Abstract:We recommend a low-threshold psychiatric emergency care for asylum seekers in the central refugee reception facility. This should not be done on voluntary basis, but must be regulated by law. For comprehensive care by national healthcare physicians, the social welfare law on asylum seekers (1993) must be revised.
“…Richter et al (9) examined mental distress among refugees in reception facilities. The participants were still going through the asylum procedure at that time, with a short length of stay in Germany.…”
Section: Discussionmentioning
confidence: 99%
“…Several studies have investigated the mental health problems of Syrian refugees in recent years. Prevalence rates range from 20.5 to 35.7% for PTSD (7–12), from 20 to 43.9% for depression (7–9, 12, 13), and from 19.3 to 31.8% for anxiety (8, 12). …”
Background: High rates of prevalence of mental distress among the Syrian refugee population have been repeatedly confirmed. However, little is known about the influence of length of stay, living conditions, and residence permission in the host country or about the duration of the escape journey and travel conditions on mental health in this refugee population. This study examines the mental health of Syrian refugees, taking into account the circumstances in their country of origin and host country, as well as their escape conditions.Methods: This investigation formed part of a registry-based study. A sample of 518 adult Syrian refugees in Erlangen, Germany, who have residence permission was identified. The response rate was 38.6%; a total of 200 Syrian refugees thus participated in the study. The respondents were investigated for post-traumatic stress disorder (ETI), depression (PHQ-9), generalized anxiety (GAD-7) and post-migration variables.Results: The prevalence of participants who had personally experienced and/or witnessed traumatic events was 75.3%. Symptoms of PTSD were found in 11.4% of the participants. Moderate to severe depression was confirmed in 14.5% and moderate to severe generalized anxiety in 13.5% of the sample. The criteria for at least one diagnosis were met by 30.5% of the participants. More severe PTSD symptoms were associated with older age, shorter validity of the residence permit, larger number of traumatic events (TEs) and higher generalized anxiety symptoms. Depression symptoms were associated with younger age, shorter duration of escape journey, larger number of TEs and higher generalized anxiety symptoms. Generalized anxiety symptoms correlated with female gender, PTSD, and depression symptoms.Conclusions: These findings suggest that Syrian refugees in Germany are a vulnerable population, especially if they have experienced and/or witnessed multiple traumatic events. However, post-migration conditions and positive future prospects in the host country can be protective factors for this population.
“…Richter et al (9) examined mental distress among refugees in reception facilities. The participants were still going through the asylum procedure at that time, with a short length of stay in Germany.…”
Section: Discussionmentioning
confidence: 99%
“…Several studies have investigated the mental health problems of Syrian refugees in recent years. Prevalence rates range from 20.5 to 35.7% for PTSD (7–12), from 20 to 43.9% for depression (7–9, 12, 13), and from 19.3 to 31.8% for anxiety (8, 12). …”
Background: High rates of prevalence of mental distress among the Syrian refugee population have been repeatedly confirmed. However, little is known about the influence of length of stay, living conditions, and residence permission in the host country or about the duration of the escape journey and travel conditions on mental health in this refugee population. This study examines the mental health of Syrian refugees, taking into account the circumstances in their country of origin and host country, as well as their escape conditions.Methods: This investigation formed part of a registry-based study. A sample of 518 adult Syrian refugees in Erlangen, Germany, who have residence permission was identified. The response rate was 38.6%; a total of 200 Syrian refugees thus participated in the study. The respondents were investigated for post-traumatic stress disorder (ETI), depression (PHQ-9), generalized anxiety (GAD-7) and post-migration variables.Results: The prevalence of participants who had personally experienced and/or witnessed traumatic events was 75.3%. Symptoms of PTSD were found in 11.4% of the participants. Moderate to severe depression was confirmed in 14.5% and moderate to severe generalized anxiety in 13.5% of the sample. The criteria for at least one diagnosis were met by 30.5% of the participants. More severe PTSD symptoms were associated with older age, shorter validity of the residence permit, larger number of traumatic events (TEs) and higher generalized anxiety symptoms. Depression symptoms were associated with younger age, shorter duration of escape journey, larger number of TEs and higher generalized anxiety symptoms. Generalized anxiety symptoms correlated with female gender, PTSD, and depression symptoms.Conclusions: These findings suggest that Syrian refugees in Germany are a vulnerable population, especially if they have experienced and/or witnessed multiple traumatic events. However, post-migration conditions and positive future prospects in the host country can be protective factors for this population.
