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1.
Disasters ; 44(1): 44-62, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31231849

RESUMEN

Reconceiving or reframing the humanitarian consequences of displacement in terms of 'dispersed dependencies', a term drawn from the field of mental health, sheds light on the disruptive experience of displacement and on affected individuals' relations with other displaced people, hosts, states and humanitarian actors. Dependency for a person is neither a problem nor abnormal; independence is in effect about having a viable set of dispersed dependencies. This description, when applied in the context of disaster or displacement, challenges some humanitarian attitudes and offers some positive directions for humanitarian actors who seek to engage in assistance that is sustainable, contextual, and focused on human choice and dignity.


Asunto(s)
Desastres , Refugiados/psicología , Sistemas de Socorro/organización & administración , Humanos
2.
BMC Public Health ; 19(1): 1485, 2019 Nov 08.
Artículo en Inglés | MEDLINE | ID: mdl-31703660

RESUMEN

BACKGROUND: Refugees are particularly vulnerable to poor mental health outcomes due to exposure to pre migration trauma and post migration stressors. Research has demonstrated evidence to suggest that the professional help-seeking among refugee groups is low or problematic. This study seeks to examine help-seeking for emotional problems in two large samples of Iraqi and Afghan refugees in Australia. METHODS: This study uses data from two waves of the Building a New Life in Australia, the longitudinal study of Humanitarian migrants. The data was collected face-to-face between 2013 and 2016, among humanitarian migrants. All participants held a permanent protection visa and had arrived in Australia or been granted their visa between period of May to December 2013. The study sample included 1288 participants born in Iraq and Afghanistan (aged 15 and over). In the Wave 3 interview (2015-2016) participants reported on professional help received to deal with emotional problems. RESULTS: Approximately 36 and 37% of the Iraqi and Afghan groups respectively, reported seeking help for emotional problems. Within the Iraqi group, associations between mental health status, namely general psychological distress and PTSD and help-seeking were found but this was not present in the Afghan group, where age seemed to play a role in help-seeking. Frequency of help received was low with approximately 47% of the Iraqi and 57% of the Afghan groups reporting having received help 5 times or less in the last 12 months. CONCLUSIONS: Findings from this study provide clear directions on areas where culturally tailored mental health promotion programs should target in these two refugee communities. Further, the differences in help-seeking behaviour of these communities should be noted by both clinicians and policy makers as efforts to provide culturally responsive mental health services.


Asunto(s)
Trastornos Mentales/psicología , Aceptación de la Atención de Salud/psicología , Refugiados/psicología , Migrantes/psicología , Adolescente , Adulto , Afganistán/etnología , Australia , Bases de Datos Factuales , Femenino , Humanos , Irak/etnología , Estudios Longitudinales , Masculino , Trastornos Mentales/etnología , Persona de Mediana Edad , Aceptación de la Atención de Salud/etnología , Adulto Joven
3.
Rev Prat ; 69(6): 676-678, 2019 Jun.
Artículo en Francés | MEDLINE | ID: mdl-31626433

RESUMEN

Today, people all over the world are on the move. Women and girls account for nearly half of the 244 million migrants. They are sometimes forced to leave their country of origin to flee physical, psychological or sexual violence and gender discrimination. Then the migratory route and the new life in the country of asylum expose them to situations of vulnerability and they are therefore at risk of physical, psychological or sexual abuse. The risk of HIV infection is high. Practitioners in host countries receive these women for various reasons in consultation. Knowing their background allows us to support them and offer them care adapted to their needs and requests. The first step is systematic screening by professionals. Secondly, multidisciplinary care is essential: social actors, psychologists, sexologists, infectiologists, gynaecologists, pain specialists, etc. This requires specific training for professionals confronted with these populations.


