking help were, that the people wanted to solve the problem on their own or that the problem did not bother them very much. A lack of trust and understanding regarding the healthcare system and fear of discrimination and stigmatisation were also perceived as additional barriers to care. DISCUSSION: The study revealed a high percentage of mental health needs. This could be due to the high number of traumatic events and post-migration stressors. A longer period of residence in Germany and easier access to the public health system through the health insurance card could have encouraged the health care utilization. The treatment gap was caused by barriers to care such as a lack of knowledge or trust of the German health care system and fear of stigmatisation and discrimination. CONCLUSION: More information about access to care structures and more low-threshold services need to be implemented. These should be organised on an interdisciplinary basis and focus on culturally and racially sensitive care. Mental health awareness should be strengthened and under no circumstances should the access to care be restricted any further.

[The Connection between Objective and Subjective Attributions of a Migration Background with Perceived Discrimination and Racism]. / Der Zusammenhang zwischen objektiven und subjektiven Zuschreibungen eines Migrationshintergrundes mit wahrgenommener Diskriminierung und Rassismus.

BACKGROUND: The criteria-oriented assessment of the population with a migration background that is common in Germany is currently being criticized from a social science and methodological perspective, among others. In particular, its usefulness as an indicator of perceived discrimination against the population with a migration background can be critically questioned based on the current state of research METHOD: Based on a population-representative data set (N=1,989) for the city of Berlin, the subjective perception of a migration background based on self-attribution and anticipated external attribution of a migration background was recorded in addition to the objective assessment of a migration background. Furthermore, socio-demographic and migration-specific characteristics as well as perceived discrimination were assessed. Using descriptive and inferential statistical methods, differences between the objective and subjective assessment of a migration background and their relationship with perceived discrimination were analyzed. RESULTS: Less than half (38%, 154/400) of the respondents identified as having a migrant background using the criterion-oriented approach reported describing themselves as migrants. 36% (144/405) reported that they believed that others in Germany described them as a person with a migrantion background. Respondents with a migration background are significantly more likely to experience discrimination on grounds of skin color, religion or country of origin compared to respondents without a migration background. Furthermore, it was found that both the self-attribution and the anticipated attribution by others as a migrant are positively associated with experiences of discrimination and racism. DISCUSSION: The results suggest that migration-sensitive research should not simply differentiate between people with and without a migration background according to official criteria. Rather, the subjective perceptions of one's own attribution as a migrant seem more suitable as indicators of discrimination and should be taken into account in future research or surveys on experiences of discrimination.

An internet-based cognitive behavioural intervention for adults with depression in Arabic-speaking countries: A randomized controlled trial.

Internet-based interventions have proven to be effective for the treatment of depression in different samples, but evidence from the Middle East and North Africa (MENA) region is scarce. The aim of this study was to investigate the acceptance and efficacy of an internet-based cognitive behavioural writing intervention for Arabic-speaking participants with depression living in the MENA region. A total of 259 participants (167 female, age in years: M = 25.58, SD = 6.39) with depressive symptoms indicative of clinical relevance were randomly allocated to a treatment group (TG; nTG = 128) or a waitlist control group (WG; nWG = 131). The TG received an internet-based intervention over a 6-week period. The primary outcome was depressive symptoms, and secondary outcomes were anxiety and quality of life (QoL). T-tests with change scores from pre- to post-treatment were used for data analyses. Intention-to-treat (ITT) as well as completer analyses were calculated. The ITT analysis revealed significant differences between the TG and WG in depression (T257 = -4.89, p < 0.001, d = 0.70) and QoL (T257 = 3.39, p < 0.001, d = 0.47). Significant differences regarding anxiety symptoms (T257 = 3.25, p < 0.05, d = 0.53) were identified for the completer sample. The general dropout rate was 39.9%. The results indicate the feasibility and efficacy of an internet-based cognitive behavioural writing intervention in adults from Arabic-speaking countries. The development and implementation of such interventions can be used to improve access to psychological help and adequate treatment.

Mental healthcare access among resettled Syrian refugees in Leipzig, Germany.

