Risk and Protective Factors for Common Mental Disorders among Urban Somali Refugee Youth

BackgroundIn low- and middle-income countries little is known about changes in women's mental health status from the perinatal period to 15 months postpartum or the factors associated with different trajectories.AimsTo determine the incidence and rates of recovery from common mental disorders (CMD) among rural Vietnamese women and the risk and protective factors associated with these outcomes from the perinatal period to 15 months after giving birth.MethodIn a population-based prospective study, a systematically recruited cohort of women completed baseline assessments in either the last trimester of pregnancy or 4–6 weeks after giving birth and were followed up 15 months later. The common mental disorders of major depression, generalised anxiety and panic disorder were assessed by psychiatrist-administered Structured Clinical Interview for DSM-IV Disorders at both baseline and follow-up.ResultsA total of 211 women provided complete data in this study. The incidence rate of CMD in the first postpartum year was 13% (95% CI 8–19), and 70% (95% CI 59–80) of women who had perinatal CMD recovered within the first postpartum year. Incidence was associated with having experienced childhood maltreatment, experiencing the intimate partner as providing little care, sensitivity, kindness or affection, and the chronic stress of household poverty. Recovery was associated with higher quality of a woman's relationships with her intimate partner and her own mother, longer period of mandated rest following birth, and sharing of domestic tasks and infant care.ConclusionsModifiable social factors, in particular the quality of a woman's closest relationships with her partner and her own mother, and participation by family members in domestic work and infant care, are closely related to women's mental health in the first year after giving birth in resource-constrained settings.

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Risk and protective factors for mental disorders with onset in childhood/adolescence: An umbrella review of published meta-analyses of observational longitudinal studies

Neuroscience & Biobehavioral Reviews ◽

10.1016/j.neubiorev.2020.09.002 ◽

2020 ◽

Author(s):

Marco Solmi ◽

Elena Dragioti ◽

Celso Arango ◽

Joaquim Radua ◽

Edoardo Ostinelli ◽

...

Keyword(s):

Mental Disorders ◽

Protective Factors ◽

Longitudinal Studies ◽

Risk And Protective Factors ◽

Umbrella Review ◽

Meta Analyses

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Trajectories of antidepressant use and characteristics associated with trajectory groups among young refugees and their Swedish-born peers with diagnosed common mental disorders—findings from the REMAIN study

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-021-02139-0 ◽

2021 ◽

Author(s):

S. Rahman ◽

S. Filatova ◽

L. Chen ◽

E. Björkenstam ◽

H. Taipale ◽

...

Keyword(s):

Mental Disorders ◽

Disability Pension ◽

Common Mental Disorders ◽

Multinomial Logistic Regression ◽

Common Mental Disorder ◽

Influential Factors ◽

Transcultural Psychiatry ◽

Refugee Youth ◽

Study Population ◽

Antidepressant Use

Abstract Purpose This study aimed to (1) identify the trajectories of prescribed antidepressants in refugee youth and matched Swedish-born peers diagnosed with common mental disorder (CMD) and (2) characterize the trajectories according to sociodemographic and medical factors. Methods The study population comprised 2,198 refugees and 12,199 Swedish-born individuals with both Swedish-born parents, aged 16–25 years in 2011, residing in Sweden and treated in specialised healthcare for CMD 2009–11. Group-based trajectory modelling was used to identify different trajectory groups of antidepressant use-based on annual defined daily dosages (DDDs). Multinomial logistic regression was applied to investigate the association of sociodemographic and medical characteristics with the identified trajectories. Nagelkerke pseudo-R2 values were estimated to evaluate the strength of these associations. Results Four trajectory groups of antidepressant use among young refugees were identified with following proportions and DDD levels in 2011: ‘low constant’ (88%, < 100), ‘low increasing’ (2%, ≈710), ‘medium decreasing’ (8%, ≈170) and ‘high increasing’ (2%, ≈860). Similar trajectories, however, with different proportions were identified in Swedish-born: 67%, 7%, 21% and 5%, respectively. The most influential factors discriminating the trajectory groups among refugees were ‘duration of stay in Sweden’ (R2 = 0.013), comorbid ‘other mental disorders’ (R2 = 0.009) and ‘disability pension’ (R2 = 0.007), while ‘disability pension’ (R2 = 0.017), comorbid ‘other mental disorders’ (R2 = 0.008) and ‘educational level’ (R2 = 0.008) were the most important determinants discriminating trajectory groups among Swedish-born youth. Conclusion The lower use of antidepressants in refugees with CMDs compared to their Swedish-born counterparts warrants health literacy programs for refugees and training in transcultural psychiatry for healthcare professionals.