Asunto(s)
Violencia Doméstica , Refugiados , Delitos Sexuales , Migrantes , Femenino , Infecciones por VIH , Humanos , Refugiados/psicología , Migrantes/psicología , Violencia
4.
Soins Psychiatr ; 40(324): 21-24, 2019.
Artículo en Francés | MEDLINE | ID: mdl-31623802

RESUMEN

Emergency psychiatric units are receiving more and more foreign unaccompanied minors: for many of these young people it is their first contact with psychiatric services. This context of crisis crystallises the administrative and legal paradoxes at work in the support of these youngsters. Coordination between emergency care, statutory bodies and community-based care enables stability to be established while the care project is being set up.


Asunto(s)
Niño Abandonado/psicología , Servicio de Urgencia en Hospital , Trastornos Mentales/terapia , Menores/psicología , Servicio de Psiquiatría en Hospital , Refugiados/psicología , Adolescente , Niño , Humanos
5.
Soins Psychiatr ; 40(324): 29-32, 2019.
Artículo en Francés | MEDLINE | ID: mdl-31623804

RESUMEN

Many unaccompanied minors in the care of children's welfare services are housed in a children's home after their assessment. Adapting to this living environment means going from a high level of autonomy to being subject to certain rules, as well as giving oneself permission to settle and accept the support of the educational setting. Care is an important aspect of a children's home: the body is an indicator of the health of these youngsters.


Asunto(s)
Niño Abandonado/psicología , Cuidados en el Hogar de Adopción/psicología , Servicios de Salud Mental , Menores/psicología , Refugiados/psicología , Niño , Humanos
6.
Soins Psychiatr ; 40(324): 33-36, 2019.
Artículo en Francés | MEDLINE | ID: mdl-31623805

RESUMEN

Transcultural consultations receive unaccompanied minors experiencing psychological distress as a result of their personal history in their country of origin, their harrowing journey until their arrival in France and their vulnerable situation. Presentation of the mental health pathway and identity issues of one of these young unaccompanied foreigners, and asylum seeker.


Asunto(s)
Niño Abandonado/psicología , Menores/psicología , Trastornos Psicóticos/terapia , Refugiados/psicología , Estrés Psicológico/psicología , Adolescente , Niño , Características Culturales , Francia , Humanos , Psicoterapia
7.
BMC Health Serv Res ; 19(1): 676, 2019 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-31533817

RESUMEN

BACKGROUND: Asylum seekers coming to most countries are offered a specific health examination. A previous study concluded that a considerable proportion of those taking part of it in Sweden had poor experiences of the communication in and the usefulness of this examination and had poor health literacy. The aim of this study was to explore in greater depth the experiences of the health examination for asylum seekers among Arabic- and Somali-speaking participants in Sweden. A secondary aim was to examine experiences and discuss findings using a health literacy framework. METHODS: Seven focus group discussions were conducted with 28 Arabic and Somali speaking men and women that participated in a health examination for asylum seekers. Data were analyzed by latent content analysis. RESULTS: One overarching theme - beneficial and detrimental - was found to represent the participants' experiences of the health examination for asylum seekers. Three categories were identified that deal with those experiences. The category of "gives some good" describes the examination as something that "gives support and relief" and "cares on a personal level." The category of "causes feelings of insecurity" describes the examination as something that "lacks clarity" and that "does not give protection." The category "causes feelings of disappointment" views the examination as something that "does not fulfil the image of a health examination" and "does not focus on the individual level." CONCLUSION: The health examination for asylum seekers was experienced as beneficial and detrimental at the same time. The feelings were influenced by the experiences of information and communication before, during and after the examination and on how health literate the organizations providing the HEA are. To achieve more satisfied participants, it is crucial that all organizations providing the HEA become health literate and person-centered.