Our aim was to examine mental health needs and access to mental healthcare services among Syrian refugees in the city of Leipzig, Germany. We conducted a cross-sectional survey with Syrian refugee adults in Leipzig, Germany in 2021/2022. Outcomes included PTSD (PCL-5), depression (PHQ-9), anxiety (GAD-7) and somatic symptom (SSS-8). Descriptive, regression and effect modification analyses assessed associations between selected predictor variables and mental health service access. The sampling strategy means findings are applicable only to Syrian refugees in Leipzig. Of the 513 respondents, 18.3% had moderate/severe anxiety symptoms, 28.7% had moderate/severe depression symptoms, and 25.3% had PTSD symptoms. A total of 52.8% reported past year mental health problems, and 48.9% of those participants sought care for these problems. The most common reasons for not accessing mental healthcare services were wanting to handle the problem themselves and uncertainty about where to access services. Adjusted Poisson regression models (n = 259) found significant associations between current mental health symptoms and mental healthcare service access (RR: 1.47, 95% CI: 1.02-2.15, p = 0.041) but significance levels were not reached between somatization and trust in physicians with mental healthcare service access. Syrian refugees in Leipzig likely experience high unmet mental health needs. Community-based interventions for refugee mental health and de-stigmatization activities are needed to address these unmet needs in Leipzig.

Changes in trauma appraisal during brief internet-based exposure and cognitive restructuring treatment for Arabic-speaking people with PTSD.

Background: Maladaptive trauma appraisal plays an important role in the development and maintenance of posttraumatic stress disorder (PTSD). While studies have demonstrated the effectiveness of exposure and cognitive treatments for PTSD symptomatology, the effect of such treatments on specific trauma appraisals is still not well understood.Objective: The study investigated the effect of an exposure and a cognitive restructuring internet-based treatment on specific trauma appraisals in Arabic-speaking participants with PTSD.Method: 334 participants received either an exposure (n = 167) or a cognitive restructuring (n = 167) internet-based treatment. PTSD symptom severity (PCL-5) and specific trauma appraisals (TAQ) were assessed at pre- and post-treatment. Changes in specific trauma appraisals within and between the two treatments were analyzed using multi-group change modelling. Associations between changes in PTSD symptom severity and changes in trauma appraisals were evaluated using Pearson product-moment correlation. For both treatments, participants with versus without reliable improvement were compared regarding changes in specific trauma appraisals using Welch tests. Analyses were performed on 100 multiple imputed datasets.Results: Both treatments yielded significant changes in shame, self-blame, fear, anger, and alienation (all ps < .001). Changes in betrayal were only significant in the cognitive restructuring treatment (p < .001). There was no evidence of differences between treatments for any specific trauma appraisal. Changes in PTSD symptom severity were significantly associated with changes in trauma appraisals (all ps < .001). In both treatments, participants who experienced reliable improvement in PTSD symptom severity showed significantly larger pre- to post-treatment changes in specific trauma appraisals compared to those without reliable improvement. Again, differences in betrayal were only significant in the cognitive restructuring treatment.Conclusions: The findings indicate that both treatments are effective in reducing trauma appraisals in Arabic-speaking people with PTSD. Changes in trauma appraisal seem to be associated with changes in PTSD symptomatology.Trial registration: German Clinical Trials Register identifier: DRKS00010245.

Exposure and cognitive restructuring treatment in Arabic-speaking individuals with PTSD yield significant changes in shame, self-blame, fear, anger, and alienation.Changes in PTSD symptoms are positively associated with changes in specific trauma appraisals.There is no evidence of differences between both treatments for any specific trauma appraisal.

The German PCL-5: evaluating structural validity in a large-scale sample of the general German population.

