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Schoenberger SF, Schönenberg K, Fuhr DC, Nesterko Y, Glaesmer H, Sondorp E, Woodward A, Sijbrandij M, Cuijpers P, Massazza A, McKee M, Roberts B. Mental healthcare access among resettled Syrian refugees in Leipzig, Germany. Glob Ment Health (Camb) 2024; 11:e25. [PMID: 38572249 PMCID: PMC10988152 DOI: 10.1017/gmh.2024.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 01/18/2024] [Accepted: 01/28/2024] [Indexed: 04/05/2024] Open
Abstract
Our aim was to examine mental health needs and access to mental healthcare services among Syrian refugees in the city of Leipzig, Germany. We conducted a cross-sectional survey with Syrian refugee adults in Leipzig, Germany in 2021/2022. Outcomes included PTSD (PCL-5), depression (PHQ-9), anxiety (GAD-7) and somatic symptom (SSS-8). Descriptive, regression and effect modification analyses assessed associations between selected predictor variables and mental health service access. The sampling strategy means findings are applicable only to Syrian refugees in Leipzig. Of the 513 respondents, 18.3% had moderate/severe anxiety symptoms, 28.7% had moderate/severe depression symptoms, and 25.3% had PTSD symptoms. A total of 52.8% reported past year mental health problems, and 48.9% of those participants sought care for these problems. The most common reasons for not accessing mental healthcare services were wanting to handle the problem themselves and uncertainty about where to access services. Adjusted Poisson regression models (n = 259) found significant associations between current mental health symptoms and mental healthcare service access (RR: 1.47, 95% CI: 1.02-2.15, p = 0.041) but significance levels were not reached between somatization and trust in physicians with mental healthcare service access. Syrian refugees in Leipzig likely experience high unmet mental health needs. Community-based interventions for refugee mental health and de-stigmatization activities are needed to address these unmet needs in Leipzig.
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Affiliation(s)
- Samantha F. Schoenberger
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Kim Schönenberg
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Daniela C. Fuhr
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Research Group Implementation Research and Mental Health, Leibniz Institute of Prevention Research and Epidemiology, Bremen, Germany
- Health Sciences, University of Bremen, Bremen, Germany
| | - Yuriy Nesterko
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
- Research Department, Center ÜBERLEBEN, Berlin, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Egbert Sondorp
- Department of Global Health, KIT Royal Tropical Institute, Amsterdam, the Netherlands
| | - Aniek Woodward
- Department of Global Health, KIT Royal Tropical Institute, Amsterdam, the Netherlands
| | - Marit Sijbrandij
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Alessandro Massazza
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Bayard Roberts
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Moutsou I, Georgaca E, Varaklis T. Psychotherapeutic and Psychosocial Interventions with Unaccompanied Minors: A Scoping Review. Healthcare (Basel) 2023; 11:healthcare11060918. [PMID: 36981575 PMCID: PMC10048295 DOI: 10.3390/healthcare11060918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/15/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Unaccompanied minors (UAMs) are considered a particularly vulnerable population, facing severe threats regarding their physical and mental health. As their number has increased in recent years worldwide, research on mental health interventions has become necessary. The implementation of psychotherapeutic interventions has been documented, but psychosocial interventions seem to not have been consistently studied. In this review, we summarize the psychotherapeutic and psychosocial interventions with UAMs that have been studied up to now. Following the PRISMA guidelines for scoping reviews, we searched four databases and included studies and practice papers; there were no restrictions on publication date, geographical region, language, or method. We identified 46 studies on psychotherapeutic interventions and 16 studies on psychosocial interventions that met the inclusion criteria. Psychotherapeutic interventions were mainly based on cognitive behavioural, psychodynamic, narrative, art and transcultural approaches and aimed at improving UAMs' trauma, mental health and wellbeing, as well as professionals' skills and therapeutic protocols. Several studies showed promising results, with the cognitive behavioural approaches being the most researched. However, more research is needed in order to draw conclusions in terms of effectiveness. Psychosocial interventions followed various approaches and aimed at UAMs' empowerment, wellbeing, support and integration, as well as at improving caregivers' skills. Nonetheless, they seem not only very heterogeneous but also understudied, and we believe that a focus on them would be very useful. Methodological limitations and their implications for future research are discussed.
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Affiliation(s)
- Irene Moutsou
- School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Eugenie Georgaca
- School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Theofilos Varaklis
- School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
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Lava SAG, de Luca D, Milani GP, Leroy P, Ritz N, de Winter P. Please stop the Russian-Ukrainian war - children will be more than grateful. Eur J Pediatr 2022; 181:2183-2185. [PMID: 35298706 PMCID: PMC8927752 DOI: 10.1007/s00431-022-04444-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Sebastiano A. G. Lava
- grid.8515.90000 0001 0423 4662Paediatric Cardiology Unit, Department of Paediatrics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Daniele de Luca
- grid.50550.350000 0001 2175 4109Division of Pediatrics and Neonatal Critical Care, A. Béclère Medical Center, Paris Saclay University Hospitals, APHP, Paris, France
| | - Gregorio P. Milani
- grid.414818.00000 0004 1757 8749Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy ,grid.4708.b0000 0004 1757 2822Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Milan, Italy
| | - Piet Leroy
- grid.412966.e0000 0004 0480 1382Department of Pediatrics, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Nicole Ritz
- grid.413354.40000 0000 8587 8621Department of Paediatrics and Paediatric Infectious Diseases, Children’s Hospital, Lucerne Cantonal Hospital, Lucerne, Switzerland ,grid.6612.30000 0004 1937 0642Mycobacterial and Migrant Health Research Group, Department of Clinical Research, University of Basel Children’s Hospital, University of Basel, Basel, Switzerland
| | - Peter de Winter
- Department of Pediatrics, Spaarne Gasthuis, Haarlem and Hoofddorp, the Netherlands. .,KU Leuven Department of Development and Regeneration, Leuven, Belgium. .,KU Leuven Child & Youth Institute, Leuven, Belgium.