Asunto(s)
Alfabetización en Salud , Refugiados/psicología , Adulto , Anciano , Árabes , Comunicación , Femenino , Grupos Focales , Humanos , Masculino , Persona de Mediana Edad , Organizaciones , Satisfacción Personal , Refugiados/estadística & datos numéricos , Somalia/etnología , Suecia , Adulto Joven
8.
Nervenarzt ; 90(11): 1103-1108, 2019 Nov.
Artículo en Alemán | MEDLINE | ID: mdl-31559479

RESUMEN

Poverty and social exclusion are closely related to an increased risk for the deterioration of mental health. In 2018 approximately 19% of the German population were threatened by poverty and the associated social ostracization. Migrant groups in particular often show an increased risk for poverty and are often exposed to multiple socioeconomic stress factors depending on the context of migration, pre-migration and post-migration social factors. Numerous studies have shown that societal exclusion, precarious living conditions and the residential environment negatively affect mental health beyond the effects of pre-migration risk factors. This article provides a review and discussion on the relationship between mental health, poverty and related constructs, such as social cohesion, social capital and social exclusion in general as well as in specific risk groups, such as migrant and refugee populations.


Asunto(s)
Salud Mental , Pobreza , Refugiados , Migrantes , Humanos , Refugiados/psicología , Factores Socioeconómicos , Migrantes/psicología
9.
Psychiatr Danub ; 31(Suppl 3): 395-399, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31488759

RESUMEN

BACKGROUND: According to the United Nations High Commissioner for Refugees the number of people forced to leave their home as a result of conflict, persecution, violence or human rights violations remains high with 68.5 million forcibly displaced people worldwide. Asylum seekers are vulnerable in terms of mental health but they receive very little specific psychiatric care. The purpose of this literature review is to examine current situation regarding asylum seekers' psychiatric healthcare. SUBJECTS AND METHODS: This research was conducted using a keyword search on Medline, PubMed and Google Scholar. RESULTS: The literature on the management of the mental health of asylum seekers focuses on the issue of post-traumatic stress disorder. There is little data on other forms of mental illness in this population. The prevalence of post-traumatic stress disorder among asylum seekers is higher than in the general population and its clinical expression is varied and often complex because it involves various vulnerability factors. Guidelines for post-traumatic stress disorder recommend cognitive behavioral therapy with, in some cases, the use of pharmacotherapy. Given the specificities of the asylum seekers' population, in many cases it is not possible to set up such therapy immediately. Asylum seekers face a number of challenges in accessing mental healthcare. CONCLUSION: Management of the mental health of asylum seekers requires special attention and guidelines for the general population are not directly applicable to this specific population. The literature focuses on the issue of post-traumatic stress disorder. This review was not able to analyse the state of existing care offer in Belgium for managing the mental health of asylum seekers and the care pathways they take.


Asunto(s)
Salud Mental , Psiquiatría , Refugiados/psicología , Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/terapia , Bélgica , Humanos , Salud Mental/estadística & datos numéricos , Prevalencia , Psiquiatría/organización & administración , Psiquiatría/estadística & datos numéricos
10.
Prax Kinderpsychol Kinderpsychiatr ; 68(6): 488-502, 2019 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-31480942

RESUMEN

Quality of Life and Behavioral Problems of Unaccompanied Minor Refugees in Child Care Facilities Unaccompanied minor refugees (UMR) who arrive in Germany are generally placed in institutional child care facilities. UMR are a very burdened group, however other children and adolescents in institutional care are burdened as well, and their quality of life is often reduced. The aim of the current study was thus to compare quality of life and behavioral problems of UMR in child care facilities with those of other resident adolescents. For a total of 50 UMR, data regarding behavioral problems was available, for 41 UMR ratings on quality of life, both from external assessments. Two parallel comparison samples of other adolescents in the same institutional care facilities were drawn with adolescents with and without a migration background. Results show that in general, UMR show fewer behavioral problems than the other two groups, especially in externalizing behavior. For internalizing behavior, no differences were evident. For quality of life, no differences could be found between the three groups of inhabitants in institutional care. This indicates that the same factors determining quality of life are present in all three groups, but that the underlying mental problems are different in UMR than in other adolescents. Thus, staff in institutional care should possibly work differently with these group of adolescents than with other inhabitants and should be educated respectively.


