Prevalence of psychiatric diagnoses in asylum seekers with follow-up

Abstract

BackgroundIn the study, the frequency and nature of asylum seekers’ psychiatric diagnoses in a German admission center were examined. Additional aims were to identify changes in those diagnoses over time and to investigate health care utilization of mentally ill asylum seekers in the community.MethodsThe sample for the study “Psychiatric Examination of Asylum Seekers” in Bavaria consisted of a total of 283 asylum seekers and included 2 subsamples: help-seeking individuals and a randomly selected group. 34 of all asylum seekers were part of an extensive psychiatric follow-up examination (t2) about six months after the first examination (t1). Here, we used psychometric tools and a psychiatric interview by a medical doctor and a psychologist with the help of translators.Results79% of help-seekers and 45% of the random group received at least one psychiatric diagnosis at t1. The most frequent diagnoses were trauma- and stress-related disorders, affective disorders, and insomnia. Men and Muslims were underrepresented in the help-seeking group. In the follow-up subsample, the rate of psychiatric diagnoses went down from 74% at t1 to 38% at t2. In contrast, the number of PTSD cases increased from 4 at t1 to 7 at t2. The severity of PTSD symptoms such as hyperarousal and avoidance also increased. Of the 13 persons in the follow-up-sample diagnosed with depression at t1, only 2 still fit the criteria of the disease at t2. Only 5 subjects had received some sort of psychotherapy or counseling.ConclusionThe prevalence of mental illness in asylum seekers reported here corresponds to the usual range in the literature. It is significantly higher than in European civil society, especially regarding PTSD. At t2, the diagnoses of PTDS had increased within several months without evident additional traumatic events. Asylum seekers’ psychiatric diagnoses soon after arrival should be recorded carefully and examination should be repeated after six months. The psychiatric and psychotherapeutic treatment of asylum seekers is still insufficient. Psychoeducative steps should be taken to relieve the stigma on mental illness, especially among males and Muslims.

The prevalence of mental illness in refugees and asylum seekers: A systematic review and meta-analysis

“…All were observational, except one RCT from which we included baseline prevalence data [24]. Studies were undertaken in 15 countries: Australia (652 refugees) [33][34][35][36][37], Austria (150) [38], China (65) [32], Germany (1,104) [39][40][41][42][43][44], Italy (297) [39], Lebanon (646) [45,46], Nepal (574) [25], Norway (64) [23], South Korea (200) [47], Sweden (86) [48], Switzerland (164) [49,50], Turkey (238) [51], Uganda (77) [24], UK (420) [39,52], and the US (406) [31,53]. Participants were from four geographic regions: the Middle East (43%), Europe (29%), Asia (20%), and Africa (5%), with two studies reporting refugee samples coming from 18 different countries (3%) [26,41] (97% of total sample due to unreported countries of origin).…”

“…Six studies of psychotic illness were identified (n = 1,695) [23,31,36,39,43,45]. Participants had a weighted mean age of 37.6 years and 51% were female.…”

“…psychological treatment for those affected by war [31,43]. One of these studies compared their help-seeking population to a randomly recruited sample, and there was a difference in prevalence rates, with higher rates in the help-seeking population [43].…”

Mental disorders among young adults of immigrant background: a nationwide register study in Norway

“…Specifically, findings indicate an increased burden of mental disorders among refugees and asylum seekers [3][4][5][6], also when compared to non-refugee immigrants [7,8]. The prevalence of post-traumatic stress disorder (PTSD) is reported to be significantly higher in refugees compared to the general population [3,9,10]. For example, most studies assessing PTSD prevalence, predominantly conducted in Western countries, report either estimates of 20% and above [5] or a tenfold risk compared to the majority [3].…”

Entwicklung einer Kultursensiblen Version des Mini-International Neuropsychiatric Interview (MINI) in hocharabischer Sprache

“…Vor allem in den arabischsprachigen Ländern des Nahen Ostens wie Syrien, dem Libanon, Irak, Israel und Palästina führen anhaltende Konflikte und eine daraus resultierende Migration und Flucht zu immensen psychischen Beeinträchtigungen der Bevölkerung in den Heimat-und Aufnahmeländern [1]. Während die Datenlage zu den Prävalenzraten von psychischen Störungen der arabischsprachigen Bevölkerung noch sehr lückenhaft ist, zeigen Studien mit arabischsprachigen Geflüchteten in Deutschland deutlich erhöhte Prävalenzraten für das Auftreten einer psychischen Störung von 30 -95 % [3][4][5]. Zu den häufigsten Störungen in dieser Population zählen posttraumatische Belastungsstörungen mit Prävalenzschätzungen zwischen 29 und 81 %, Depressionen (14 -88 %) und Angststörungen (27 -92 %) (für einen Überblick siehe Winkler et al [6]).…”