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Risk Factors and Prevalence of Mental Illness in Refugees

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Abstract

This chapter aims to help medical providers identify the refugees at risk for developing mental health problems. We begin by describing the current mental health screening requirements both overseas and after arrival in the United States. The challenges of screening for mental health disorders in this population are discussed. The following pre-migration factors are considered to contribute to the risk for mental illness in refugees: age, gender, education, rural versus urban origin, history of torture, death of family members. Post migration factors such as communication problems or housing have also been studied as having potential impact upon refugees’ mental health. Depression (14 to 80% prevalence) and posttraumatic stress disorder (with a prevalence between 7 and 48%) are the most common psychiatric disorders described in this population.

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References

  1. Center for Diesease Control. Guidelines for mental health screening during the domestic medical examination for newly arrived refugees. 2013. http://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/mental-health-screening-guidelines.html; Accessed 3 Apr 2013

  2. Harvard Program in Refugee and Trauma, Measuring Trauma, Measuring Torture manual on CD-ROM. http://hprt-cambridge.org/?page_id=420, Accessed 20 Aug 2013.

  3. Swinkels H, Pottie K, Tugwell P, et al. Canadian Collaboration for Immigrant and Refugee Health (CCIRH). Development of guidelines for recently arrived immigrants and refugees to Canada: Delphi consensus on selecting preventable and treatable conditions. Can Med Assoc J. 2011;183(12):E928–32.

    Article  Google Scholar 

  4. Sondergaard HP, Ekblad S, Theorell T. Screening for post-traumatic stress disorder among refugees in Stockholm. Nord J Psychiatry. 2003;57(3):185–9.

    Article  PubMed  Google Scholar 

  5. Fenta H, Hyman I, Noh S. Determinants of depression among Ethiopian immigrants and refugees in Toronto. J Nerv Ment Dis. 2004;192(5):363–72.

    Article  PubMed  Google Scholar 

  6. Porter M, Haslam N. Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis. JAMA. 2005;294(5):602–12.

    Article  CAS  PubMed  Google Scholar 

  7. Schubert CC, Punamaki RL. Mental health among torture survivors: cultural background, refugee status and gender. Nord J Psychiatry. 2011;65(3):175–82.

    Article  PubMed  Google Scholar 

  8. Kroll J, Yusuf AI, Fujiwara K. Psychoses, PTSD, and depression in somali refugees in minnesota. Soc Psychiatr Psychiatri Epidemiol. 2011;46(6):481–93.

    Article  Google Scholar 

  9. Teodorescu DS, Heir T, Hauff E, et al. Mental health problems and post-migration stress among multi-traumatized refugees attending outpatient clinics upon resettlement to Norway. Scand J Psychol. 2012;53(4):316–32.

    Article  PubMed  Google Scholar 

  10. Mills E, Singh S, Roach B, et al. Prevalence of mental disorders and torture among Bhutanese refugees in Nepal: a systemic review and its policy implications. Med Conflict Surviv. 2008;24(1):5–15.

    Article  Google Scholar 

  11. Mollica RF, McInnes K, Poole C, et al. Dose-effect relationships of trauma to symptoms of depression and post-traumatic stress disorder among Cambodian survivors of mass violence. Br J Psychiatry. 1998;173:482–8.

    Article  CAS  PubMed  Google Scholar 

  12. Tang SS, Fox SH. Traumatic experiences and the mental health of Senegalese refugees. J Nerv Ment Dis. 2001;189(8):507–12.

    Article  CAS  PubMed  Google Scholar 

  13. Marshall GN, Schell TL, Elliott MN, et al. Mental health of Cambodian refugees 2 decades after resettlement in the United States. JAMA. 2005;294(5):571–9.

    Article  CAS  PubMed  Google Scholar 

  14. Fawzi MC, Betancourt TS, Marcelin L, et al. Depression and post-traumatic stress disorder among Haitian immigrant students: implications for access to mental health services and educational programming. BMC Public Health. 2009;9:482.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Ichikawa M, Nakahara S, Wakai S. Effect of post-migration detention on mental health among Afghan asylum seekers in Japan. Aust New Zeal J Psychiatr. 2006;40(4):341–6.

