Objective: To determine migration related distress pattern in refugees and feasibility of a de novo established, central low-threshold outpatient clinic serving more than 80,000 newly arrived refugees in the metropole of Berlin.Methods: In an observational cohort study the relative prevalence of major psychiatric disorders by age, place of living within berlin, language and region of origin were assessed in a refugee cohort from 63 nationalities speaking 36 languages.Findings: Within 18 months, a total of 3,096 cases with a mean age of 29.7 years (11.7) have been referred from all 12 districts and 165 of 182 subdistricts of Berlin to the CCC. 33.7% of the patients were female. The three most frequent diagnoses were unipolar depression (40.4%), posttraumatic stress disorder (24.3%), and adjustment disorder (19.6%).Conclusion: The present data gives insight into the distribution of mental disorders in a large sample of refugees and provides evidence that a CCC is an effective service to quickly and broadly provide psychiatric consultations and thus to overcome classical barriers refugees usually experience in the host communities. In Berlin, Germany, and Europe treatment resources for this population should focus on stress and trauma related disorders.
Zusammenfassung: Eine kombinierte Behandlung aus Pharmakotherapie und Psychotherapie bei unipolaren depressiven Patienten ist gängige Praxis. Für diese Vorgehensweise liegt allerdings nur wenig empirische Evidenz vor. Der vorliegende Artikel gibt einen Überblick über den gegenwärtigen Stand der Literatur zur Wirksamkeit von Kombinationsbehandlung im Vergleich zu Monotherapie mit Pharmako- oder Psychotherapie. Berücksichtigt werden vorrangig Studien zur Akuttherapie, Erhaltungstherapie sowie zur Rezidivprophylaxe depressiver Episoden. Zusammenfassend lässt sich sagen, dass von einer kombinierten Behandlung insbesondere Patienten mit schweren Verläufen der Depression in der Akutbehandlung sowie Patienten mit rezidivierenden und chronischen Verläufen der Depression profitieren.
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