Background: In attempts to elucidate PTSD, recent factor analytic studies resulted in complex models with a proliferating number of factors that lack psychometrical and clinical utility. Recently, suggestions have been made to optimize factor analytic practices to meet a refined set of statistical and psychometric criteria.Objective: This study aims to assess the factorial structure of the German version of the PCL-5, implementing recent methodological advancements to address the risk of overfitting models. In doing so we diverge from traditional factor analytical research on PTSD.Method: On a large-scale sample of the German general population (n = 1625), exploratory factor analyses were run to investigate the dimensionality found within the data. Subsequently, we validated and compared all model suggestions from our preliminary analyses plus all standard and common alternative PTSD factor models (including the ICD-11 model) from previous literature with confirmatory factor analyses. We not only consider model fit indices based on WLSMV estimation but also deploy criteria such as favouring less complex models with a parsimonious number of factors, sufficient items per factor, low inter-factor correlations and number of model misspecifications.Results: All tested models showed adequate to excellent fit in respect to traditional model fit indices; however, models with two or more factors increasingly failed to meet other statistical and psychometric criteria.Conclusion: Based on the results we favour a two-factor bifactor model with a strong general PTSD factor and two less dominant specific factors - one factor with trauma-related symptoms (re-experiencing and avoidance) and one factor with global psychological symptoms (describing the trauma's higher-order impact on mood, cognition, behaviour and arousal).From the perspective of clinical utility, we recommend the cut-off scoring method for the German version of the PCL-5. Basic psychometric properties and scale characteristics are provided.

We contribute new insights to the debate on the factor structure of the PTSD Checklist (PCL-5) based on a large German general population sample deploying the newest methodological developments in a revised factor-analytical approach.Combining theoretical, statistical and practical considerations, we favour a two-factor bifactor model with a strong general PTSD factor and two less dominant specific factors ­ one factor with trauma-related symptoms and one factor with global psychological symptoms.For clinical practitioners, we recommend using the cut-off scoring method.

Exposure Versus Cognitive Restructuring Techniques in Brief Internet-Based Cognitive Behavioral Treatment for Arabic-Speaking People With Posttraumatic Stress Disorder: Randomized Clinical Trial.

BACKGROUND: Cognitive behavioral interventions delivered via the internet are demonstrably efficacious treatment options for posttraumatic stress disorder (PTSD) in underserved, Arabic-speaking populations. However, the role of specific treatment components remains unclear, particularly in conflict-affected areas of the Middle East and North Africa. OBJECTIVE: This study aims to evaluate 2 brief internet-based treatments in terms of efficacy, including change in PTSD symptom severity during treatment. Both treatments were developed in line with Interapy, an internet-based, therapist-assisted cognitive behavioral therapy protocol for PTSD and adapted to the specific research question. The first treatment comprised self-confrontation and social sharing (exposure treatment; 6 sessions); the second comprised cognitive restructuring and social sharing (cognitive restructuring treatment; 6 sessions). The 2 treatments were compared with each other and with a waitlist control group. METHODS: In total, 365 Arabic-speaking participants from the Middle East and North Africa (mean age 25.49, SD 6.68 y) with PTSD were allocated to cognitive restructuring treatment (n=118, 32.3%), exposure treatment (n=122, 33.4%), or a waitlist control group (n=125, 34.2%) between February 2021 and December 2022. PTSD symptom severity, posttraumatic maladaptive cognitions, anxiety, depressive and somatoform symptom severity, and quality of life were assessed via self-report at baseline and after treatment or waiting time. PTSD symptom severity was also measured throughout treatment or waiting time. Treatment satisfaction was assessed after treatment completion. Treatment use and satisfaction were compared between the 2 treatment conditions using appropriate statistical tests (eg, chi-square and Welch tests). Multiple imputation was performed to address missing data and evaluate treatment-associated changes. These changes were analyzed using multigroup change modeling in the completer and intention-to-treat samples. RESULTS: Overall, 200 (N=240, 83.3%) participants started any of the treatments, of whom 123 (61.5%) completed the treatment. Treatment condition was not significantly associated with the proportion of participants who started versus did not start treatment (P=.20) or with treatment completion versus treatment dropout (P=.71). High treatment satisfaction was reported, with no significant differences between the treatment conditions (P=.48). In both treatment conditions, PTSD, anxiety, depressive and somatoform symptom severity, and posttraumatic maladaptive cognitions decreased, and quality of life improved significantly from baseline to the posttreatment time point (P≤.001 in all cases). Compared with the baseline assessment, overall PTSD symptom severity decreased significantly after 4 sessions in both treatment conditions (P<.001). Moreover, both treatment conditions were significantly superior to the waitlist control group regarding overall PTSD symptom severity (P<.001) and most other comorbid mental health symptoms (P<.001 to P=.03). Differences between the 2 conditions in the magnitude of change for all outcome measures were nonsignificant. CONCLUSIONS: Internet-based cognitive behavioral treatments for PTSD focusing primarily on either self-confrontation or cognitive restructuring are applicable and efficacious for Arabic-speaking participants. TRIAL REGISTRATION: German Clinical Trials Register DRKS00010245; https://drks.de/search/de/trial/DRKS00010245.

