The Development of Posttraumatic Stress Disorder and Depression Symptoms in Iraqi Refugees

Yamin, Jolin B.; Sudan, Sukhesh; Lumley, Mark A.; Dhalimi, Abir; Arnetz, Judith E.; Stemmer, Paul M.; Burghardt, Paul; Jamil, Hikmet; Arnetz, Bengt B.

doi:10.1097/nmd.0000000000001360

Cited by 6 publications

(4 citation statements)

References 63 publications

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“…The women included in the internal control group were not diagnosed with PTSD; however, they shared the same environment as those diagnosed with PTSD. The hypothesis mentioned is supported by previous research showing associations between contextual factors and CRP levels in developing mental health problems in refugees [ 32 ].…”

Section: Discussionsupporting

confidence: 68%

Post-traumatic Stress Disorder: The Influence of the Environmental Context and Analysis of Oxidative Stress and Inflammatory and Glycemic Markers in Women Living in Kurdistan Regional Government-Iraq

Hasan,

Alkass,

Persike

2024

Cureus

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Background Internally displaced persons (IDP) camps are still home to a large number of female survivors of the Yazidi genocide carried out in Iraq in 2014 by the Islamic organization known as the Islamic State of Iraq and Syria (ISIS). Many of these women suffer from a persistent form of post-traumatic stress disorder (PTSD), which can last for many years. On the other hand, little is known about the intricate etiology of PTSD. Objectives In this observational cross-sectional study, the biochemical parameters, including inflammatory and oxidative stress (OXS) markers, were evaluated in two groups: the case group (women with newly diagnosed PTSD) and the control group (apparently healthy women). Furthermore, how the environment impacts the biochemical and OXS parameters of people not diagnosed with PTSD but living in IDP camps was also analyzed. Materials and methods The PTSD group (n=55, age=30.0 years) was made up of women survivors of genocide-related events living in IDP camps in the Kurdistan region of Iraq. The studied parameters in the PTSD group have been compared to two healthy control groups: (1) internal control group (n=55, age=28.1 years): healthy women living inside the IDP camps; and (2) external control group (n=55, age=28.3 years): healthy women living outside the IDP camps. The diagnosis of PTSD was conducted using a validated Kurdish version of the PTSD Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (PCL-5) scale. Blood samples were collected to determine the level of glycated hemoglobin (HbA1c) and the concentrations of fasting serum glucose (FSG), C-reactive protein (CRP), ceruloplasmin (CP), 8-hydroxydeoxyguanosine (8-OHdG), glutathione (GSH), malondialdehyde (MDA), protein carbonyls (PC), and catalase (CAT) activity. Results Women with PTSD presented increased values of FSG (4.41%, p<0.05), HbA1c (4.74%, p<0.05), and CRP (114.29%, p<0.05), as well as increased levels of 8-OHdG (185.97%, p<0.001), CP (27.08%, p<0.001), MDA (141.97%, p<0.001), and PC (63.01%, p<0.001), besides increased CAT activity (121.5%, p<0.001), when compared with the control groups. A significant reduction of GSH (-20.33%, p<0.05) was observed in PTSD patients as compared to the external control group. In relation to the internal control group, women diagnosed with PTSD presented significantly increased levels of FSG (3.88%, p<0.05), HbA1c (2.83%, p<0.05), CRP (77.97%, p<0.05), and PC (41.3%, p<0.05), as well as increased levels of 8-OHdG (118.84%, p<0.001), CP (22.72%, p<0.001), MDA (90.67%, p<0.001), and CAT activity (55.31%, p<0.001). Healthy individuals residing in IDP camps, compared with external healthy control, presented significantly elevated levels of 8-OHdG (30.68%, p<0.001), MDA (26.91%, p<0.001), PC (15.37%, p<0.001), and CAT activity (42.62%, p<0.001). Conclusion Our findings indicate that PTSD significantly influences glycemic, inflammatory, oxidant, and antioxidant param...

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Section: Discussionsupporting

confidence: 68%

Post-traumatic Stress Disorder: The Influence of the Environmental Context and Analysis of Oxidative Stress and Inflammatory and Glycemic Markers in Women Living in Kurdistan Regional Government-Iraq

Hasan,

Alkass,

Persike

2024

Cureus

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“… 163–168 Exercise-based interventions may be especially ideal for persons resettling as refugees, who may experience increases in BMI and hypertension following resettlement, coincident with stress, depression, and acculturation. 23 , 169 These mind-body and exercise-based modalities could also help address the somatic distress that many persons resettling as refugees experience and that contributes to worsened depression, anxiety, and PTSD, 75 , 170 as well as blunted posttraumatic growth. 114 Interventions that also address acculturation may be of benefit to both physical and mental health.…”

Section: Addressing Mental Health Concerns In Persons Resettled As Re...mentioning

confidence: 99%

“… 114 Interventions that also address acculturation may be of benefit to both physical and mental health. 169 Kumar, Soffer, and Begg offer an exemplary set of recommendations for providers working with persons resettled as refugees using movement-based and body-focused interventions. 171 …”

Section: Addressing Mental Health Concerns In Persons Resettled As Re...mentioning

confidence: 99%

Addressing Mental Health Concerns in Refugees and Displaced Populations: Is Enough Being Done?

