Abstract
BackgroundPost-traumatic stress disorder (PTSD) is a major health problem among refugees worldwide. After resettlement, the prevalence of PTSD remains high despite the fact that various PTSD treatments are known to be effective.MethodsWe examined the course of PTSD and the role of mental health care utilisation at a 7-year interval (2003–2010) among a cohort of refugees from Iran, Afghanistan, and Somalia after resettlement in the Netherlands.ResultsThe unchanged high prevalence of PTSD (16.3% in 2003 and 15.2% in 2010) was attributable in part to late onset of PTSD symptoms (half of the respondents with PTSD at T2 were new cases for whom PTSD developed after 2003). The second reason concerned the low use of mental health care services at T1. Whereas the multivariate analyses showed the effectiveness of mental health care, only 21% of respondents with PTSD at T1 had had contact with a mental health care provider at that time. Use of mental health care during the first wave increased the odds of improvement in PTSD symptoms between both measurements (OR 7.58, 95% CI 1.01; 56.85).ConclusionsThe findings of this study suggest there are two possible explanations for the persistently high prevalence of PTSD among refugees. One is the late onset of PTSD and the other is the low utilisation of mental health care. Health care professionals should be aware of these issues, especially given the effectiveness of mental health care for this condition.
Highlights
Post-traumatic stress disorder (PTSD) is a major health problem among refugees worldwide
This might indicate the chronicity of a severe mental illness, this persistently high prevalence seems to be at odds with the availability of effective forms of treatment for PTSD [8,9]
We were more likely to see an improvement in PTSD symptoms during the second wave for those who had made use of mental health care during the first wave, which suggests that the low use of health care services contributes to the remaining high prevalence of PTSD
Summary
Post-traumatic stress disorder (PTSD) is a major health problem among refugees worldwide. In the Netherlands, the lifetime prevalence of PTSD is 7.4% for the general population [6], While the proportion of refugees with PTSD is smaller after resettlement in the host countries, it remains relatively high compared with the general population [5,7]. This might indicate the chronicity of a severe mental illness, this persistently high prevalence seems to be at odds with the availability of effective forms of treatment for PTSD [8,9]. Since several PTSD treatments are known to be effective among diverse groups, the question arises as to why there is little change in the proportion of resettled refugees with PTSD, even several years after resettlement [5]
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