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Verhagen IL, Noom MJ, Lindauer RJL, Daams JG, Hein IM. Mental health screening and assessment tools for forcibly displaced children: a systematic review. Eur J Psychotraumatol 2022; 13:2126468. [PMID: 36212114 PMCID: PMC9542271 DOI: 10.1080/20008066.2022.2126468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background: An unprecedentedly large number of people worldwide are forcibly displaced, of which more than 40 percent are under 18 years of age. Forcibly displaced children and youth have often been exposed to stressful life events and are therefore at increased risk of developing mental health issues. Hence, early screening and assessment for mental health problems is of great importance, as is research addressing this topic. However, there is a lack of evidence regarding the reliability and validity of mental health assessment tools for this population. Objective: The aim of the present study was to synthesise the existing evidence on psychometric properties of patient reported outcome measures [PROMs] for assessing the mental health of asylum-seeking, refugee and internally displaced children and youth. Method: Systematic searches of the literature were conducted in four electronic databases: MEDLINE, PsycINFO, Embase and Web of Science. The methodological quality of the studies was examined using the COSMIN Risk of Bias checklist. Furthermore, the COSMIN criteria for good measurement properties were used to evaluate the quality of the outcome measures. Results: The search yielded 4842 articles, of which 27 met eligibility criteria. The reliability, internal consistency, structural validity, hypotheses testing and criterion validity of 28 PROMs were evaluated. Conclusion: Based on the results with regard to validity and reliability, as well as feasibility, we recommend the use of several instruments to measure emotional and behavioural problems, PTSD symptoms, anxiety and depression in forcibly displaced children and youth. However, despite a call for more research on the psychometric properties of mental health assessment tools for forcibly displaced children and youth, there is still a lack of studies conducted on this topic. More research is needed in order to establish cross-cultural validity of mental health assessment tools and to provide optimal cut-off scores for this population. HIGHLIGHTS Research on the psychometric properties of mental health screening and assessment tools for forcibly displaced children and youth is slowly increasing.However, based on the current evidence on the validity and reliability of screening and assessment tools for forcibly displaced children, we are not able to recommend a core set of instruments. Instead, we provide suggestions for best practice.More research of sufficient quality is important in order to establish crsoss-cultural validity and to provide optimal cut-off scores in mental health screening and assessment tools for different populations of forcibly displaced children and youth.
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Affiliation(s)
- Ilse L Verhagen
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Marc J Noom
- Department of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | - Ramón J L Lindauer
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Joost G Daams
- Medical Library, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Irma M Hein
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, Amsterdam, Netherlands
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Bergevin A, Husain M, Cruz M, Blanc CL, Dieme A, Girardin ML, Toujouse C, Tkhayat RB, Slabab S, Corseri O, Maglorius M, Vercamer C, Eskander E, Desselas E, Lachaume N, Garraffo A, Sorge F, Roux EL, Gaschignard J, Caseris M, Faye A. Medical check-up of newly arrived unaccompanied minors: A dedicated pediatric consultation service in a hospital. Arch Pediatr 2021; 28:689-695. [PMID: 34756657 DOI: 10.1016/j.arcped.2021.09.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 03/15/2021] [Accepted: 09/26/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS Healthcare for the increasing number of migrants in Europe, and particularly of unaccompanied minors (UMs) seeking asylum, has become a major challenge. We aimed to describe the health issues of UMs managed in a dedicated pediatric consultation service in a care center in Paris. METHODS All UMs attending a dedicated migrant medical consultation service in Robert Debré Hospital, Paris, France, were included in a single-center retrospective observational study from September 1, 2017, to September 30, 2018. RESULTS Out of the 107 UMs who were included, 87% had a health problem (n=93) and 52% had an infectious disease (n=56). The main infectious diagnoses were schistosomiasis (22%), latent tuberculosis (22%), intestinal parasitosis (16%), and chronic hepatitis B (8%). Posttraumatic stress disorder (PTSD) and overweight were common (35% and 20%, respectively). The median age was 15 years old (IQR, 14-16), the male/female ratio was 95/12. Most of the children were from sub-Saharan Africa (n=67), 46% had crossed Libya (n=49) and, when compared to the other migration routes, faced an increasing risk of violence (69%, p=0.04), imprisonment (53%, p=0.03), and forced labor (48%, p=0.02). The median duration of the trip before reaching France was 6 months (IQR, 2-13), the median time to consultation was 2 months (0-5) and was not associated with an increased risk of health problems. A total of 43 UMs were lost to follow-up. CONCLUSION Health problems, particularly infectious diseases and PTSD, are common among UMs and should prompt an early medical consultation with psychiatric evaluation. Follow-up is problematic and could be improved by an on-line health book.