Asunto(s)
Cuidado del Niño , Menores/psicología , Problema de Conducta , Calidad de Vida , Refugiados/psicología , Adolescente , Niño , Cuidado del Niño/organización & administración , Alemania , Instituciones de Salud , Humanos
11.
Prax Kinderpsychol Kinderpsychiatr ; 68(6): 475-487, 2019 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-31480944

RESUMEN

Chances of Psychotherapeutic Interventions and Stabilization with Unaccompanied Minor Refugees During Clearing Procedure and During the Transition Phase to Youth Welfare In the present clinical report, the experiences with psychotherapeutic crisis intervention for unaccompanied refugee minors in an initial reception and clearing office in Berlin, which have been financed since December 2016 by the association Spatz e. V. from the St Joseph hospital in Berlin-Tempelhof, is reflected. The financing offer results due to the developments in 2015 - a year with an above-average increase in incoming refugees. The significant increase also led to significantly longer waiting times in the clearing process. The forced persistence in a provisional state often led to instability of the psychic coping capacity of the adolescents. However, although there is a high level of psychological distress, post-traumatic as well as depressive symptoms the refugee adolescents have no access to outpatient psychotherapy during the clearing procedure (or the financial coverage of the discussions by health insurance or youth welfare offices). Despite uncertain framework conditions by an unclear future perspective and the resulting lack of "external safety", psychotherapeutic sessions with a focus on stabilization, empowerment and psychoeducation is nevertheless helpful in order to support young people in crisis situation, to counteract acute crisis and to counteract chronification of existing symptoms.


Asunto(s)
Intervención en la Crisis (Psiquiatría) , Menores/psicología , Psicoterapia , Refugiados/psicología , Adolescente , Niño , Depresión/psicología , Depresión/terapia , Humanos , Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/terapia
12.
Scand J Trauma Resusc Emerg Med ; 27(1): 85, 2019 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-31492200

RESUMEN

BACKGROUND: Asylum-seekers from Africa immigrate to Israel through the Sinai desert and are often exposed to traumatic events. OBJECTIVE: To identify the scope and types of medical services required by asylum-seekers and the relationship between delayed medical care to development of post-traumatic stress disorder (PTSD) and overutilization of medical services. METHODS: Asylum-seekers that entered Israel between 2009 and 2012 who utilized the Open Clinic of Physicians for Human Rights were interviewed to record their experiences in the Sinai, and document the traumatic events they were exposed to, their medical diagnoses, and clinic visits. Linkages between diagnoses to exposure to traumatic events and period of time until presentation to the clinic were investigated. RESULTS: Male vs female asylum-seekers visited the clinic more times (24% vs 15% respectively, utilized > 5 visits). Higher ransom and longer periods in Sinai correlated with higher number of clinic visits and PTSD. Asylum-seekers with PTSD versus other medical complaints approached the clinic more times (> 5 visits). Asylum-seekers that approached the clinic closer to their arrival time (up to 18 months from arrival) versus a later period (> 18 months) presented a significantly lower prevalence of PTSD (3.4 and 40.5% respectively; p < 0.001) and lower utilization of clinic's services (p < 0.001). CONCLUSIONS: PTSD among asylum-seekers appears to be associated more with length of exposure to stressful events than number/types of traumatic events and with delay in receiving medical care. Improving access to medical care may reduce asylum-seekers' development of PTSD and lead to lower utilization of services.


Asunto(s)
Prestación de Atención de Salud , Salud Mental , Aceptación de la Atención de Salud , Refugiados/psicología , Trastornos por Estrés Postraumático/etnología , Adulto , África/etnología , Femenino , Humanos , Israel/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/terapia , Adulto Joven
13.
Artículo en Inglés | MEDLINE | ID: mdl-31374949

RESUMEN

Refugees worldwide suffer high levels of distress and are at increased risk for death by suicide. The Refugee Health Screener (RHS) was developed to screen for emotional distress among refugees and can be used to assess distress severity. This paper examines the association between distress severity and suicidal ideation in a sample of refugees residing in asylum accommodations. Data from the RHS and item 9 on the Patient Health Questionnaire-9 (PHQ-9) was analyzed. Results showed that individuals at moderate and severe levels of distress were much more likely to exhibit suicidal ideation than individuals with low levels of distress. Even though we cannot conclude that individuals with low levels of distress do not have thoughts of ending their lives, further suicide assessment is warranted in asylum seekers with moderate to severe distress on the RHS.


