Common mental disorders in asylum seekers and refugees: umbrella review of prevalence and intervention studies

Turrini, Giulia; Purgato, Marianna; Ballette, Francesca; Nosè, Michela; Ostuzzi, Giovanni; Barbui, Corrado

doi:10.1186/s13033-017-0156-0

Cited by 288 publications

(256 citation statements)

References 37 publications

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“…The best control condition fur such an RCT is questionable, since 7ROSES aims to increase self-efficacy, while previously established treatments (e.g. Turrini et al, 2017) for the target population primarily focus on reduction in PTSD and depression. Hence, before comparing 7ROSES to established interventions it is necessary to determine if it impacts PTSD and depression symptom levels.…”

Section: Discussionmentioning

confidence: 99%

“…In current guideline-informed interventions (e.g., American Psychological Association [APA], 2017), little attention is paid to post-migration sources of stress which refugees experience (Miller & Rasmussen, 2010;Strang & Ager, 2010;Turrini et al, 2017), despite their impact on refugee health and well-being (Chu, Keller, & Rasmussen, 2013;Li, Liddell, & Nickerson, 2016;Porter & Haslam, 2005;Priebe, Giacco, & El-Nagib, 2016). Examples of such stressors are poverty, unsafe living conditions, loss of social network (Lambert & Alhassoon, 2015), discrimination, and insecurity about legal status (Laban, Gernaat, Komproe, van der Tweel, & De Jong, 2005).…”

Section: Introductionmentioning

confidence: 99%

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7ROSES, a transdiagnostic intervention for promoting self-efficacy in traumatized refugees: a first quantitative evaluation

Heemstra

Scholte

Haagen

et al. 2019

European Journal of Psychotraumatology

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Objective: Due to traumatic experiences and highly prevalent post-migration stressors, refugees are vulnerable for developing psychopathology. To date, research has mainly evaluated trauma-focused therapies, targeting post traumatic stresss symptoms. Treatments targeting post-migration stressors are relatively understudied. The present cohort study evaluated the potential effectiveness of 7ROSES, a transdiagnostic intervention that aims to increase self-efficacy among treatment-seeking refugees in dealing with postmigration stressors. Because it can be applied by non-specialist health care workers, it can be disseminated on a large scale, thereby increasing options for psychosocial support for refugees. Method: Forty-nine refugees (65% male, average age: 36.02 years, SD = 8.52) with psychopathology were included. Before and after participation in 7ROSES, self-efficacy was measured using the General Self-Efficacy Scale (GSES), and general psychopathology using the Brief Symptom Inventory (BSI). Results: Completers analysis yielded a significant increase in GSES scores (Z = −2.16, p = .03) and significant decrease in BSI scores (Z = −2.05, p = .04) with medium-small effects (both r = −.28). Intent-to-treat analysis, using predictive mean matching imputation, yielded significant results for the GSES (p = .012) but not for the BSI (p = .14) with small effects (GSES r = .14, BSI r = .12). Reliable change indices established negative change in 3%, no change in 70%, and positive change in 27% based on the GSES; percentages were 11.5%, 65.5%, and 23%, respectively, based on the BSI. Conclusion: Findings provide preliminary evidence that 7ROSES could improve self-efficacy and general mental health in refugees with psychopathology. ARTICLE HISTORY

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

7ROSES, a transdiagnostic intervention for promoting self-efficacy in traumatized refugees: a first quantitative evaluation

Heemstra

Scholte

Haagen

et al. 2019

European Journal of Psychotraumatology

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“…Among other priorities, WHO's plan emphasizes the urgent need to mainstream refugee and migrant healthcare services, promote a range of short-term and long-term interventions, address the social determinants of health, and integrate mental health within refugee healthcare provision. Refugee populations exposed to war and torture have elevated rates of depression, PTSD, anxiety, chronic pain, and acute medical conditions [3][4][5][6][7]. Karen refugees from Burma have high rates of torture and war trauma related to a 70year armed conflict with the government of Burma [8], and the health effects of these experiences have been compounded by lengthy stays in refugee camps on the Thai-Burma border without legal access to medical care, education, employment, or adequate food [9].…”

Section: Introductionmentioning

confidence: 99%

“…Few trials exist in the field of refugee health due to the ethical and practical challenges of conducting experimental research with this population [26,27]. Research has been constrained by small sample sizes, uneven comparison group sizes, singular outcomes, lack of control groups, lack of randomization, and non-blind assessment [3,28].…”