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Affiliation(s)
- A Bergevin
- General Pediatric Department, Nord Ouest Hospital, Villefranche sur Saône, 69655 France; Pediatric Residents Association, AJP, Paris, 75 France.
| | - M Husain
- Pediatric Residents Association, AJP, Paris, 75 France
| | - M Cruz
- Pediatric Residents Association, AJP, Paris, 75 France; APHP, General Pediatric Department Robert Debré Hospital, Paris 75019 France
| | - C Le Blanc
- Pediatric Residents Association, AJP, Paris, 75 France; APHP, General Pediatric Department Jean Verdier Hospital, Bondy 93140 France
| | - A Dieme
- Pediatric Residents Association, AJP, Paris, 75 France; General Pediatric Department Ambroise Paré, Boulogne-Billancourt 92100 France
| | - M-L Girardin
- Pediatric Residents Association, AJP, Paris, 75 France; Pediatric Intensive Care Unit, Hautepierre Hospital, Strasbourg 67200 France
| | - C Toujouse
- Pediatric Residents Association, AJP, Paris, 75 France
| | - R Ben Tkhayat
- Pediatric Residents Association, AJP, Paris, 75 France
| | - S Slabab
- Pediatric Residents Association, AJP, Paris, 75 France
| | - O Corseri
- Pediatric Residents Association, AJP, Paris, 75 France; APHP, General Pediatric Department Robert Debré Hospital, Paris 75019 France
| | - M Maglorius
- Pediatric Residents Association, AJP, Paris, 75 France
| | - C Vercamer
- Pediatric Residents Association, AJP, Paris, 75 France; APHP, General Pediatric Department Jean Verdier Hospital, Bondy 93140 France
| | - E Eskander
- Pediatric Residents Association, AJP, Paris, 75 France
| | - E Desselas
- Pediatric Residents Association, AJP, Paris, 75 France; General Pediatric Department Montpellier Hospital, Paris 34295 France
| | - N Lachaume
- APHP, General Pediatric Department Robert Debré Hospital, Paris 75019 France; APHP, General Pediatric Department Louis Mourier Hospital, Colombes, 92700 France
| | - A Garraffo
- APHP, General Pediatric Department Robert Debré Hospital, Paris 75019 France; Pediatric Department, Villeneuve-Saint-Georges Hospital, Villeneuve-Saint-Georges, 94190 France
| | - F Sorge
- APHP, General Pediatric Department Robert Debré Hospital, Paris 75019 France; APHP, General Pediatric Department Necker Hospital, Paris, 75015 France
| | - E Le Roux
- Clinical Epidemiology Department Robert Debré Hospital, Paris, 48 boulevard Sérurier 75019 France; Paris Diderot Medical University, 10 avenue de Verdun Paris, 75010 France; ECEVE, INSERM 1123, 10 avenue de Verdun Paris, 75010 France
| | - J Gaschignard
- APHP, General Pediatric Department Robert Debré Hospital, Paris 75019 France
| | - M Caseris
- APHP, General Pediatric Department Robert Debré Hospital, Paris 75019 France
| | - A Faye
- APHP, General Pediatric Department Robert Debré Hospital, Paris 75019 France; Clinical Epidemiology Department Robert Debré Hospital, Paris, 48 boulevard Sérurier 75019 France; Paris Diderot Medical University, 10 avenue de Verdun Paris, 75010 France.
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Müller LRF, Gossmann K, Schmid RF, Rosner R, Unterhitzenberger J. A pilot study on ecological momentary assessment in asylum-seeking children and adolescents resettled to Germany: Investigating compliance, post-migration factors, and the relation between daily mood, sleep patterns, and mental health. PLoS One 2021; 16:e0246069. [PMID: 33524043 PMCID: PMC7850498 DOI: 10.1371/journal.pone.0246069] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 01/12/2021] [Indexed: 11/19/2022] Open
Abstract
Background Asylum-seeking children and adolescents (ASCs) resettled to western countries show elevated levels of psychological distress. While research on the mental health of ASCs is increasing, less is known about their day-to-day living experiences such as their daily mood, sleep patterns, and post-migration factors. Moreover, no examination in situ, using smartphone-assisted ecological momentary assessment (EMA), has been conducted up to now among ASCs. Furthermore, we do not know if screening measures succeed in reflecting the daily mood of ASCs experienced in everyday life. Methods We undertook a smartphone-assisted EMA study over a two-week period with 3 measurements a day. Participants were N = 40 ASCs from 10 different countries who had resettled to Germany. They completed standardized questionnaires screening for history of trauma and clinical symptoms (post-traumatic stress symptoms, depression, and anxiety) that were carried out in interview-like settings, and they participated in the subsequent EMA where they rated mood, sleep parameters, and post-migration factors on a daily basis. Multilevel models of clinical symptoms, daily mood, and sleep parameters were computed based on a total of 680 measurements. Results The multiply traumatized and highly distressed participants reported different levels of discrimination, and various social activities and contacts in the EMA. The overall compliance rate was shown to be 40.5%. Higher PTSS and anxiety scores were associated with lower levels of daily mood and poorer outcomes of some sleep parameters. Depression scores were not associated with any of the variables assessed in the EMA. Conclusions Smartphone-assisted EMA among ASCs resettled to Germany proved to be implementable despite a rather low compliance rate. Not only do ASCs show high symptom levels, they are also affected by these symptoms in their daily lives. The results emphasize the need for concise screenings and psychological treatment for this high-risk population. Limitations include the convenient nature of the sample and the lack of a comparison group.