Asunto(s)
Refugiados/psicología , Estrés Psicológico , Ideación Suicida , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Suecia
14.
Artículo en Inglés | MEDLINE | ID: mdl-31344781

RESUMEN

Rates of help-seeking for mental health problems are low amongst refugee communities, despite the high prevalence of PTSD reported amongst these individuals. Research suggests that the key barriers to seeking help for psychological problems include structural barriers (e.g., unstable housing), cultural barriers (e.g., mental health stigma), and barriers specific to refugees and asylum seekers (e.g., visa status). This study examined the effect of structural, cultural and refugee specific barriers on the relationship between PTSD symptom severity and intentions to seek help from professional, social, and community sources. Data was collected from 103 male refugees and asylum seekers with an Arabic-, Farsi-, or Tamil-speaking background. Participants completed measures indexing demographics, trauma exposure, PTSD symptoms, mental health stigma, and help-seeking intentions. Path analyses indicated that PTSD severity was associated with lower help-seeking intentions indirectly via mental health stigma (self-stigma for seeking help and self-stigma for PTSD) and visa security. PTSD severity was also associated with greater help-seeking intentions from community members indirectly via structural barriers. These findings are important to consider when identifying key barriers to mental health help-seeking and developing interventions designed to increase help-seeking for psychological problems, within this group.


Asunto(s)
Servicios de Salud Mental/estadística & datos numéricos , Refugiados/psicología , Trastornos por Estrés Postraumático/psicología , Adulto , Australia , Humanos , Intención , Masculino , Salud Mental , Persona de Mediana Edad , Estigma Social , Trastornos por Estrés Postraumático/terapia , Adulto Joven
15.
Am J Orthopsychiatry ; 89(4): 493-507, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31305117

RESUMEN

This article outlines key dimensions of culturally sensitive cognitive-behavioral therapy (CBT), and examines the application to Southeast Asian populations. Our treatment, culturally adapted (CA) multiplex CBT, was initially developed to treat traumatized Southeast Asian refugees, and has been shown to be efficacious for those and other groups. As described in the article, CA multiplex CBT is based on the multiplex model of distress generation and our conceptualization of key dimensions of culturally sensitive and effective treatment. We will describe why our CA-CBT may have applicability to Asian populations more generally, for example, due to its emphasis on mindfulness, contextual sensitivity (viz., flexibility), somatic complaint, and somatic-focused emotion regulation (e.g., applied stretching). We illustrate key dimensions of CA treatment, giving examples from how these principles are employed in CA multiplex CBT. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Grupo de Ascendencia Continental Asiática/psicología , Terapia Cognitivo-Conductual , Asistencia Sanitaria Culturalmente Competente , Refugiados/psicología , Emociones , Humanos , Estrés Psicológico/psicología
16.
Sleep Health ; 5(4): 335-343, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31320291

