Prevalencija mentalnih bolesti kod izbjeglica i tražilaca azila: sistematski pregled i meta-analiza.
PLoS medicine
Sažetak istraživanja
Pozadina Globalno gledano, broj izbjeglica i tražilaca azila dostigao je rekordne vrijednosti. Prošla istraživanja mentalnog zdravlja izbjeglica izvijestila su o velikim varijacijama u podacima o prevalenci mentalnih bolesti, što se djelimično može pripisati metodološkim ograničenjima. Ovaj sistematski pregled ima za cilj da sumira trenutni korpus dokaza o prevalenci mentalnih bolesti u globalnim izbjegličkim populacijama i prevaziđe metodološka ograničenja pojedinačnih studija.
Metode i nalazi Sveobuhvatna pretraga elektronskih baza podataka je sprovedena od 1. januara 2003. do 4. februara 2020. (MEDLINE, MEDLINE In-Process, EBM Reviews, Embase, PsycINFO, CINAHL, PILOTS, Web of Science). Kvantitativne studije su uključene ako je dijagnoza mentalne bolesti uključivala klinički intervju i korištenje validirane mjere procjene i prijavila najmanje 50 učesnika. Kvalitet studije ocjenjivan je deskriptivnim pristupom zasnovanim na šablonu prema dizajnu studije (modificirana Newcastle-Ottawa skala). Provedeni su modeli slučajnih efekata, zasnovani na ponderima inverzne varijanse. Urađene su analize podgrupa za spol, veličinu uzorka, trajanje raseljavanja, status vize, zemlju porijekla, trenutno prebivalište, vrstu intervjua (uz pomoć tumača ili maternji jezik) i dijagnostičke mjere. Sistematski pregled je registrovan na PROSPERO (CRD) 42016046349. Pretraga je dala rezultat od 21.842 zapisa. Dvadeset šest studija, koje su uključivale jedno randomizirano kontrolirano ispitivanje i 25 opservacijskih studija, dale su rezultate za 5.143 odrasla izbjeglica i tražitelja azila. Istraživanja su sprovedena u 15 zemalja: Australiji (652 izbjeglice), Austriji (150), Kini (65), Njemačkoj (1.104), Italiji (297), Libanu (646), Nepalu (574), Norveškoj (64), Južnoj Koreji (200), Švedskoj (86), Švicarskoj (164), Uganda (164), Ujedinjenom Kraljevstvu (2372) Amerika (406). Prevalencija posttraumatskog stresnog poremećaja (PTSP) iznosila je 31,46% (95% CI 24,43-38,5), prevalencija depresije je bila 31,5% (95% CI 22,64-40,38), prevalencija anksioznih poremećaja bila je 11% i prevalencija CI 95,375-1, prevalencija CI 22,64-40,38 psihoza je bila 1,51% (95% CI 0,63-2,40). Ograničenje studije je da je značajna heterogenost bila prisutna u procjenama prevalencije PTSP-a, depresije i anksioznosti, a ograničene kovarijacije su prijavljene u uključenim studijama.
Zaključci Ovaj sveobuhvatni pregled generiše trenutne procjene prevalencije ne samo za PTSP već i za depresiju, anksioznost i psihozu. Izbjeglice i tražioci azila imaju visoku i upornu stopu PTSP-a i depresije, a rezultati ovog pregleda naglašavaju potrebu za kontinuiranom, dugotrajnom brigom o mentalnom zdravlju nakon početnog perioda preseljenja.
Prikaži originalni naslov i sažetak na engleskom
The prevalence of mental illness in refugees and asylum seekers: A systematic review and meta-analysis.
Background Globally, the number of refugees and asylum seekers has reached record highs. Past research in refugee mental health has reported wide variation in mental illness prevalence data, partially attributable to methodological limitations. This systematic review aims to summarise the current body of evidence for the prevalence of mental illness in global refugee populations and overcome methodological limitations of individual studies.
Methods and findings A comprehensive search of electronic databases was undertaken from 1 January 2003 to 4 February 2020 (MEDLINE, MEDLINE In-Process, EBM Reviews, Embase, PsycINFO, CINAHL, PILOTS, Web of Science). Quantitative studies were included if diagnosis of mental illness involved a clinical interview and use of a validated assessment measure and reported at least 50 participants. Study quality was assessed using a descriptive approach based on a template according to study design (modified Newcastle-Ottawa Scale). Random-effects models, based on inverse variance weights, were conducted. Subgroup analyses were performed for sex, sample size, displacement duration, visa status, country of origin, current residence, type of interview (interpreter-assisted or native language), and diagnostic measure. The systematic review was registered with PROSPERO (CRD) 42016046349. The search yielded a result of 21,842 records. Twenty-six studies, which included one randomised controlled trial and 25 observational studies, provided results for 5,143 adult refugees and asylum seekers. Studies were undertaken across 15 countries: Australia (652 refugees), Austria (150), China (65), Germany (1,104), Italy (297), Lebanon (646), Nepal (574), Norway (64), South Korea (200), Sweden (86), Switzerland (164), Turkey (238), Uganda (77), United Kingdom (420), and the United States of America (406). The prevalence of posttraumatic stress disorder (PTSD) was 31.46% (95% CI 24.43-38.5), the prevalence of depression was 31.5% (95% CI 22.64-40.38), the prevalence of anxiety disorders was 11% (95% CI 6.75-15.43), and the prevalence of psychosis was 1.51% (95% CI 0.63-2.40). A limitation of the study is that substantial heterogeneity was present in the prevalence estimates of PTSD, depression, and anxiety, and limited covariates were reported in the included studies.
Conclusions This comprehensive review generates current prevalence estimates for not only PTSD but also depression, anxiety, and psychosis. Refugees and asylum seekers have high and persistent rates of PTSD and depression, and the results of this review highlight the need for ongoing, long-term mental health care beyond the initial period of resettlement.
Izvorni podaci
- DOI
- 10.1371/journal.pmed.1003337
- PMID
- 32956381
- PMCID
- PMC7505461
- Provjereno
- 2026-07-26
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