在一家难民健康诊所就诊的难民和寻求庇护者的心理健康状况，包括与匹配的澳大利亚出生居民样本进行比较。
The mental health status of refugees and asylum seekers attending a refugee health clinic including comparisons with a matched sample of Australian-born residents.
作者信息
Shawyer Frances, Enticott Joanne C, Block Andrew A, Cheng I-Hao, Meadows Graham N
机构信息
Southern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, 3800, Australia.
Royal District Nursing Service Institute, 31 Alma Rd, St Kilda, VIC, Australia.
出版信息
BMC Psychiatry. 2017 Feb 21;17(1):76. doi: 10.1186/s12888-017-1239-9.
BACKGROUND
The aim of this study was to survey refugees and asylum-seekers attending a Refugee Health Service in Melbourne, Australia to estimate the prevalence of psychiatric disorders based on screening measures and with post-traumatic stress disorder (PTSD) specifically highlighted. A secondary aim was to compare the prevalence findings with Australian-born matched comparators from the 2007 National Survey of Mental Health and Well-Being.
METHODS
We conducted a cross-sectional survey of 135 refugees and asylum-seeker participants using instruments including Kessler-10 (K10) and PTSD-8 to obtain estimates of the prevalence of mental disorders. We also performed a comparative analysis using matched sets of one participant and four Australian-born residents, comparing prevalence results with conditional Poisson regression estimated risk ratios (RR).
RESULTS
The prevalence of mental illness as measured by K10 was 50.4%, while 22.9% and 31.3% of participants screened positive for PTSD symptoms in the previous month and lifetime, respectively. The matched analysis yielded a risk ratio of 3.16 [95% confidence interval (CI): 2.30, 4.34] for abnormal K10, 2.25 (95% CI: 1.53, 3.29) for PTSD-lifetime and 4.44 (95% CI: 2.64, 7.48) for PTSD-month.
CONCLUSIONS
This information on high absolute and relative risk of mental illness substantiate the increased need for mental health screening and care in this and potentially other refugee clinics and should be considered in relation to service planning. While the results cannot be generalised outside this setting, the method may be more broadly applicable, enabling the rapid collection of key information to support service planning for new waves of refugees and asylum-seekers. Matching data with existing national surveys is a useful way to estimate differences between groups at no additional cost, especially when the target group is comparatively small within a population.
背景
本研究旨在对澳大利亚墨尔本一家难民健康服务机构的难民和寻求庇护者进行调查，以根据筛查措施估计精神障碍的患病率，并特别突出创伤后应激障碍（PTSD）。次要目的是将患病率调查结果与2007年澳大利亚全国心理健康与幸福调查中出生在澳大利亚的匹配对照者进行比较。
方法
我们对135名难民和寻求庇护者参与者进行了横断面调查，使用了包括凯斯勒10项量表（K10）和PTSD-8在内的工具来获取精神障碍患病率的估计值。我们还进行了一项比较分析，将一名参与者与四名出生在澳大利亚的居民进行匹配，用条件泊松回归估计风险比（RR）来比较患病率结果。
结果
用K10测量的精神疾病患病率为50.4%，而分别有22.9%和31.3%的参与者在前一个月和一生中PTSD症状筛查呈阳性。匹配分析得出，K10异常的风险比为3.16 [95%置信区间（CI）：2.30, 4.34]，终生PTSD的风险比为2.25（95% CI：1.53, 3.29）及过去一个月PTSD的风险比为4.44（95% CI：2.64, 7.48）。
结论
关于精神疾病高绝对风险和相对风险的这些信息证实了在这家以及其他可能的难民诊所增加心理健康筛查和护理的必要性，并且在服务规划时应予以考虑。虽然这些结果不能推广到该环境之外，但该方法可能具有更广泛的适用性，能够快速收集关键信息以支持为难民和寻求庇护者的新一波人群进行服务规划。将数据与现有的全国性调查相匹配是一种无需额外成本就能估计群体间差异的有用方法，特别是当目标群体在总体中相对较小时。
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