“…Most of the refugees who came to Germany within the last three years have experienced traumatic events including combat, terror attacks, imprisonment, torture, kidnapping, or rape (Richter, Lehfeld, & Niklewski, 2015). In addition, flight itself is associated with life-threatening and other traumatic experiences.…”
Section: Introductionmentioning
confidence: 99%
“…Furthermore, placement in provisional collective housing and insecure outcome of the asylum proceedings further contribute to the accumulation of distress and to the maintenance and aggravation of mental disorders (Fazel & Wheeler, 2005; Sulaiman-Hill & Thompson, 2012). Epidemiological studies indicate that about half of the refugees in reception centres suffer from mental disorders that need to be treated (Heeren et al, 2014; Richter et al, 2015), among them posttraumatic stress disorder (PTSD; 21–54%), depression (20–56%), anxiety disorders (40–56%), and somatic symptoms without medical explanation (37%; Rohlof, Knipscheer, & Kleber, 2014). Figure 1.Flowchart of participants.
…”
Background: Approximately half of all asylum seekers suffer from trauma-related disorders requiring treatment, among them Posttraumatic Stress Disorder (PTSD), depression, anxiety, and somatic symptoms. There is a lack of easily accessible, low-threshold treatments taking the cultural background into account. Culturally Adapted CBT (CA CBT) is a well evaluated, transdiagnostic group intervention for refugees, using psychoeducation, meditation, and Yoga-like exercises. Objective: An uncontrolled pilot study with male Farsi-speaking refugees from Afghanistan and Iran was conducted to investigate feasibility with this ethnic group; a group for which no previous CBT trials have been reported.
Method: The participants were nine Farsi-speaking, male refugees with M.I.N.I./DSM-IV diagnoses comprising PTSD, major depressive disorder, and anxiety disorders. Treatment components were adapted to the specific cultural framework of perception of symptoms, causes, ideas of healing, and local therapeutic processes. Before and after 12 weeks of treatment, the primary outcome was assessed using the General Health Questionnaire (GHQ-28). Secondary outcome measures were the Posttraumatic Checklist, Patient Health Questionnaire, Somatic Symptom Scale, World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), Affective Style Questionnaire (ASQ), and Emotion Regulation Scale (ERS).
Results: Seven participants completed treatment. In the completer analysis, improvements were found on almost all questionnaires. Large effect sizes were seen for the GHQ-28 (d = 2.0), WHOQOL-BREF scales (d = 1.0–2.3), ASQ tolerating subscale (d = 2.2), and ERS (d = 1.7). With respect to feasibility, cultural adaptation seemed to be a crucial means to promote effectiveness.
Conclusion: CA CBT may reduce general psychopathological distress and improve quality of life. Improvement in emotion regulation strategies may mediate treatment effects. More support should be provided to enhance coping with the uncertainty of asylum status and stressful housing conditions. CA CBT appears to be a promising transdiagnostic treatment, serving as an initial low-threshold therapy in a stepped care approach.
“…Since refugee populations present high rates of exposure to traumatic events and subsequent PTSD compared to the general population [16, 17] and are also frequently affected by experiences of childhood maltreatment [18], they may be especially prone to risk-taking behavior. With respect to the current refugee crisis [19], assessing predictors of risk-taking behavior in displaced individuals is essential.…”
Exposure to traumatic stressors and subsequent trauma-related mental changes may alter a person’s risk-taking behavior. It is unclear whether this relationship depends on the specific types of traumatic experiences. Moreover, the association has never been tested in displaced individuals with substantial levels of traumatic experiences. The present study assessed risk-taking behavior in 56 displaced individuals by means of the balloon analogue risk task (BART). Exposure to traumatic events, symptoms of posttraumatic stress disorder and depression were assessed by means of semi-structured interviews. Using a novel statistical approach (stochastic gradient boosting machines), we analyzed predictors of risk-taking behavior. Exposure to organized violence was associated with less risk-taking, as indicated by fewer adjusted pumps in the BART, as was the reported experience of physical abuse and neglect, emotional abuse, and peer violence in childhood. However, civil traumatic stressors, as well as other events during childhood were associated with lower risk taking. This suggests that the association between global risk-taking behavior and exposure to traumatic stress depends on the particular type of the stressors that have been experienced.
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