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Affiliation(s)
| | - Katharina Gossmann
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
| | - Regina F. Schmid
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
| | - Rita Rosner
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
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Grau L, Carretier E, Moro MR, Revah-Levy A, Sibeoni J, Lachal J. A qualitative exploration of what works for migrant adolescents in transcultural psychotherapy: perceptions of adolescents, their parents, and their therapists. BMC Psychiatry 2020; 20:564. [PMID: 33243219 PMCID: PMC7690022 DOI: 10.1186/s12888-020-02970-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 11/17/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Migrant adolescents are at a higher risk than their native-born counterparts of psychiatric disorders, and their care is a public health issue. In France, transcultural psychotherapy is a treatment provided by a group of therapists designed to meet the specific needs of these patients when usual care appears ineffective. The objective of this study was to explore the therapeutic elements at work in transcultural psychotherapy. METHODS We conducted a qualitative study crossing the perspectives of adolescents receiving transcultural psychotherapy, their parents, their first-line therapist (FLT), and the transcultural therapists. The families were chosen by purposive sampling. Data were collected during semi-structured individual (for FLTs) and group (families and transcultural therapists) interviews that explored the therapeutic elements involved and effective in transcultural psychotherapy. We used interpretative phenomenological analysis (IPA) to examine the data. In all, 44 participants were questioned: three adolescents (2 girls and 1 boy, all aged 18 to 21 years) and their parents (3 mothers and 1 father), three FLTs (2 child psychiatrists and 1 psychologist), and the 34 therapists participating in the three transcultural psychotherapy groups. RESULTS The analysis uncovered three themes: (1) the perceived effectiveness of the group's functioning; (2) the recounting of the individual, family, and cultural history to allow for complexity and nuance; and (3) the personal investment by therapists, made possible by the group. CONCLUSIONS Our results show some therapeutic elements at work in transcultural psychotherapy that enable it to meet the particular needs of some migrant adolescents that are unmet in standard therapy. Continuing to study transcultural psychotherapy and assess its effectiveness is essential for promoting and optimizing psychiatric care for migrant adolescents.
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Affiliation(s)
- Léa Grau
- UFR des Lettres, des Sciences de l'Homme et des Sociétés Unité Transversale de Recherche Psychogenèse et Psychopathologie, UTRPP EA4403, Univ. Paris 13, F-93430, Villetaneuse, France
| | - Emilie Carretier
- UFR des Lettres, des Sciences de l'Homme et des Sociétés Unité Transversale de Recherche Psychogenèse et Psychopathologie, UTRPP EA4403, Univ. Paris 13, F-93430, Villetaneuse, France
- AP-HP, Hôpital Cochin, Maison de Solenn, 97 Boulevard de Port Royal, 75014, Paris, France
| | - Marie-Rose Moro
- AP-HP, Hôpital Cochin, Maison de Solenn, 97 Boulevard de Port Royal, 75014, Paris, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, F-94807, Villejuif, France
- Université de Paris, PCPP, F-92100, Boulogne-Billancourt, France
| | - Anne Revah-Levy
- Service Universitaire de Psychiatrie de l'Adolescent, Centre Hospitalier d'Argenteuil, F95100, Argenteuil, France
- ECSTRRA Team, UMR-1153, Inserm, Université de Paris, Paris, France
| | - Jordan Sibeoni
- Service Universitaire de Psychiatrie de l'Adolescent, Centre Hospitalier d'Argenteuil, F95100, Argenteuil, France
- ECSTRRA Team, UMR-1153, Inserm, Université de Paris, Paris, France
| | - Jonathan Lachal
- AP-HP, Hôpital Cochin, Maison de Solenn, 97 Boulevard de Port Royal, 75014, Paris, France.
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, F-94807, Villejuif, France.
- Université de Paris, PCPP, F-92100, Boulogne-Billancourt, France.
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Eiset AH, Loua AS, Kruse A, Norredam M. The health status of newly arrived asylum-seeking minors in Denmark: a nationwide register-based study. Int J Public Health 2020; 65:1763-1772. [PMID: 33084920 DOI: 10.1007/s00038-020-01501-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/21/2020] [Accepted: 10/02/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Asylum-seeking minors are known to be at increased risk of physical and mental diseases compared to both native children and adult asylum seekers. We present a nationwide register-based study based on the health assessment of 7210 newly arrived minors in Danish asylum centres from 1 January 2011 to 31 December 2015. METHODS We describe socio-demographic characteristics, trauma history and symptoms of physical and mental health. To associate the reporting of traumatic events and signs of anxiety or depression, we performed logistic regression analysis. RESULTS We found a high, albeit varying, prevalence of traumatic experiences, sleeping and eating problems, and head- and toothache. In the subgroup that was assessed for need of urgent support, more than two of every five minor scored above the threshold. In the subgroup examined by a doctor, one of every four had at least one abnormal finding. CONCLUSIONS The prevalence of trauma and mental health symptoms and the association of the two were striking. Our findings underline that timely recognition and appropriate treatment of childhood traumas should be given high priority in the receiving communities.