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Risk and protective factors for mental disorders beyond genetics: an evidence‐based atlas

World Psychiatry ◽

10.1002/wps.20894 ◽

2021 ◽

Vol 20 (3) ◽

pp. 417-436

Author(s):

Celso Arango ◽

Elena Dragioti ◽

Marco Solmi ◽

Samuele Cortese ◽

Katharina Domschke ◽

...

Keyword(s):

Mental Disorders ◽

Protective Factors ◽

Risk And Protective Factors ◽

Evidence Based

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Common mental disorders in young refugees in Sweden: the role of education and duration of residency

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1311 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

E Mittendorfer Rutz ◽

M Helgesson ◽

M Norredam ◽

M Sijbrandij ◽

C Jamil de Montgomery ◽

...

Keyword(s):

Health Care ◽

Mental Disorders ◽

Anxiety Disorders ◽

Posttraumatic Stress ◽

Lower Risk ◽

Common Mental Disorders ◽

Stress Disorders ◽

Refugee Youth ◽

Risk Estimates

Abstract Background Studies investigating risks of common mental disorders (CMDs) in refugee youth are sparse. The current study examined health care use due to CMDs in unaccompanied and accompanied refugee youth and Swedish-born, and the role of education and residency duration. Methods This register-based, longitudinal cohort study included 743,671 individuals (whereof 33,501 refugees) between 19-25 years, residing in Sweden in 2009. Refugees were classified as unaccompanied/accompanied. Risk estimates of CMDs, measured as health care and antidepressant treatment, between 2010-2016 were calculated as adjusted hazard ratios (aHR) with 95% confidence intervals (CI). Highest attained education in 2009, and residency duration were examined as potential modifiers. Results Compared to Swedish-born youth, refugees had a lower risk of treated major depressive and anxiety disorders (aHR): 0.73 (95% CI 0.68-0.78) and 0.74 (95% CI 0.70-0.79) respectively), but a higher risk for posttraumatic stress disorders (PTSD). Compared to Swedish-born, unaccompanied had an 8-fold elevated risk for PTSD (aHR: 8.40, 95% CI 6.16-11.47) and accompanied refugees had a nearly 3-fold risk of PTSD (aHR: 2.78, 95% CI 2.29-3.37). Rates of PTSD decreased with years spent in Sweden. The risk of CMDs decreased with increasing education. Conclusions Young refugees had a lower risk of treated depressive and anxiety disorders, but a higher risk for PTSD. In refugees, the rates of anxiety disorders increased slightly over time, whereas the rates of PTSD decreased. Last, low education was an important predictor for CMDs. Key messages Our study highlights the need to specifically focus on stress-related mental disorders in studies on refugees as risk estimates might differ. Moreover, providing scalable low-intensity interventions to address CMDs including posttraumatic stress are an important first step in order to prevent prolonged suffering and persistence of PTSD in refugee youth.

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Risk and protective factors for comorbidity of PTSD, depression, and anxiety among Somali refugees in Kenya

International Journal of Social Psychiatry ◽

10.1177/0020764020978685 ◽

2020 ◽

pp. 002076402097868

Author(s):

Hyojin Im ◽

Laura ET Swan ◽

Abdilkadir H Warsame ◽

Maimuna M Isse

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Protective Factors ◽

Psychosocial Factors ◽

Trauma Exposure ◽

Risk And Protective Factors ◽

Depression Symptoms ◽

Comorbid Depression ◽

Somali Refugees ◽

Symptom Awareness

Background: Comorbid common mental disorders (CMDs) are pervasive in refugee populations. However, limited research has explored psychosocial factors for mental disorder comorbidity in Somali refugee samples. Aims: This study aims to explore potential risk and protective factors for comorbid depression-anxiety and comorbid depression-PTSD by examining associations between trauma exposure, psychosocial factors, and mental health symptoms among a sample of Somali refugees displaced in urban Kenya. Methods: We used snowball sampling to recruit Somali youth aged 15 to 35years( N = 250, n = 143 female, n = 88 male, n = 19 unknown gender). We measured 16 common types of trauma exposure and three psychosocial factors (endorsing violence, willingness to share problems, and symptom awareness) and used the HSCL-25 and PCL-C to capture individual and comorbid CMD symptoms, using guided cutoff points and/or algorithms. We then ran a series of logistic regression analyses to examine relationships between trauma exposure, psychosocial factors, and individual and comorbid CMD symptoms. Results: Findings showed that increased trauma exposure predicted symptoms of individual and comorbid CMDs. Increased symptom awareness and endorsement of violence predicted comorbid depression-PTSD and comorbid anxiety-depression symptoms, respectively. Willingness to share problems buffered depressive symptoms but did not predict comorbidity. Conclusions: These findings revealed the high CMD comorbidity prevalence with differential effects of trauma and psychosocial factors on individual or comorbid mental disorders. This study suggests a need for transdiagnostic approaches that cut across Western diagnostic boundaries and consider culturally responsive and relevant items for mental health measures.

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