[Assessment of the Individual Experience of Sexual Violence in War and Forced Displacement and its Consequences Among Male Victims: A Narrative Literature Review]. / Dimensionale Erfassung des individuellen Erlebens kriegs- und vertreibungsbezogener sexualisierter Gewalt und ihrer Folgen bei männlichen Betroffenen: Eine narrative Literaturübersicht.

From a psychological perspective, male survivors of sexual violence in the context of war and forced displacement represent a highly burdened population. An adequate assessment of traumatic events and trauma related disorders is often hampered by both disclosure barriers from the patient side as well as by lack of awareness on the part of healthcare professionals regarding male victimization. Based on a narrative literature review, relevant characteristics of violence and their relation to the diagnostic process are elaborated on eight dimensions of individual experience of violence (form of violence, frequency and severity, perpetrator-victim context, societal discrimination, subjective evaluation, concept of masculinity, culture-specific norms, and trauma sequelae). The dimensions are delineated in a case study. In order to thoroughly assess sexualized experiences of violence, there is a need for sensitivity on the part of practitioners to the signs of male victimization and regular assessment of sexualized violence in male patients. In this context, certainty about the confidentiality of the information disclosed and recognition of the injustice are of central importance for those affected. In the long term, the development of specialized support services for male victims is needed.

Mental health of recently arrived male refugees in Germany reporting sexual violence.

Conflict-related sexual violence (CRSV) is one of the most severe and stigmatizing human rights violations. The recognition of men and boys as targets of sexual violence is a rather recent development. In the present study data on experiences of sexual violence as well as mental health outcomes were analysed in recently arrived male refugees (N = 392) in Germany. More than one third of the men interviewed (n = 128; 36.6%) reported having experienced sexual violence. Compared to male refugees without experiences of sexual violence, male refugee survivors showed higher prevalence rates of PTSD. Moreover, some differences were found between the subgroups on the single symptoms level, indicating higher severity in those affected by sexual violence, including negative alterations in cognition/mood, suicidal ideation, and nervousness or shakiness inside. The findings provide initial data on prevalence of sexual violence and related mental health outcomes in male refugees newly arrived in Germany and emphasize the significance of sexual violence as a risk factor for different mental health outcomes. This provides clear implications for health care professionals that could aid them in better identifying those affected. Finally, further research is urgently needed that takes a closer, more differentiated look at sexual violence in male refugee populations.

Challenges faced by university students during the COVID-19: An international study in five countries during the early phase of the pandemic.

This study focused on the specific challenges of university students in the face of the COVID-19 pandemic and examined similarities and differences in COVID-related concerns and difficulties in functioning in samples of undergraduate students in five countries. A sample of 4306 undergraduate university students (43.8% males, 56.2% females) from Israel, Kosovo, Ukraine, Cyprus and Germany participated in an anonymous online survey during the first wave of the pandemic, between March and June 2020. Study variables included the assessment of the exposure to COVID-19, perceived health status, specific COVID-related concerns and functional difficulties, social support, and the perceived level of coping. Similar concerns about the uncertainty regarding the termination of the health crisis and worry for the health of family members were identified as the most common concerns in the five countries. Challenges in online learning and financial difficulties were rated as the most central difficulties. Both COVID-related concerns and COVID-related difficulties predicted lower levels of perceived coping. Greater social support was associated with better perceived coping. Policymakers should be informed by the accumulating research showing the substantive relationships between academic difficulties and perceived COVID-related distress and coping.

Prevalence of suicidal ideation and suicide attempts among refugees: a meta-analysis.