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Affiliation(s)
- Andreas Halgreen Eiset
- Centre for Global Health (GloHAU), Department of Public Health, Aarhus University, Aarhus, Denmark.
| | - Arendse Sander Loua
- Section of Immigrant Medicine, Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark
| | - Alexandra Kruse
- Section of Immigrant Medicine, Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark.,Department of Paediatrics, Copenhagen University Hospital, Hvidovre, Denmark
| | - Marie Norredam
- Section of Immigrant Medicine, Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark.,Danish Research Centre for Migration, Ethnicity, and Health (MESU), Section for Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Asylum-Seeking Children with Medical Complexity and Rare Diseases in a Tertiary Hospital in Switzerland. J Immigr Minor Health 2020; 23:669-679. [PMID: 33083944 PMCID: PMC8233290 DOI: 10.1007/s10903-020-01100-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2020] [Indexed: 02/06/2023]
Abstract
The aim of this study was to assess the characteristics of asylum-seeking children with medical complexity visiting a tertiary care hospital in Switzerland, detailing their underlying medical conditions and management. Asylum-seeking patients with frequent visits between January 2016 and December 2017 were identified using administrative and electronic health records. Of 462 patients, 19 (4%) fulfilled the inclusion criteria with 811 (45%) visits. The age of the 19 patients ranged from 0 to 16.7 years (median of 7 years) with two main age groups identified: < 2 years and > 12 years. Nine (47%) patients originated from Syria. A total of 34/811(4%) visits were hospital admissions, 66/811 (8%) emergency department visits and 320/811(39%) outpatient department visits. In children < 2 years genetic diseases (5/8; 63%) and nutritional problems (6/8; 75%) were most common; in adolescents, orthopedic diseases (4/8; 50%) and mental health problems (4/8; 50%). Asylum-seeking children with medical complexity represent a small but important group of patients requiring frequent medical consultations. The high proportion of young patients with genetic diseases and severe nutritional problems suggests that new strategies are required in the management of this specific group of asylum-seeking children. This could be achieved by improved co-ordination between hospital and non-hospital care exploring options for integrated care.
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Rometsch C, Denkinger JK, Engelhardt M, Windthorst P, Graf J, Nikendei C, Zipfel S, Junne F. Care providers' views on burden of psychosomatic symptoms of IS-traumatized female refugees participating in a Humanitarian Admission Program in Germany: A qualitative analysis. PLoS One 2020; 15:e0239969. [PMID: 33017408 PMCID: PMC7535032 DOI: 10.1371/journal.pone.0239969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 09/17/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Traumatized refugees often suffer from diverse psychosomatic symptoms. Female Yazidi refugees from Northern Iraq who survived attacks of the so-called "Islamic State" were brought to Germany to receive special medical and psychotherapeutic treatment in a unique worldwide humanitarian admission program (HAP). Here, we report on their psychosomatic symptoms and helpful strategies from the perspective of care providers. METHODS Care providers (N = 84) in this HAP were interviewed in an individual setting as well as in focus groups to gather information about the HAP beneficiaries' psychosomatic symptoms. Data analysis followed Qualitative Content Analysis by Mayring. RESULTS The care providers reported five main psychological burdens of the Yazidis: 1) insecurity regarding loss, 2) worries about family members, 3) ambivalence about staying in Germany or returning to Iraq, 4) life between two worlds and 5) re-actualization of the traumatic experiences. The predominant psychological symptoms the care providers noticed were fear, depressive symptoms, feelings of guilt, and sleep and eating disorders. Regarding somatic symptoms, the care providers mainly received complaints about pain in the head, back, chest and stomach. Helpful strategies for providing adequate health care were care providers' cooperating with physicians, precise documentation of beneficiaries' symptoms, and additional support in directing the beneficiaries through the health care system. Regarding psychotherapy, interpreters help to overcome language barriers, onsite psychotherapy, flexible therapy appointments, psychoeducational methods, time for stabilization, and support in coping with daily life aspects. In the care providers' experience, psychotherapists have to build a relationship of trust. After grief therapy, a trauma-specific therapy in a culturally adapted way is possible. CONCLUSION The HAP is a unique model health care program to offer highly traumatized refugees medical and psychological help. Care providers reported on several (psycho-)somatic symptoms of the traumatized women. The strategies the HAP care providers perceived as helpful can be recommended for similar projects in the future.
