Karakter, Postbus 40244 Dr. E. Schattenkerkweg 1, 8004, DE Zwolle, The Netherlands.
De Bascule/Academic Medical Centre Amsterdam, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands.
Eur J Pediatr. 2018 Feb;177(2):163-169. doi: 10.1007/s00431-017-3027-4. Epub 2017 Nov 10.
Currently hundreds of thousands of minor refugees entered Europe. This group has been exposed to traumatic events pre-, during, and post-migration and is at increased risk of developing psychiatric disorders. In this article, we describe the results of our literature search on screening and interventions for post-traumatic stress disorder (PTSD) in minor refugees, in order to make recommendations for clinical practice. Results show that studies on diagnostic accuracy of assessment instruments and efficacy of mental healthcare interventions in this population are lacking. Traumatic experiences pre-flight, during the flight and at resettlement, superimposed by parental PTSD, and other contextual factors, might lead to more than 25% of minor refugees developing PTSD.
To enhance the number of minor refugees recognized with PTSD, we recommend the use of a brief screening instrument. A public health approach, focusing on environmental supportive factors is the first step in treatment for this group, followed by short-term psychological group interventions focusing on psycho-education and stress reduction. Minor refugees with no improvement in PTSD symptoms by these interventions need referral to specialized mental health care services. Mental health providers should be culturally competent. What is Known: • Post-traumatic stress disorder, anxiety, sleeping problems, and depression are the most common psychiatric disorders in minor refugees. • Evidence based methods on screening and interventions in minor refugees with psychiatric disorders are lacking. What is New: • In the absence of validated screening tools a best practice reliable, quick and child-friendly tool is presented. • A layered system for mental health care and psychosocial support in minor refugees is explained.
目前有数十万名未成年难民进入欧洲。这些难民在入境前、入境期间和入境后都经历过创伤性事件,他们患精神疾病的风险增加。在本文中,我们描述了我们对未成年难民创伤后应激障碍(PTSD)筛查和干预措施的文献检索结果,以便为临床实践提供建议。结果表明,针对该人群评估工具的诊断准确性和心理健康护理干预措施的疗效的研究尚缺乏。飞行前、飞行中和重新安置期间的创伤经历,加上父母的 PTSD 和其他环境因素,可能导致超过 25%的未成年难民患上 PTSD。
为了增加识别出患有 PTSD 的未成年难民人数,我们建议使用简短的筛查工具。公共卫生方法,重点关注环境支持因素,是治疗该群体的第一步,随后是短期心理小组干预,重点是心理教育和减轻压力。通过这些干预措施,PTSD 症状没有改善的未成年难民需要转介至专门的精神卫生保健服务。精神卫生服务提供者应具备文化能力。
• 创伤后应激障碍、焦虑、睡眠问题和抑郁是未成年难民中最常见的精神疾病。• 缺乏针对未成年难民精神障碍的筛查和干预的循证方法。
• 在缺乏经过验证的筛查工具的情况下,提出了一种可靠、快速且适合儿童使用的最佳实践工具。• 解释了未成年难民心理健康护理和心理社会支持的分层系统。