RESUMEN

BACKGROUND: Worldwide, 68.5 million individuals are refugees, asylum seekers, or internally displaced. Although many studies have examined mental health concerns in this population, few studies have assessed sleep or examined the relationship between sleep and mental health or psychosocial functioning. OBJECTIVES: The objectives were to (1) examine the prevalence of sleep disturbance within refugees and asylum seekers from diverse backgrounds, (2) examine mental health and psychosocial factors associated with sleep disturbance, and (3) explore whether symptoms cluster together in unique subsets of individuals. METHODS: Clinician-administered interview data (N = 2703) were obtained from a large mental health service in greater Melbourne, Australia. Data included patient demographics, sleep disturbance, mental health (anxiety, depression, traumatic stress symptoms), and psychosocial concerns (family dysfunctions, interpersonal difficulties, social isolation). RESULTS: A total of 75.5% of the sample reported moderate or severe sleep disturbance. Severity of sleep disturbance was positively correlated with severity of mental health symptoms, psychosocial concerns, age, and migration status. This was true in both refugee and asylum seeker populations and in both adults and children. Cluster analyses revealed 3 subsets of individuals: those with "severe sleep and anxiety symptoms," "mild to moderate symptoms," and "mild symptoms." Using "mild symptoms" as the comparator, being a refugee and increasing age were associated with a 1.57- and 1.02-fold increase, respectively, in the likelihood of classification as "severe sleep and anxiety problems" and 1.70- and 1.02-fold increase, respectively, in the likelihood of classification as "mild to moderate symptoms." CONCLUSION: These findings suggest that systematic screening of sleep disturbance among refugees and asylum seekers during health-related visits is needed.


Asunto(s)
Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Servicios de Salud Mental/estadística & datos numéricos , Refugiados/psicología , Trastornos del Sueño-Vigilia/epidemiología , Adolescente , Adulto , Anciano , Australia/epidemiología , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Prevalencia , Refugiados/estadística & datos numéricos , Factores de Riesgo , Adulto Joven
17.
Niger J Clin Pract ; 22(7): 913-919, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31293254

RESUMEN

Background: Non-communicable diseases (NCDs) are a major challenge to health and social development in the 21st century, and North Korea is no exception. However, there is a lack of information concerning NCDs in North Korea, and a different approach is needed to understand the NCDs burden there. This study examines the perceptions and experiences of refugee doctors from North Korea concerning the NCDs burden in North Korea. Methods: Focus group discussions were conducted with 10 refugee doctors from North Korea who had been recruited through snowball sampling. Results: North Korean refugee doctors participating in this study indicated that NCDs are the highest priority diseases, that North Koreans did not appear to have a high level of understanding and knowledge of NCDs, that economic breakdown was the primary cause of the NCDs burden, and that a high priority should be assigned to targeting NCDs in North Korea. Discussion: Although the North Korean refugee doctors were medical professionals, they faced serious challenges accessing and managing patients with NCDs. South Korea needs to prepare for a potentially large number of people with NCDs should a freer movement of peoples occur between the two countries.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Enfermedades no Transmisibles/epidemiología , Médicos/psicología , Refugiados/psicología , Adulto , República Popular Democrática de Corea/etnología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Percepción , Refugiados/estadística & datos numéricos , República de Corea/epidemiología
18.
J Forensic Leg Med ; 66: 113-116, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31277038

RESUMEN

Immigration and asylum-seeking are issues that have recently. warranted increased attention and significance. In the aftermath of terrorist attacks, people are more wary of asylum seekers who are usually held in detention centers after fleeing persecution and not for criminal or immigration charges. Asylum seekers may raise suspicions due to inconsistent statements and can be held in detention for the duration of the process and/or denied asylum. Inconsistencies may be influenced by psychiatric symptoms, cognitive abilities, the type of past trauma experienced, the questioning style of the interviewer, and are usually unrelated to dishonesty or malingering making psychiatric consult important in many of these evaluations.


Asunto(s)
Trastornos de Adaptación/diagnóstico , Entrevista Psicológica , Refugiados/psicología , Trastornos por Estrés Postraumático/diagnóstico , Adulto , Emigración e Inmigración , Femenino , Psiquiatría Forense , Humanos , Texas
19.
BMC Public Health ; 19(1): 908, 2019 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-31286909

