Long-term mental health of war-refugees: a systematic literature review
Long-term mental health of war-refugees: a systematic literature review
复制标题
DOI：
10.1186/s12914-015-0064-9
复制
发表时间：
2015-10-28
影响因子：
3
通讯作者：
Priebe, Stefan
中科院分区：
文献类型：
--
作者：
Bogic, Marija;Njoku, Anthony;Priebe, Stefan
背景：全世界有数百万战争难民，其中大多数在接受国滞留多年。然而，人们对他们的长期心理健康状况知之甚少。这篇评论旨在评估精神障碍的患病率，并确定其相关因素长期定居的战争refugees.Methods：我们进行了系统的研究，评估目前的患病率和/或相关因素与抑郁症和焦虑症的成年战争难民5年或更长的流离失所后。我们检索了Medline、Embase、CINAHL、PsycINFO和PILOTS从成立到2014年10月的数据，检索了参考文献列表，并联系了专家。由于研究之间的高度异质性，没有讨论精神障碍的总体估计。相反，流行率进行了审查naradically和异质性研究之间的可能来源进行了调查，亚组分析和naradically。一项描述性分析研究了移民前和移民后的因素与精神障碍在此population.Results：审查确定了29项研究，对长期的心理健康，共16,010受战争影响的难民。抑郁症（范围2.3- 80%）、创伤后应激障碍（4.4- 86%）和未具体说明的焦虑症（20.3- 88%）的患病率存在显着的研究间异质性，尽管患病率估计通常在20%及以上的范围内。临床和方法学因素均对观察到的异质性有很大贡献。方法质量较高的研究报告的流行率一般较低。患病率也与难民来自哪个国家和他们在哪个国家定居有关。来自前南斯拉夫和柬埔寨的难民以及居住在美国的难民报告的精神障碍率最高。描述性合成表明，更大的暴露于移民前的创伤经历和移民后的压力是最一致的因素与所有三种疾病，而一个贫穷的移民后的社会经济地位，特别是与depress.Conclusions：有必要更方法一致和严格的研究长期定居的战争难民的心理健康。现有的证据表明，精神障碍往往是高度流行的战争难民多年后重新安置。这种增加的风险可能不仅是遭受战争创伤的后果，也可能受到移徙后社会经济因素的影响。
Background: There are several million war-refugees worldwide, majority of whom stay in the recipient countries for years. However, little is known about their long-term mental health. This review aimed to assess prevalence of mental disorders and to identify their correlates among long-settled war-refugees.Methods: We conducted a systematic review of studies that assessed current prevalence and/or factors associated with depression and anxiety disorders in adult war-refugees 5 years or longer after displacement. We searched Medline, Embase, CINAHL, PsycINFO, and PILOTS from their inception to October 2014, searched reference lists, and contacted experts. Because of a high heterogeneity between studies, overall estimates of mental disorders were not discussed. Instead, prevalence rates were reviewed narratively and possible sources of heterogeneity between studies were investigated both by subgroup analysis and narratively. A descriptive analysis examined pre-migration and post-migration factors associated with mental disorders in this population.Results: The review identified 29 studies on long-term mental health with a total of 16,010 war-affected refugees. There was significant between-study heterogeneity in prevalence rates of depression (range 2.3-80 %), PTSD (4.4-86 %), and unspecified anxiety disorder (20.3-88 %), although prevalence estimates were typically in the range of 20 % and above. Both clinical and methodological factors contributed substantially to the observed heterogeneity. Studies of higher methodological quality generally reported lower prevalence rates. Prevalence rates were also related to both which country the refugees came from and in which country they resettled. Refugees from former Yugoslavia and Cambodia tended to report the highest rates of mental disorders, as well as refugees residing in the USA. Descriptive synthesis suggested that greater exposure to pre-migration traumatic experiences and post-migration stress were the most consistent factors associated with all three disorders, whilst a poor post-migration socio-economic status was particularly associated with depression.Conclusions: There is a need for more methodologically consistent and rigorous research on the mental health of long-settled war refugees. Existing evidence suggests that mental disorders tend to be highly prevalent in war refugees many years after resettlement. This increased risk may not only be a consequence of exposure to wartime trauma but may also be influenced by post-migration socio-economic factors.