Section: Introductionmentioning

confidence: 99%

Intensive psychotherapy and case management for Karen refugees with major depression in primary care: a pragmatic randomized control trial

et al. 2020

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Background: Despite an unparalleled global refugee crisis, there are almost no studies in primary care addressing real-world conditions and longer courses of treatment that are typical when resettled refugees present to their physician with critical psychosocial needs and complex symptoms. We studied the effects of a year of psychotherapy and case management in a primary care setting on common symptoms and functioning for Karen refugees (a newly arrived population in St Paul, Minnesota) with depression.Methods: A pragmatic parallel-group randomized control trial was conducted at two primary care clinics with large resettled Karen refugee patient populations, with simple random allocation to 1 year of either: (1) intensive psychotherapy and case management (IPCM), or (2) care-as-usual (CAU). Eligibility criteria included Major Depression diagnosis determined by structured diagnostic clinical interview, Karen refugee, ages 18-65. IPCM (n = 112) received a year of psychotherapy and case management coordinated onsite between the case manager, psychotherapist, and primary care providers; CAU (n = 102) received care-as-usual from their primary care clinic, including behavioral health referrals and/or brief onsite interventions. Blinded assessors collected outcomes of mean changes in depression and anxiety symptoms (measured by Hopkins Symptom Checklist-25), PTSD symptoms (Posttraumatic Diagnostic Scale), pain (internally developed 5-item Pain Scale), and social functioning (internally developed 37-item instrument standardized on refugees) at baseline, 3, 6 and 12 months. After propensity score matching, data were analyzed with the intention-to-treat principle using repeated measures ANOVA with partial eta-squared estimates of effect size. Results: Of 214 participants, 193 completed a baseline and follow up assessment (90.2%). IPCM patients showed significant improvements in depression, PTSD, anxiety, and pain symptoms and in social functioning at all time points, with magnitude of improvement increasing over time. CAU patients did not show significant improvements. The largest mean differences observed between groups were in depression (difference, 5.5, 95% CI, 3.9 to 7.1, P < .001) and basic needs/safety (difference, 5.4, 95% CI, 3.8 to 7.0, P < .001).Conclusions: Adult Karen refugees with depression benefited from intensive psychotherapy and case management coordinated and delivered under usual conditions in primary care. Intervention effects strengthened at each interval, suggesting robust recovery is possible.

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“…Since 2015, many umbrella reviews have been conducted evaluating the evidence base on the psychosocial epidemiology of mental health in diverse populations [22][23][24][25][26][27]. Although several reviews have reported psychological impacts of quarantine or isolation [28,29], no umbrella review or overview of the reviews was found, which can inform the mental health implications of quarantine and isolation at the global landscape.…”

Section: Introductionmentioning

confidence: 99%

Mental health outcomes of quarantine and isolation for infection prevention: A systematic umbrella review of the global evidence

Hossain¹,

Sultana²,

Purohit³

2020

Preprint

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Background: Transmission of infectious diseases is often prevented by quarantine and isolation of the populations at risk. These approaches restrict the mobility, social interactions, and daily activities of the affected individuals. In recent novel coronavirus disease (COVID-19) pandemic, quarantine and isolation are being adopted in many contexts, which necessitates an evaluation of global evidence on how such measures impact the mental health outcomes among populations. This umbrella review aimed to synthesize the available evidence on mental health outcomes of quarantine and isolation for preventing infectious diseases.Materials and methods: We searched nine major databases and additional sources and included articles if they were systematically conducted reviews, published as peer-reviewed journal articles, and reported mental health outcomes of quarantine or isolation in any population.Results: Among 1364 citations, only eight reviews met our criteria. Most of the primary studies in those reviews were conducted in high-income nations and in hospital settings. These articles reported a high burden of mental health problems among patients, informal caregivers, and healthcare providers who experienced quarantine or isolation. Prevalent mental health problems among the affected individuals include depression, anxiety, mood disorders, psychological distress, posttraumatic stress disorder, insomnia, fear, stigmatization, low self-esteem, lack of self-control, and other adverse mental health outcomes.Conclusion: This umbrella review found severe mental health problems among individuals and populations who have undergone quarantine and isolation in different contexts. This evidence necessitates multipronged interventions including policy measures for strengthening mental health services globally and promoting psychosocial wellbeing among high-risk populations.

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Common mental disorders in asylum seekers and refugees: umbrella review of prevalence and intervention studies

Cited by 288 publications

References 37 publications

7ROSES, a transdiagnostic intervention for promoting self-efficacy in traumatized refugees: a first quantitative evaluation

7ROSES, a transdiagnostic intervention for promoting self-efficacy in traumatized refugees: a first quantitative evaluation

Intensive psychotherapy and case management for Karen refugees with major depression in primary care: a pragmatic randomized control trial

Mental health outcomes of quarantine and isolation for infection prevention: A systematic umbrella review of the global evidence

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