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Affiliation(s)
- Caroline Rometsch
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Jana Katharina Denkinger
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Martha Engelhardt
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Petra Windthorst
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Johanna Graf
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
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11
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Diverse and Complex Challenges to Migrant and Refugee Mental Health: Reflections of the M8 Alliance Expert Group on Migrant Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103530. [PMID: 32443521 PMCID: PMC7277923 DOI: 10.3390/ijerph17103530] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/08/2020] [Accepted: 05/12/2020] [Indexed: 12/17/2022]
Abstract
Forced migration is likely to continue to grow in the coming years due to climate change, disease outbreaks, conflict, and other factors. There are a huge number of challenges to maintaining good health, and specifically good mental health, among migrants at all stages of migration. It is vital to fully understand these diverse challenges so that we can work towards overcoming them. In 2017, as a response to the growing health challenges faced by migrants and refugees, the M8 Alliance created an expert group focussing on migrant and refugee health. The group meets annually at the Sapienza University of Rome, Italy, and this article is based on the discussions that took place at the third annual meeting (6–7 June 2019) and a special session on “Protecting the Mental Health of Refugees and Migrants,” which took place on 27 October at the World Health Summit 2019 in Berlin. Our discussions are also supported by supplementary literature to present the diverse and complex challenges to the mental health of migrants and refugees. We conclude with some lessons learned and hope for the future.
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12
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Analysis of Refugee Children Hospitalized in a Tertiary Pediatric Hospital. J Immigr Minor Health 2020; 23:11-18. [DOI: 10.1007/s10903-020-01026-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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13
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Radjack R, Touhami F, Woestelandt L, Minassian S, Mouchenik Y, Lachal J, Moro MR. Cultural Competence of Professionals Working With Unaccompanied Minors: Addressing Empathy by a Shared Narrative. Front Psychiatry 2020; 11:528. [PMID: 32595535 PMCID: PMC7301836 DOI: 10.3389/fpsyt.2020.00528] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 05/22/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The number of migrant youth traveling without parents continues to rise in Europe and North America. Some of t hem leave their home countries on their own and find themselves in a new country, separated from their family and cut off from their cultural roots. Besides those who leave to study, work, and pursue a better life, others are escaping war-torn countries. They need adequate social, educational, and therapeutic spaces, where they can feel entitled to speak. Social workers often ask about how they can understand these young people better so that they can provide them with better care (cope with their trauma and suspicion, deal with the cultural distance between the adolescents and their social workers, etc). AIM At Cochin Hospital in Paris, we led a participative action-research program to transmit cultural competence to social workers who provide care for these youth. The aim was to develop an approach to help these young migrants to share their representations about themselves and to train these social workers to encourage this sharing in a culturally sensitive manner. METHODS This study used a qualitative method that mixed narrative and transcultural approaches. Two researchers met each youth and social worker with an interpreter-cultural mediator three times (once a month) to assess changes in their relationships during the study. The youth were asked to bring three items of their choice, representing their past, present, and future. They could use their imagination and creativity. We also used the circle test described by Cottle for this purpose. We used a phenomenological approach to analyze the interviews. RESULTS AND DISCUSSION This study included 29 young people from 13 different countries and 29 social workers. A transcultural approach appears to be a useful framework for reactivating their identity construction process. It promotes the emergence of cultural representations and takes their experiences before, during, and after migration into account. We assisted them in developing their ability to produce a thorough narrative of their bicultural adolescences and simultaneously helped their social workers to develop their cultural competence. CONCLUSION Together, a transcultural approach and methods stimulating the production of narrative are relevant ways to help children to describe their representations of themselves, especially those who have learned to protect themselves by remaining silent. This protocol could be useful for both preventive action and therapy for psychotrauma.
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Affiliation(s)
- Rahmeth Radjack
- AP-HP, Hôpital Cochin, Maison de Solenn, Paris, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France.,UTRPP, University Sorbonne Paris Nord, Paris, France.,University of Paris, Sorbonne Paris Cité, Paris, France
| | - Fatima Touhami
- AP-HP, Hôpital Cochin, Maison de Solenn, Paris, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France.,UTRPP, University Sorbonne Paris Nord, Paris, France
| | - Laure Woestelandt
- AP-HP, Hôpital Cochin, Maison de Solenn, Paris, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| | - Sevan Minassian
- AP-HP, Hôpital Cochin, Maison de Solenn, Paris, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| | | | - Jonathan Lachal
- AP-HP, Hôpital Cochin, Maison de Solenn, Paris, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France.,University of Paris, Sorbonne Paris Cité, Paris, France
| | - Marie Rose Moro
- AP-HP, Hôpital Cochin, Maison de Solenn, Paris, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France.,University of Paris, Sorbonne Paris Cité, Paris, France
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Schrier L, Wyder C, Del Torso S, Stiris T, von Both U, Brandenberger J, Ritz N. Medical care for migrant children in Europe: a practical recommendation for first and follow-up appointments. Eur J Pediatr 2019; 178:1449-1467. [PMID: 31240389 DOI: 10.1007/s00431-019-03405-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 05/31/2019] [Accepted: 06/04/2019] [Indexed: 12/21/2022]
Abstract
Between 2015 and 2017, an estimated 200,000 to 400,000 children were seeking asylum each year in EU/EEA countries. As access to high-quality health care is important, we collected and compared current recommendations across Europe for a consensus recommendation on medical care for migrant (asylum-seeking and refugee) children. Existing recommendations were collected from published literature and identified through national representatives from paediatric societies of 31 EU/EEA countries through the European Academy of Paediatrics (EAP). Recommendations were systematically extracted and collected in a database. Those mentioned in at least one recommendation were evaluated for inclusion, and evidence on recommendations was specifically identified in literature searches focused on recent evidence from Europe. For eight EU/EEA countries, a national recommendation was identified. Growth and development, vision and hearing impairment, skin and dental problems, immunisations, anaemia, micronutrient deficiency, helminths, hepatitis B and C, human immunodeficiency virus, malaria, schistosomiasis, syphilis, tuberculosis, mental health disorder and sexual health were most frequently mentioned and therefore selected for inclusion in the recommendation.Conclusion: The current document includes general recommendations on ethical standards, use of interpreters and specific recommendations for prevention or early detection of communicable and non-communicable diseases. It may serve as a tool to ensure the fundamental right that migrant children in Europe receive a comprehensive, patient-centred health care.