Grasser¹

2022

RMHP

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There are over 82.4 million forcibly displaced people worldwide, about a quarter of whom are resettling as refugees. In the wake of the global refugee crisis spurred by conflict, religious and political persecution, human rights violations, and climate disasters, a mental health has crisis followed. Not only does trauma experienced in home countries and as part of forced migration affect mental health, so too do post-migration traumatic events, discrimination, lack of access to quality and affordable healthcare and housing, and acculturation. To address mental health concerns in refugees and displaced populations, collective action is needed not only from health care providers but also from mental health researchers, funders, journals, resettlement agencies, government entities, and humanitarian organizations. The present review highlights the work of numerous scholars and organizations with the goal of understanding the mental health concerns of forcibly displaced persons within and across ecological systems. The present review seeks to bring attention to the experiences of forcibly displaced persons, summarize the growing body of research understanding the acute and chronic effects of forced displacement and possible interventions, and give a call to action for all members of the global community at every level to engage in joint efforts to improve mental health in refugees and displaced persons. Notably, there is a need for more interventions at the familial and community level that serve not only as treatment but also as prevention. Smartphone-based interventions, mind-body modalities, and interventions delivered by lay and non-clinician community members hold promise. Numerous strides could be made in refugee mental health and treatment when funding agencies include these goals in their research priorities. Despite the challenges they have faced, persons who resettle as refugees are incredibly resilient and deserve to be afforded every right, opportunity, dignity, and respect.

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“…The relationship between war-or trauma-associated exposures and adverse mental health is well established [1][2][3][4][5]. Although exposure to trauma is necessary to develop trauma-associated mental health disorders, exposure alone is not sufficient [3].…”

Section: Introductionmentioning

confidence: 99%

Association Between Inflammatory Biomarkers and Mental Health Symptoms in Middle Eastern Refugees in the US

Ghandour¹,

Yamin²,

Arnetz³

et al. 2022

Cureus

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Introduction: Refugees are at increased risk for trauma-related mental health disorders, including anxiety, depression, and post-traumatic stress disorder (PTSD). The underlying biological mechanisms linking trauma to mental disorders need additional study, and the possible pathophysiological role of the immune system is attracting increasing interest. In this study, we investigated whether two well-known proinflammatory cytokines (interleukin (IL-8) and IL-6) are associated with mental health symptoms in Middle Eastern refugees displaced to the United States.Methods: Refugees (n=64, mean age=37.6 years) ages ranged from 21 to 74 years (mean=37.62, SD=11.84) were interviewed one month after arrival in Michigan, United States, using a validated survey in Arabic. Questions covered pre-displacement trauma, current anxiety, depression, and PTSD symptoms. Blood, collected immediately following the interview, was analyzed for the levels of interleukins. Multivariate linear regression was used to determine the association between mental health symptoms and IL-6 and IL-8.Results: In multivariate modeling, older age (β=0.37; p<0.01) and anxiety (β=0.31; p<0.05) were positively associated with IL-8. Age (β=0.28; p<0.05) and pre-displacement trauma (β=0.40; p<0.05) were positively associated with IL-6. Depression (β=-0.38) was negatively associated with IL-6.Conclusion/relevance: This study of inflammatory biomarkers suggests the possibility of differential associations between mental health symptoms (anxiety and depression) and pro-inflammatory markers (IL-6 and IL-8). To enhance our ability to prevent and more effectively treat trauma-exposed refugees, we need to better understand the neuroinflammatory mechanisms contributing to mental disorders.

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The Development of Posttraumatic Stress Disorder and Depression Symptoms in Iraqi Refugees

Cited by 6 publications

References 63 publications

Post-traumatic Stress Disorder: The Influence of the Environmental Context and Analysis of Oxidative Stress and Inflammatory and Glycemic Markers in Women Living in Kurdistan Regional Government-Iraq

Post-traumatic Stress Disorder: The Influence of the Environmental Context and Analysis of Oxidative Stress and Inflammatory and Glycemic Markers in Women Living in Kurdistan Regional Government-Iraq

Addressing Mental Health Concerns in Refugees and Displaced Populations: Is Enough Being Done?

Association Between Inflammatory Biomarkers and Mental Health Symptoms in Middle Eastern Refugees in the US

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