1-year follow-up of the mental health and stress factors in asylum-seeking children and adolescents resettled in Germany

Abstract

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. Electronic supplementary material The online version of this article (10.1186/s12889-019-7263-6) contains supplementary material, which is available to authorized users.

Improving Mental Health Care for Unaccompanied Young Refugees Through A Stepped Care Approach Versus Usual Care+: Study Protocol of A Cluster Randomized Controlled Hybrid Effectiveness Implementation Trial

“…These ndings are in line with several studies from other European countries reporting high PTSS rates from 20% [5] to 76% [6]. On average, symptoms tend to be stable over time [7] even though another recent study by Müller et al [8] indicated a signi cant reduction in PTSS severity after 12 months. However, the rates for clinically relevant PTSS (38%) were still high.…”

“…However, participants can directly bene t from successful treatment and long-term symptom reduction can be achieved. Even for the control group who will not receive the stepped-care, we do not expect any harm: in two previous studies [2,8] we assessed young refugees' mental health without providing further interventions. No serious or adverse events were reported during the two studies.…”

Food insecurity, state fragility and youth mental health: A global perspective

“…The epidemiological data on mental health are scarce as state fragility also impacts health surveillance efforts. However, research on asylum-seeking youth from Afghanistan, Syria, Eritrea and Iraq found persistently high prevalence of emotional and behavioural problems ( Bronstein et al, 2013 ) posttraumatic stress symptoms ( Müller et al, 2019 ) and hair cortisol concentrations ( Sierau et al, 2019 ) after resettlement in Europe. A study of Kosovar Albanians shortly after the 1998-99 Kosovo war found that 17% of youth and adults over age 15 suffered from posttraumatic stress disorder ( Lopes Cardozo et al, 2000 ).…”

Improving mental health care for unaccompanied young refugees through a stepped-care approach versus usual care+: study protocol of a cluster randomized controlled hybrid effectiveness implementation trial

“…However, participants can directly benefit from successful treatment and long-term symptom reduction can be achieved. Even for the control group who will not receive the stepped-care, we do not expect any harm: in two previous studies [ 2 , 8 ], we assessed young refugees’ mental health without providing further interventions. No serious or adverse events were reported during the two studies.…”

“…These findings are in line with several studies from other European countries reporting high PTSS rates from 20% [ 5 ] to 76% [ 6 ]. On average, symptoms tend to be stable over time [ 7 ] even though another recent study by Müller et al [ 8 ] indicated a significant reduction in PTSS severity after 12 months. However, the rates for clinically relevant PTSS (38%) were still high.…”