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Affiliation(s)
- Lenneke Schrier
- Willem Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - Corinne Wyder
- Kinderaerzte KurWerk, Poststrasse 9, 3400, Burgdorf, Switzerland
- Department of Paediatrics, University of Bern, Bern, Switzerland
| | | | - Tom Stiris
- Department of Neonatology, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ulrich von Both
- Division of Paediatric Infectious Diseases, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
- German Centre for Infection Research (DZIF), partner site, Munich, Germany
- Paediatric Infection and Immunity, Section of Paediatric, Department of Medicine, Imperial College London, London, UK
| | - Julia Brandenberger
- Migrant Health Service, University Children's Hospital Basel, University of Basel, Spitalstrasse 33, 4056, Basel, Switzerland
| | - Nicole Ritz
- Migrant Health Service, University Children's Hospital Basel, University of Basel, Spitalstrasse 33, 4056, Basel, Switzerland.
- Infectious Diseases and Vaccinology Unit, University Children's Hospital Basel, University of Basel, Basel, Switzerland.
- Department of Paediatrics, The University of Melbourne, Parkville, Australia.
- Infectious Diseases Unit, Royal Children's Hospital Melbourne, Parkville, Australia.
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15
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Müller LRF, Gossmann K, Hartmann F, Büter KP, Rosner R, Unterhitzenberger J. 1-year follow-up of the mental health and stress factors in asylum-seeking children and adolescents resettled in Germany. BMC Public Health 2019; 19:908. [PMID: 31286909 PMCID: PMC6615278 DOI: 10.1186/s12889-019-7263-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 06/30/2019] [Indexed: 11/29/2022] Open
Abstract
Background Asylum-seeking children and adolescents (ASCs) who have resettled in Western countries show elevated rates of psychological distress, including Posttraumatic Stress Symptoms (PTSS), depression, and anxiety. Most longitudinal data suggest a relatively stable course of symptoms during the first years in exile. However, no longitudinal examination of the mental health of ASCs, who resettled in Europe in the wake of the 2015–17 European migrant crisis, has been conducted so far. Methods A prospective cohort study looked at 98 ASCs who resettled in southern Germany throughout 2015–17. They mainly came from Afghanistan, Syria, Eritrea, and Iraq. Baseline assessments were undertaken 22 months, on average, after resettlement, and follow-up assessments 1 year thereafter. Seventy-two ASCs could be secured for the follow-up. The measures included self-report questionnaires screening for PTSS, depression, anxiety, externalizing behavior, and post-migration factors that were administered in an interview-like setting. Results were analyzed using hierarchical multiple regression analysis. Results Participating ASCs reported on average eight potentially traumatic experiences and high levels of psychological distress at baseline that had significantly declined at follow-up. At follow-up, rates of clinically significant symptoms ranged from 9.7% (externalizing behavior) to 37.5% (PTSS). There was considerable individual variation in symptom change resulting in multiple mental health trajectories. ASCs whose asylum applications had been rejected presented significantly more symptoms than ASCs whose asylum applications had been accepted between assessments. Baseline psychopathology and asylum status predicted follow-up symptom severity. Conclusions In contrast to earlier studies, the symptom severity in this sample of ASCs in Germany ameliorated between assessments. Decisions on the asylum applications of ASCs are thought to contribute to the course of symptoms. Since levels of psychological distress were still high, dissemination and implementation of appropriate treatments for ASCs is crucial. Electronic supplementary material The online version of this article (10.1186/s12889-019-7263-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Katharina Gossmann
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Ostenstraße 25, 85072, Eichstätt, Germany
| | - Franziska Hartmann
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Ostenstraße 25, 85072, Eichstätt, Germany
| | - Karl Phillipp Büter
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Ostenstraße 25, 85072, Eichstätt, Germany
| | - Rita Rosner
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Ostenstraße 25, 85072, Eichstätt, Germany
| | - Johanna Unterhitzenberger
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Ostenstraße 25, 85072, Eichstätt, Germany
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Pfeiffer E, Sachser C, Tutus D, Fegert JM, Plener PL. Trauma-focused group intervention for unaccompanied young refugees: "Mein Weg"-predictors of treatment outcomes and sustainability of treatment effects. Child Adolesc Psychiatry Ment Health 2019; 13:18. [PMID: 30976315 PMCID: PMC6442414 DOI: 10.1186/s13034-019-0277-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 03/15/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Current research on treatment predictors and long-term effects of trauma-focused interventions for (unaccompanied) refugee minors is limited. This secondary analysis of a recent randomised controlled trial (RCT), evaluating the trauma-focused group intervention "Mein Weg" (English "My Way") compared to usual care, investigated several refugee-specific