    Article  Google Scholar 

  16. Silove D, Steel Z, Susljik I, et al. The impact of the refugee decision on the trajectory of PTSD, anxiety, and depressive symptoms among asylum seekers: a longitudinal study. Am J Disaster Med. 2007;2(6):321–9.

    PubMed  Google Scholar 

  17. Montgomery E. Long-term effects of organized violence on young middle eastern refugees’ mental health. Soc Sci Med. 2008;67(10):1596–603.

    Article  PubMed  Google Scholar 

  18. Warfa N, Bhui K, Craig T, et al. Post-migration geographical mobility, mental health and health service utilisation among Somali refugees in the UK: a qualitative study. Health Place. 2006;12(4):503–15.

    Article  PubMed  Google Scholar 

  19. Schweitzer RD, Brough M, Vromans L, et al. Mental health of newly arrived Burmese refugees in Australia: contributions of pre-migration and post-migration experience. Aust New Zeal J Psychiatr. 2011;45(4):299–307.

    Article  Google Scholar 

  20. Nickerson A, Bryant RA, Steel Z, et al. The impact of fear for family on mental health in a resettled Iraqi refugee community. J Psychiatr Res. 2010;44(4):229–35.

    Article  PubMed  Google Scholar 

  21. Hollifield M, Warner TD, Lian N, et al. Measuring trauma and health status in refugees: a critical review. JAMA. 2002;288(5):611–21.

    Article  PubMed  Google Scholar 

  22. Kirmayer LJ, Narasiah L, Munoz M, et al. Canadian Collaboration for Immigrant and Refugee Health (CCIRH). Common mental health problems in immigrants and refugees: general approach in primary care. Can Med Assoc J. 2011;183(12):E959–67.

    Article  Google Scholar 

  23. Westermeyer J. Working with an interpreter in psychiatric assessment and treatment. J Nerv Ment Dis. 1990;178(12):745–9.

    Article  CAS  PubMed  Google Scholar 

  24. Berthold SM, Wong EC, Schell TL, et al. U.S. Cambodian refugees’ use of complementary and alternative medicine for mental health problems. Psychiatr Serv. 2007;58(9):1212–8.

    Article  PubMed  Google Scholar 

  25. Lopes Cardozo B, Blanton C, Zalewski T, et al. Mental health survey among landmine survivors in Siem Reap province, Cambodia. Med Conflict Surviv. 2012;28(2):161–81.

    Article  Google Scholar 

  26. Slewa-Younan S, Chippendale K, Heriseanu A, et al. Measures of psychophysiological arousal among resettled traumatized Iraqi refugees seeking psychological treatment. J Trauma Stress. 2012;25(3):348–52.

    Article  PubMed  Google Scholar 

  27. Husain F, Anderson M, Lopes Cardozo B, et al. Prevalence of war-related mental health conditions and association with displacement status in postwar Jaffna district, Sri Lanka. JAMA. 2011;306(5):522–31.

    Article  CAS  PubMed  Google Scholar 

  28. Jamil H, Farrag M, Hakim-Larson J, et al. Mental health symptoms in Iraqi refugees: posttraumatic stress disorder, anxiety, and depression. J Cult Divers. 2007;14(1):19–25.

    PubMed  Google Scholar 

  29. Sabin M, Sabin K, Kim HY, et al. The mental health status of Mayan refugees after repatriation to Guatemala. Pan Am J Publ Health. 2006;19(3):163–71.

    Article  Google Scholar 

  30. Basoglu M, Livanou M, Crnobaric C, et al. Psychiatric and cognitive effects of war in former Yugoslavia: association of lack of redress for trauma and posttraumatic stress reactions. JAMA. 2005;294(5):580–90.

    Article  CAS  PubMed  Google Scholar 

  31. Steel Z, Silove D, Chey T, et al. Mental disorders, disability and health service use amongst Vietnamese refugees and the host Australian population. Acta Psychiatr Scand. 2005;111(4):300–9.

    Article  CAS  PubMed  Google Scholar 

  32. Karunakara UK, Neuner F, Schauer M, et al. Traumatic events and symptoms of post-traumatic stress disorder amongst Sudanese nationals, refugees and Ugandans in the west Nile. Afr Health Sci. 2004;4(2):83–93.

    PubMed Central  PubMed  Google Scholar 

  33. Van Ommeren M, de Jong JT, Sharma B, et al. Psychiatric disorders among tortured Bhutanese refugees in Nepal. Arch Gen Psychiatry. 2001;58:475–82.

