Abstract
Aims and method This study aimed to identify predictors of symptom severity for post-traumatic stress disorder (PTSD) and depression in asylum seekers and refugees referred to a specialised mental health centre. Trauma exposure (number and domain of event), refugee status and severity of PTSD and depression were assessed in 688 refugees.Results Symptom severity of PTSD and depression was significantly associated with lack of refugee status and accumulation of traumatic events. Four domains of traumatic events (human rights abuse, lack of necessities, traumatic loss, and separation from others) were not uniquely associated with symptom severity. All factors taken together explained 11% of variance in PTSD and depression.Clinical implications To account for multiple predictors of symptom severity including multiple traumatic events, treatment for traumatised refugees may need to be multimodal and enable the processing of multiple traumatic memories within a reasonable time-frame.
Highlights
Aims and method This study aimed to identify predictors of symptom severity for post-traumatic stress disorder (PTSD) and depression in asylum seekers and refugees referred to a specialised mental health centre
Symptom severity of PTSD and depression was significantly associated with lack of refugee status and accumulation of traumatic events
In a sample of Mandean refugees, Nickerson et al[7] found that PTSD and prolonged grief disorder were predicted by traumatic loss, whereas PTSD only was predicted by difficulties related to loss of culture and support
Summary
Asylum seekers/temporary refugees (n = 21) and resettled refugees (n = 169) showed significantly lower post-traumatic stress disorder (PTSD) symptom reduction between intake and 1 year after intake than did a comparison group of non-refugees (n = 37), but the interaction effect was clinically small (partial Z2 = 0.03). Refugees who had more severe symptoms at intake showed significantly greater symptom reduction after 1 year. Additional treatment focusing on improving quality of life may be needed for refugees whose PTSD symptom severity remains high. Low treatment response in refugees is often attributed to patient-related factors,[1] such as trauma history, current stressors and complex psychopathology. Many asylum seekers and refugees have been exposed to multiple, prolonged, interpersonal traumatic events such as war and human trafficking.[2] In addition, they have to handle the
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