Somatic comorbidity among migrants with posttraumatic stress disorder and depression – a prospective cohort study

Abstract

BackgroundIn a cohort of migrants in Denmark, we compared somatic disease incidence among migrants diagnosed with posttraumatic stress disorder (PTSD) and depression with migrants without a diagnosed psychiatric disorder.MethodsThe study builds on a unique cohort of migrants who obtained residence permit in Denmark from 1993 to 2010 (N = 92,104). The association with somatic disease was explored via register linkage. We used Poisson regression to model incidence rate ratios (IRR) adjusted for age, sex, income and region of origin. The Danish Data Protection Agency granted authorisation for the implementation of the project (No 2012-41-0065).ResultsOur results showed that migrants diagnosed with PTSD and depression had significantly higher rates of somatic diseases compared with migrants without diagnosed psychiatric disorders – especially, infectious disease (IRR, 1.89; 95% CI, 1.45–2.48; p < 0.01), neurological disease (IRR, 2.35; 95% CI, 1.91–2.91; p < 0.01) and pulmonary disease (IRR, 1.69; 95% CI, 1.37–2.00; p < 0.01). We further saw differences in the IRRs according to region of origin.ConclusionMigrants with PTSD and depression had a significantly higher rates of somatic comorbidity compared with migrants without a diagnosed psychiatric disorder. The rates were especially high for infectious, neurological and pulmonary diseases. Our results further suggest difference in the rates of somatic comorbidity according to region of. Preventive and treatment services should pay special attention to improve the overall health of migrants with PTSD and depression.

Risk of childhood psychiatric disorders in children of refugee parents with post-traumatic stress disorder: a nationwide, register-based, cohort study

“…Also, refugees might have poor access to health care, resulting in an underestimation of psychiatric diagnoses. [25][26][27] Furthermore, it is unknown whether refugees included in the study had received treatment for psychiatric disorders in their country of origin or during the asylum-seeking phase before obtaining permission to reside in Denmark. Underestim ation of parental psychopathology in the registers (and, particularly, PTSD given that private initiatives for traumatised refugees are relatively common) probably biased the findings towards a null HR and, thereby, underestimated the magnitude of the HRs found in the current study.…”

“…28 Also, PTSD can vary over time and mimic other psychiatric disorders. 26 Thus, it is difficult to dis tinguish the effects of PTSD and determine the unique contribution of this condition. We partly accounted for this confounding factor by excluding children of parents with psychiatric disorders other than PTSD.…”

Understanding Refugees' Health

“…31,72 The diagnoses of depression and PTSD are associated with a higher rate of infectious, neurological, and pulmonary diseases. 73 Careful workup of these patients is therefore mandatory. In addition, somatization and psychosis are common and may lead to emergency consultations.…”

The coexistence of somatic and mental ilnesses

“…Także pacjenci cierpiący na zespół stresu pourazowego są obciążeni zwiększonym ryzykiem występowania chorób somatycznych -przede wszystkim chorób sercowo-naczyniowych i cukrzycy [37].…”