Screening for Posttraumatic Stress Disorder in Refugees: Comparison of the Diagnostic Efficiency of Two Self‐Rating Measures of Posttraumatic Stress Disorder

Abstract

There is a high prevalence of posttraumatic stress disorder (PTSD) in the refugee population. In order to identify affected individuals and offer targeted help, there is an urgent need for easily understandable, reliable, valid, and efficient screening measures. The aim of the present study was to compare the diagnostic efficiency of the Process of Recognition and Orientation of Torture Victims in European Countries to Facilitate Care and Treatment (PROTECT) questionnaire (PQ) to that of the eight‐item short‐form Posttraumatic Diagnostic Scale (PDS‐8) and the Patient Health Questionnaire (PHQ‐9). Using structured clinical interviews, the prevalence rates of PTSD and major depression episode (MDE) were assessed in a refugee sample (N = 118), and receiver operating characteristic analyses were determined and compared. Of participants in the sample, 29.7%, 95% CI [22.0%, 38.5%], were diagnosed with PTSD and 33.1%, 95% CI [24.4%, 41.9%], were diagnosed with MDE. The area under the curve (AUC) for all measures was moderate, AUCs = 0.79–0.86; hence, measures did not differ in terms of their discriminatory abilities. Using the favored cutoff points, sensitivity and specificity were 80–97% and 60–70%, respectively. In terms of their discriminatory abilities, none of the investigated measures can be favored more than the others. Thus, for detection of these two disorders, the shorter PQ could be more efficient. Because the high co‐occurrence of PTSD and MDE might limit the explanatory power of results in the present study, the findings should be cross‐validated in the future.

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

“…None of these instruments were developed specifically for refugee populations but have been widely used in different cultural contexts. Nine studies mentioned the reliability or validity of the used instruments [ 23 , 35 , 36 , 39 , 41 , 44 – 46 , 51 ]. Thirteen studies conducted the assessment in the refugee’s native language [ 25 , 31 , 32 , 37 , 39 , 42 , 43 , 45 – 47 , 51 – 53 ].…”

“…Thirteen studies conducted the assessment in the refugee’s native language [ 25 , 31 , 32 , 37 , 39 , 42 , 43 , 45 – 47 , 51 – 53 ]. Thirteen studies were conducted with assistance from interpreters [ 23 , 24 , 33 – 36 , 38 , 40 , 41 , 44 , 48 – 50 ].…”

“…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).…”

“…Thirteen studies were assigned a low risk of bias and determined to be of high quality [23,24,35,37,38,40,[45][46][47][48][49][50]53]. Nine studies demonstrated moderate risk of bias PLOS MEDICINE [25,33,34,36,39,41,44,51,52]. A moderate rating was assigned to studies that had issues with the representativeness of their sample or used nonrandom sampling techniques.…”

The association between visa insecurity and mental health, disability and social engagement in refugees living in Australia

“…This scale has been used with a number of refugee groups to index depression (e.g. Comtesse & Rosner, 2019;Leiler, Bjarta, Ekdahl, & Wasteson, 2019;Wulfes, Del Pozo, Buhr-Riehm, Heinrichs, & Kroger, 2019). Internal consistency for this scale in this study was α = 0.93.…”