BACKGROUND: Suicidal ideation and attempts are one of the most serious mental health problems affecting refugees. Risk factors such as mental disorders, low socio-economic status, and stressful life events all contribute to making refugees a high-risk group. For this reason, this meta-analysis aims to investigate the prevalence of suicidal ideation and attempts among refugees in non-clinical populations. METHOD: We searched PubMed, Web of Science, PubPsych, and PsycInfo for articles reporting (period) prevalence rates of suicidal ideation and attempts. Inclusion criteria were the population of refugees or asylum seekers (aged 16 years and older), assessment of the prevalence of suicidal ideation and attempts in empirical studies in cross-sectional or longitudinal settings, written in English, and published by August 2020. Exclusion criteria were defined as a population of immigrants who have lived in the host country for a long time, studies that examined children and adolescents younger than 16 years, and research in clinical samples. Overall prevalence rates were calculated using Rstudio. RESULTS: Of 294 matches, 11 publications met the inclusion criteria. The overall period prevalence of suicidal ideation was 20.5% (CI: 0.11-0.32, I2 = 98%, n = 8), 22.3% (CI: 0.10-0.38, I2 = 97%, n = 5) for women, and 27.7% for men (CI: 0.14-0.45, I2 = 93%, n = 3). Suicide attempts had an overall prevalence of 0.57% (CI: 0.00-0.02, I2 = 81%, n = 4). CONCLUSION: There is a great lack of epidemiological studies on suicidal ideation and attempts among refugees. The high prevalence of suicidal ideation indicates the existence of heavy psychological burden among this population. The prevalence of suicide attempts is similar to that in non-refugee populations. Because of the large heterogeneity between studies, the pooled prevalence estimates must be interpreted with caution. The results underline the need for systematic and standardized assessment and treatment of suicidal ideation and attempts.

Suicidal ideation among recently arrived refugees in Germany.

BACKGROUND: Refugees are considered a high-risk population for developing mental health disorders. Yet little research has been conducted on suicidal ideation among refugees resettled in Western high-income countries. In the present hstudy, suicidal ideation and its association with different socio-demographic, flight-related, and mental health-related factors were analyzed in recently arrived refugees in Germany. METHODS: The study was conducted in a reception facility for asylum-seekers in Leipzig, where 564 newly arrived adult residents participated. The questionnaire included socio-demographic and flight-related questions as well as standardized instruments for assessing suicidal ideation (item 9 from PHQ-9), a variety of traumatic experiences (LEC-5), posttraumatic stress disorder (PCL-5), depression (PHQ-8), and somatic symptoms (SSS-8). Multiple logistic regression models were run to predict suicidal ideation in relation to different socio-demographic, flight, and mental health-related factors. RESULTS: In total, 171 (30.3%) participants who had just or very recently arrived in Germany reported having experienced suicidal ideation within the two weeks prior to being assessed. Those who reported suicidal ideation also reported higher prevalence of somatic symptoms, posttraumatic stress disorder, depression, and experiences of sexual violence, as well as worse self-rated mental and physical health. In addition, there were significant independent associations between suicidal ideation and (1) younger age, (2) longer flight duration, (3) experiences of sexual violence, (4) symptoms of posttraumatic stress disorder, and (5) symptoms of depression. CONCLUSIONS: The results emphasize the association between suicidal ideation and different clinically relevant mental health symptoms among newly arrived refugees in Germany. Special attention should not only be given to refugees suffering from symptoms of poor mental health, but also to those of younger age as well as refugees who have experienced sexual violence, as they might be affected by suicidal ideation whether or not they suffer from other mental health problems.

Factors predicting symptoms of somatization, depression, anxiety, post-traumatic stress disorder, self-rated mental and physical health among recently arrived refugees in Germany.

BACKGROUND: There is a large body of research indicating increased prevalence rates of mental disorders among refugees. However, the vast majority of the evidence available on risk factors for mental disorders among refugees focuses on post-migration stressors and was collected in surveys that were conducted months and sometimes years after the participants had resettled. OBJECTIVE: In the present study, we analyze socio-demographic and flight-related characteristics as predictors for symptoms of somatization, depression, anxiety, and post-traumatic stress disorder as well as self-rated mental and physical health in recently arrived refugees (up to 4 weeks after arrival) in Germany. METHODS: The study was conducted in a reception facility for asylum-seekers in Leipzig, Germany. A total of 1316 adult individuals arrived at the facility during the survey period; 502 took part in the study. The questionnaire (self-administrated) included socio-demographic and flight-related questions as well as standardized instruments for assessing PTSD (PCL-5), depression (PHQ-9), anxiety (HSCL-10) and somatization (SSS-8). Linear regression models were conducted to predict symptoms of different mental disorders as well as self-rated mental and physical health. RESULTS: Lack of information about family members and subjective need for health care were found to be significantly associated with symptoms of depression, somatization, anxiety, and PTSD. Better self-rated mental health was significantly associated with partnership, childlessness, lower number of traumatic events, and having information about family left behind. No associations were found between flight-related factors and symptom burden. CONCLUSIONS: The results provide initial methodologically robust insights for research and health care services, which should aid in better identifying newly arrived refugees in need of psychosocial care. Furthermore, the results might help answering the question of how to provide health care for highly vulnerable groups within refugee populations regardless their residential status.