RESUMEN

BACKGROUND: Asylum-seeking children and adolescents (ASCs) who have resettled in Western countries show elevated rates of psychological distress, including Posttraumatic Stress Symptoms (PTSS), depression, and anxiety. Most longitudinal data suggest a relatively stable course of symptoms during the first years in exile. However, no longitudinal examination of the mental health of ASCs, who resettled in Europe in the wake of the 2015-17 European migrant crisis, has been conducted so far. METHODS: A prospective cohort study looked at 98 ASCs who resettled in southern Germany throughout 2015-17. They mainly came from Afghanistan, Syria, Eritrea, and Iraq. Baseline assessments were undertaken 22 months, on average, after resettlement, and follow-up assessments 1 year thereafter. Seventy-two ASCs could be secured for the follow-up. The measures included self-report questionnaires screening for PTSS, depression, anxiety, externalizing behavior, and post-migration factors that were administered in an interview-like setting. Results were analyzed using hierarchical multiple regression analysis. RESULTS: Participating ASCs reported on average eight potentially traumatic experiences and high levels of psychological distress at baseline that had significantly declined at follow-up. At follow-up, rates of clinically significant symptoms ranged from 9.7% (externalizing behavior) to 37.5% (PTSS). There was considerable individual variation in symptom change resulting in multiple mental health trajectories. ASCs whose asylum applications had been rejected presented significantly more symptoms than ASCs whose asylum applications had been accepted between assessments. Baseline psychopathology and asylum status predicted follow-up symptom severity. CONCLUSIONS: In contrast to earlier studies, the symptom severity in this sample of ASCs in Germany ameliorated between assessments. Decisions on the asylum applications of ASCs are thought to contribute to the course of symptoms. Since levels of psychological distress were still high, dissemination and implementation of appropriate treatments for ASCs is crucial.


Asunto(s)
Ansiedad/epidemiología , Depresión/epidemiología , Refugiados/psicología , Trastornos por Estrés Postraumático/epidemiología , Estrés Psicológico/epidemiología , Adolescente , Afganistán/etnología , Ansiedad/psicología , Niño , Depresión/psicología , Eritrea/etnología , Femenino , Estudios de Seguimiento , Alemania/epidemiología , Humanos , Irak/etnología , Estudios Longitudinales , Masculino , Análisis Multivariante , Estudios Prospectivos , Análisis de Regresión , Autoinforme , Trastornos por Estrés Postraumático/psicología , Estrés Psicológico/psicología , Siria/etnología , Factores de Tiempo
20.
Artículo en Inglés | MEDLINE | ID: mdl-31261840

RESUMEN

Civilian war trauma and torture rank among the most traumatic life experiences; exposure to such experiences is pervasive in nations experiencing both internal and external conflict. This has led to a high volume of refugees resettling throughout the world with mental health needs that primary care physicians may not be screening for and prepared to effectively address. In this article, we review the literature on demographics, predictors, mental health outcomes of torture, and integrated care for the mental health needs of refugees. We searched PubMed and PSYCINFO databases for original research articles on refugees and mental health published in the English language between 2010 and present. Nine percent of 720 adults in conflict areas in Nepal, with predominance of literate married males, met the threshold for Post-Traumatic Stress Disorder (PTSD), 27.5% for depression, and 22.9% for anxiety. While, PTSD rate has been documented as high as 88.3% among torture survivors from Middle East (ME), Central Africa (CA), South Asia (SA), Southeast Europe (SE). Depression was recorded as high as 94.7% among 131 African torture survivors and anxiety as high as 91% among 55 South African torture survivors. Torture severity, post-migration difficulties, and wait time to receive clinical services were significantly associated with higher rate of mental health symptoms. Mental health screening is not a standard component of initial physical exams for refugees, yet these individuals have had high trauma exposure that should inform clinical care. Integrated care models are lacking but would greatly benefit this community to prevent progression to greater severity of mental health symptoms.


Asunto(s)
Prestación Integrada de Atención de Salud/organización & administración , Salud Mental , Refugiados/psicología , Trastornos por Estrés Postraumático/psicología , Sobrevivientes/psicología , Tortura/psicología , Adulto , Asia , Europa (Continente) , Femenino , Humanos , Masculino , Persona de Mediana Edad , Medio Oriente , Nepal/epidemiología , Prevalencia , Adulto Joven
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