    Article  PubMed  Google Scholar 

  34. D’Avanzo CE, Barab SA. Depression and anxiety among Cambodian refugee women in France and the United States. Issues Ment Health Nurs. 1998;19(6):541–56.

    Article  PubMed  Google Scholar 

  35. Peltzer K. Trauma and mental health problems of Sudanese refugees in Uganda. Cent Afr J Med. 1999;45(5):110–4.

    CAS  PubMed  Google Scholar 

  36. Holtz TH. Refugee trauma versus torture trauma: a retrospective controlled cohort study of Tibetan refugees. J Nerv Ment Dis. 1998;186(1):24–34.

    Article  CAS  PubMed  Google Scholar 

  37. Mollica RF, Lyoo IK, Chernoff MC, et al. Brain structural abnormalities and mental health sequelae in South Vietnamese ex-political detainees who survived traumatic head injury and torture. Arch Gen Psychiatry. 2009;66(11):1221–32.

    Article  PubMed  Google Scholar 

  38. Arieli A, Gilat I, Aycheh S. Suicide by Ethiopian immigrants in Israel. Harefuah. 1994;127(3–4):65–70.

    CAS  PubMed  Google Scholar 

  39. Collins CH, Zimmerman C, Howard LM, et al. Refugee, asylum seeker, immigrant women and postnatal depression: rates and risk factors. Arch Womens Ment Health. 2011;14(1):3–11.

    Article  PubMed  Google Scholar 

  40. Petry NM, Armentano C, Kuoch T, et al. Gambling participation and problems among South East Asian refugees to the United States. Psychiatr Serv. 2003;54:1142–8.

    Article  PubMed  Google Scholar 

  41. Marshall GN, Elliott MN, Schell TL, et al. Prevalence and correlates of lifetime disordered gambling in Cambodian refugees residing in Long Beach, CA. J Immigr Minor Health. 2009;11(1):35–40.

    Article  PubMed  Google Scholar 

  42. Yee BW, Nguyen DT. Correlates of drug use and abuse among Indochinese refugees: mental health implications. J Psychoactive Drugs. 1987;19(1):77–83.

    Article  CAS  PubMed  Google Scholar 

  43. Ellis BH, MacDonald HZ, Klunk-Gillis J, et al. Discrimination and mental health among Somali refugee adolescents: the role of acculturation and gender. Am J Orthopsychiatr. 2010;80(4):564–75.

    Article  Google Scholar 

  44. Al-Modallal H. Patterns of coping with partner violence: experiences of refugee women in Jordan. Public Health Nurs. 2012;29(5):403–11.

    Article  PubMed  Google Scholar 

  45. Teodorescu DS, Siqveland J, Heir T, et al. Posttraumatic growth, depressive symptoms, posttraumatic stress symptoms, post-migration stressors and quality of life in multi-traumatized psychiatric outpatients with a refugee background in Norway. Health Qual Life Outcome. 2012;10:84.

    Article  Google Scholar 

  46. Guzder J. Women who jump into wells: reflections on suicidality in women from conflict regions of the Indian subcontinent. Transcult Psychiatry. 2011;48(5):585–603.

    Article  PubMed  Google Scholar 

  47. Crozier I. Making up koro: multiplicity, psychiatry, culture, and penis-shrinking anxieties. J Hist Med Allied Sci. 2012;67(1):36–70.

    Article  PubMed  Google Scholar 

  48. Bolton P. Local perceptions of the mental health effects of the Rwandan genocide. J Nerv Ment Dis. 2001;189(4):243–8.

    Article  CAS  PubMed  Google Scholar 

  49. Hinton DE, Hinton AL, Eng KT, et al. PTSD and key somatic complaints and cultural syndromes among rural Cambodians: the results of a needs assessment survey. Med Anthropol Q. 2012;26(3):383–407.

    Article  PubMed  Google Scholar 

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Correspondence to Paula Zimbrean M.D. .

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Zimbrean, P. (2014). Risk Factors and Prevalence of Mental Illness in Refugees. In: Annamalai, A. (eds) Refugee Health Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0271-2_11

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  • DOI: https://doi.org/10.1007/978-1-4939-0271-2_11

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