Health care needs among recently arrived refugees in Germany: a cross-sectional, epidemiological study.

OBJECTIVES: The purpose of the present study is to investigate current needs for physical and/or mental health treatment in recently arrived refugees' by considering socio-demographic, flight, and mental health-related characteristics as well as different social care needs based on epidemiological data. METHODS: The study was conducted in a reception facility for asylum-seekers in Leipzig, where 569 newly arrived adult residents participated. The questionnaire included socio-demographic and flight-related questions as well as standardized instruments for assessing mental health symptoms. Logistic regression models were conducted to predict current needs for treatment of self-rated physical and mental health status. RESULTS: Greater numbers of traumatic events, positive screening results for at least one mental disorder, and a current need for assistance navigating the health care system were found to be significant predictors for current mental and physical health treatment needs. In addition, males are more likely to report current treatment needs for mental health symptoms. CONCLUSIONS: Health-related characteristics do predict newly arrived refugees' treatment needs, and socio-demographic and flight-related characteristics do not. The results provide both academia and policy makers with first implications for improving health care for refugees in need as quickly as possible.

Mental health among immigrants in Germany - the impact of self-attribution and attribution by others as an immigrant.

BACKGROUND: In Germany, the term 'migration background' has been established to differentiate between immigrants and natives. In the present study post-traumatic stress disorder (PTSD), anxiety, and depression were analysed in immigrant populations in Germany by considering self-attribution as well as attribution by others on one's own 'migration background'. METHODS: In a population-based survey (N = 2317), socio-demographic characteristics, migration background (official statistics definition vs. self-attribution as well as the anticipated attribution by others), PTSD (PCL-5), and symptoms of anxiety and depression (PHQ-4) were assessed. Logistic regression models were applied to predict mental health outcomes by considering socio-demographic and immigration-related factors. RESULTS: A total of 10.7% of respondents (N = 248) had a 'migration background'. Immigrants of the 2nd generation compared to 1st generation immigrants are less likely to see themselves as immigrants. Attribution as an immigrant (self and/or by others) was found as significant predictor for PTSD and depression, but not anxiety. CONCLUSIONS: It seems useful to focus on immigration-related factors considering subjective perspectives and not only comparing immigrants and natives using a federal statistics definition. Our findings suggest that research on the association between immigration-related factors such as attribution as an immigrant and mental health outcomes might be a promising approach to better identify subgroups at higher risk of mental distress.

Trajectories of health-related quality of life in immigrants and non-immigrants in Germany: a population-based longitudinal study.

OBJECTIVES: Due to a lack of longitudinal studies on health in immigrants, the purpose of the present study is to investigate trajectories of health-related quality of life (HRQoL) in immigrants and non-immigrants in Germany by considering the impact of immigration-related factors. METHODS: Based on longitudinal SOEP data from 2002 to 2012, the trajectories of the mental (MCS) and physical component (PCS) of HRQoL (assessed with SF-12v2) were analyzed in 8546 subjects, including 1064 immigrants by conducting hierarchical linear models. RESULTS: MCS remains stable over time, whereas PCS shows a decrease, influenced by increasing age. There were no differences between immigrants and non-immigrants concerning PCS trajectories as well as no influence of immigration-related factors on it. In contrast, MCS trajectories were influenced by immigration-related factors: 2nd-generation immigrants, participants from Turkey or Southern Europe and those who immigrated at young age show a slight decrease in MCS over time. CONCLUSIONS: The results show negative association between MCS and time in different groups of immigrants. Future research is needed for better conceptualization of the complex interplay between health and migration over time to identify subgroups at greater risk for mental distress.