Prevalence of common mental disorders among Syrian refugee children and adolescents in Sultanbeyli district, Istanbul: results of a population-based survey.

I Pivato,S Polack,A Patterson,A Sheikhani,S Hameed,N Scherer,A Örücü,İ Akıncı,G Deniz,S Volkan,C Acarturk

doi:10.1017/s2045796020001079

Abstract

Research demonstrates elevated levels of common mental disorders among Syrian refugees, but the majority of studies have, to date, focused on adult populations. This study aims to estimate the prevalence of depression, anxiety and post-traumatic stress disorder (PTSD) among Syrian children and adolescents living in Sultanbeyli district of Istanbul, Turkey. A population-based survey among Syrian children and adolescents aged 8-17 years living in Sultanbeyli district was conducted in 2019, as part of an all-age survey of disability. 80 clusters of 50 participants (all-ages) were selected from the local municipality's refugee registration database using probability proportionate to size sampling. Children aged 8-17 years were assessed for symptoms of common mental disorders using the Child Revised Impact of Event Scale (CRIES-8) and abbreviated versions of the Center for Epidemiologic Studies Depression Scale for Children (CES-DC) and the Screen for Child Anxiety Related Disorders (SCARED). Of the 852 participants, 23.7% (95% CI 19.9-27.2) screened positive for symptomatic depression, PTSD and anxiety. The prevalence estimates for depression, PTSD and anxiety were 12.5% (95% CI 9.8-15.6), 11.5% (95% CI 9.1-14.4) and 9.2% (95% CI 6.8-12.1), respectively. Depression and PTSD were significantly more common in older adolescents, whilst anxiety and PTSD were significantly more common in girls. Depression was more common in children from poorer households and those who had received no education. Children coming from larger households were less likely to show symptoms of PTSD. Syrian refugee children and adolescents are vulnerable to common mental disorders, and culturally appropriate prevention and intervention support are needed for this population.

Highlights

Exposure to potentially traumatic events, post-migration challenges and other psychological stressors can place conflict-affected populations at an increased risk of common mental disorders, such as depression, anxiety and post-traumatic stress disorder (PTSD) (Fazel et al, 2005; Turrini et al, 2017; Giacco et al, 2018; Kien et al, 2019)
Among displaced and conflict-affected populations, the World Health Organization (WHO) estimates the age-standardised prevalence of depression to be 10.8%, anxiety disorders 21.7% and PTSD alone 15.3% (Charlson et al, 2019). These estimates are considerably higher than WHO estimates for common mental disorders among the general global population, at 4.4% for depression and 3.6% for anxiety disorders (World Health Organization, 2017)
The majority of the available evidence comes from adult populations, with prevalence estimates ranging from 14% to 44% for depression (Naja et al, 2016; Tinghög et al, 2017; Acarturk et al, 2018; Georgiadou et al, 2018; Fuhr et al, 2019), 13% to 36% for anxiety (Tinghög et al, 2017; Georgiadou et al, 2018; Fuhr et al, 2019) and 11% to 83% for PTSD (Alpak et al, 2015; Tinghög et al, 2017; Acarturk et al, 2018; Chung et al, 2018; Georgiadou et al, 2018; Fuhr et al, 2019)

Summary

Introduction

Exposure to potentially traumatic events, post-migration challenges and other psychological stressors can place conflict-affected populations at an increased risk of common mental disorders, such as depression, anxiety and post-traumatic stress disorder (PTSD) (Fazel et al, 2005; Turrini et al, 2017; Giacco et al, 2018; Kien et al, 2019). These estimates are considerably higher than WHO estimates for common mental disorders among the general global population, at 4.4% for depression and 3.6% for anxiety disorders (including PTSD) (World Health Organization, 2017) Included among those at risk are persons affected by the war in Syria, with an estimated 13.1 million requiring humanitarian assistance within Syria itself, and a further 5.6 million displaced across Europe and neighbouring countries (United Nations High Commissioner for Refugees, 2019). Evidence from these settings signals elevated levels of common mental disorders among displaced Syrian refugees. Evidence among Syrian children is more limited, findings consistently demonstrate symptoms of common mental

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