Refugees settled in western countries could be about ten times more likely to have posttraumatic stress disorder than general populations in those countries, suggests a study published in this week’s issue of The Lancet.
Post-traumatic stress disorder is a potentially disabling condition characterised by traumatic flash-backs, hypervigilence, and emotional numbing that might be a risk factor for substance abuse and suicide. About 13 million people are classified as refugees worldwide. Refugees could be at excess risk of psychiatric morbidity because of forced migration, traumatic events, and resettlement in unfamiliar environments. However, the prevalence of mental disorder in these individuals has been unclear.
Mina Fazel (University of Oxford, UK) and colleagues reviewed psychiatric surveys based on interviews with refugee populations in economically developed western countries published between January 1966 and December 2002. They found 20 eligible surveys that included data from 6743 adult refugees from seven countries (Australia, Canada, Italy, New Zealand, Norway, the UK and the USA). The combined analysis of these surveys suggest about one in ten adult refugees in western countries has post-traumatic stress disorder, about one in 20 has major depression, and about one in 25 has a generalised anxiety disorder. The data also suggests that approximately 50 000 of the 500 000 current refugees living in the USA have post-traumatic stress disorder. However, the authors note that despite focusing on the larger and more rigorous surveys available there was substantial variability in the results of the studies.