Does Time Heal Trauma? 18 Month Follow-Up Study of Syrian Refugees’ Mental Health in Iraq’s Kurdistan Region

Refugees and asylum seekers are at a high risk of developing mental health disorders, especially depression and anxiety. The prevalence of these disorders in refugees and asylum seekers has been well-documented in cross-sectional studies, but it is impossible to track their course over time using this research design. Hence, this systematic review and meta-analysis used data from existing longitudinal studies to examine the course of depression and anxiety in refugees and asylum seekers in upper-middle and high-income countries. Longitudinal studies reporting depression and anxiety were systematically searched from seven databases (Ovid MEDLINE, Ovid EMBASE, Ovid CINAHL, Scopus, Web of Science, PsycINFO, and Google Scholar) and included studies that fulfilled the inclusion criteria and underwent Joanna Briggs Institute (JBI) quality assessment. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used to report the findings. An estimated pooled prevalence of depression and anxiety across time points was reported using a random effect model with a 95% confidence interval. Cochran’s Q and I2 statistics were conducted to assess heterogeneity among included studies, while funnel plots and Eggers tests were used to assess publication bias. Twenty longitudinal studies for depression and eight longitudinal studies for anxiety were included in the final analysis. The pooled prevalence of depression and Anxiety at baseline was 23.14% (95% CI: 16.34, 29.94) and 25.33% (95% CI: 5.10, 45.57), respectively. After the baseline data collection, the pooled prevalence of depression and anxiety increased over time. Specifically, the prevalence of depression rose from 17.55% (95% CI: 6.66, 28.45) 1 year after baseline to 34.04% (95% CI: 15.45, 52.63) 3 years after baseline. Similarly, the pooled prevalence of anxiety increased from 14.96% (95% CI: 10.59, 29.33) at 1 year after baseline to 33.09% (95% CI: 26.96, 39.21) at 3 years after baseline. The prevalence of depression more than doubled over the course of 3 years, rising from 17.55% at the 1-year mark after baseline to 34.04% at the 3-year mark after baseline. Similarly, the prevalence of anxiety exhibited a significant increase from 14.96% at the 1-year mark after baseline to 33.09% at the 3-year follow-up. These findings underscore the importance of implementing early settlement interventions and designing targeted measures to mitigate the prevalence of anxiety and depression among refugees and asylum seekers.

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Psychological scars of genocide: a systematic review of post-traumatic outcomes in Kurdish Anfal survivors

Mahmood,

Ahmed,

Neldner

et al. 2024

Curr Psychol

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The Anfal genocide, including the infamous Halabja chemical attack, has imprinted deep scars on the Kurdish community in Iraq that lasted for decades. Despite significant historical documentation, the enduring psychological impact on survivors is less examined. This systematic review synthesizes existing research to address this gap. Adhering to the PRISMA guidelines, this review systematically searched databases for scholarly articles examining the mental health of Kurdish survivors following the 1988 Anfal genocide, with a focus on PTSD, depression, and anxiety. Of the initial 201 articles identified, seven met the inclusion criteria. These studies were subjected to a thorough data extraction and qualitative synthesis, and their quality was appraised using the Mixed Methods Appraisal Tool (MMAT). The selected studies encompassed a combined sample of 760 participants, ranging in age from 7 to 92 years. The findings revealed high prevalence rates of PTSD, particularly in children, with a prevalence rate of 87%. In adults, PTSD and depression prevalence rates in unselected samples were estimated at 86.2% and 49%, respectively. Qualitative findings from survivors reveal a complex interplay of depression, intrusive memories, and societal isolation, compounded by poverty and discrimination, with health concerns like respiratory and ocular problems further exacerbating psychological distress. However, non-representative samples and absence of control groups limit result generalization. The literature reviewed indicates substantial psychological distress among the Anfal genocide survivors, underscoring an urgent need for targeted mental health interventions. Future research needs representative samples and validated tools for precise prevalence assessment and comprehensive impact understanding.

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Does Time Heal Trauma? 18 Month Follow-Up Study of Syrian Refugees’ Mental Health in Iraq’s Kurdistan Region

Cited by 5 publications

References 58 publications

Assessment of Mental Health Problems

Assessment of Mental Health Problems

Course of Depression and Anxiety among Refugees and Asylum Seekers: A Systematic Review and Meta-analysis of Longitudinal Studies

Psychological scars of genocide: a systematic review of post-traumatic outcomes in Kurdish Anfal survivors

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