factors such as treatment predictors and sustainability of treatment gains. METHODS In total N = 50 participants (M age = 17.00, 94% male) were included in this analysis. Evaluation of 3-month follow-up data included: posttraumatic stress symptoms [(PTSS) CATS-Self, CATS-Care], depression (PHQ-8), and dysfunctional posttraumatic cognitions (CPTCI-S). Baseline symptom severity of the above-mentioned measures, trauma load and socio-demographic factors were investigated as the treatment predictors. RESULTS Intention-to-treat-analyses (ITT) revealed the sustainability of treatment effects in self-reported PTSS (pre to post change: 6.48 ± 1.60, d = 0.62, p < 0.001; post to 3-month follow-up change: 1.41 ± 1.96, d = 0.11, p = 0.47) and depression (pre to post change: 7.82 ± 2.09, d = 0.64, p < 0.001; post to 3-month follow-up change: 1.35 ± 2.17, d = 0.05, p = 0.54). Country of origin alone was a significant predictor of the change in PTSS (b = - 8.22 ± 3.53, t(30) = - 2.33, p = 0.027), and baseline levels of depression were a significant predictor of the change in depression (b = 0.83 ± 0.19, t(33) = 4.46, p < 0.001). CONCLUSION This group intervention can serve as a valuable component in a stepped care approach with promising long-term effects for young refugees.Trial registration DRKS, #DRKS00010915. Registered 15 September 2016, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00010915.
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Affiliation(s)
- Elisa Pfeiffer
- 0000 0004 1936 9748grid.6582.9Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm University, Steinhoevelstraße 5, 89075 Ulm, Germany
| | - Cedric Sachser
- 0000 0004 1936 9748grid.6582.9Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm University, Steinhoevelstraße 5, 89075 Ulm, Germany
| | - Dunja Tutus
- 0000 0004 1936 9748grid.6582.9Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm University, Steinhoevelstraße 5, 89075 Ulm, Germany
| | - Joerg M. Fegert
- 0000 0004 1936 9748grid.6582.9Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm University, Steinhoevelstraße 5, 89075 Ulm, Germany
| | - Paul L. Plener
- 0000 0004 1936 9748grid.6582.9Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm University, Steinhoevelstraße 5, 89075 Ulm, Germany ,0000 0000 9259 8492grid.22937.3dDepartment of Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
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Prevalence of mental disorders in young refugees and asylum seekers in European Countries: a systematic review. Eur Child Adolesc Psychiatry 2019; 28:1295-1310. [PMID: 30151800 PMCID: PMC6785579 DOI: 10.1007/s00787-018-1215-z] [Citation(s) in RCA: 125] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 08/16/2018] [Indexed: 12/27/2022]
Abstract
The European Union member states received about 385,000 asylum applications from children and adolescents below 18 years in 2015, and 398,000 in 2016. The latest political crises and war have led to an upsurge in refugee movements into European countries, giving rise to a re-evaluation of the epidemiology of psychiatric disorders and mental health problems among young refugees and asylum seekers. We systematically searched five electronic databases and reference lists of pertinent review articles. We then screened the results of forward citation tracking of key articles for relevant studies in the field for the period from January 1990 to October 2017. We dually reviewed citations and assessed risk of bias. We reported the results narratively, as meta-analyses were impeded due to high heterogeneity. We included 47 studies covered in 53 articles. Overall, the point prevalence of the investigated psychiatric disorders and mental health problems varied widely among studies (presenting interquartile ranges): for posttraumatic stress disorder between 19.0 and 52.7%, for depression between 10.3 and 32.8%, for anxiety disorders between 8.7 and 31.6%, and for emotional and behavioural problems between 19.8 and 35.0%. The highly heterogeneous evidence base could be improved by international, methodologically comparable studies with sufficiently large sample sizes drawn randomly among specific refugee populations. The prevalence estimates suggest, nevertheless, that specialized mental health care services for the most vulnerable refugee and asylum-seeking populations are needed. REGISTRATION: The systematic review protocol was registered in PROSPERO on October 19th, 2017 with the number: CRD42017080039 and is available from: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=80039.
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Pediatric Healthcare for Refugee Minors in Europe: Steps for Better Insight and Appropriate Treatment. J Pediatr 2018; 197:323-324.e2. [PMID: 29801545 DOI: 10.1016/j.jpeds.2018.03.061] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 03/23/2018] [Indexed: 11/22/2022]
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Affiliation(s)
- Albertine Baauw
- Department of Pediatrics, Rijnstate Hospital, Arnhem, The Netherlands. .,Department of Pediatrics and Public Health, VU University Medical Center and Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
| | - Nicole Ritz
- Migrant Health Service, Paediatric Infectious Diseases and Vaccinology Unit and Paediatric Pharmacology and Pharmacometrics, University of Basel Children's Hospital, Basel, Switzerland.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
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