Jongedijk Ruud A, Eising Dorien D, van der Aa Niels, Kleber Rolf J, Boelen Paul A
ARQ Centrum'45, Rijnzichtweg 35, 2342 AX Oegstgeest, the Netherlands; ARQ National Psychotrauma Centre, Nienoord 10, Diemen, 1112XE, the Netherlands.
ARQ Centrum'45, Rijnzichtweg 35, 2342 AX Oegstgeest, the Netherlands.
J Affect Disord. 2020 Apr 1;266:71-81. doi: 10.1016/j.jad.2020.01.077. Epub 2020 Jan 20.
Western countries are facing many challenges hosting refugees from several regions in the world. Many of them are severely traumatized and suffer from a variety of mental health symptoms, which complicates the identification and treatment of refugees at risk. This study examined subgroups based on a broad range of psychopathology, and several predictors, including trauma characteristics and gender.
Participants were 1147 treatment-seeking, traumatized refugees. Latent profile analysis was conducted to identify different subgroups based on levels of posttraumatic stress disorder (PTSD), depression, anxiety, and somatic symptoms. Multinomial logistic regression was used to identify predictors of subgroup membership.
Three distinct subgroups were identified, reflecting Moderate (10.2%), Severe (43.0%), and Highly Severe (45.9%) symptom severity levels, respectively. Symptom severity of all psychopathology dimensions was distributed equally between the subgroups. Participants in the Severe and Highly Severe Symptoms subgroups reported more types of traumatic events compared to the Moderate subgroup. In particular, traumatic events associated with human right abuses, lack of human needs and separation from others predicted subgroup membership, as did gender.
The results are confined to treatment-seeking, traumatized refugee populations.
Distinguishable symptom severity profiles of PTSD, depression, anxiety and somatic complaints could be identified in this large treatment-seeking refugee population, without qualitative differences in symptom distribution. Instead of focusing on specific mental disorders, classification based on overall symptom severity is of interest in severely traumatized patients. This knowledge will help to identify individuals at risk and to enhance existing treatment programs for specific patient groups.
西方国家在接纳来自世界多个地区的难民时面临诸多挑战。其中许多人遭受了严重创伤,患有各种心理健康症状,这使得对有风险的难民进行识别和治疗变得复杂。本研究基于广泛的精神病理学以及包括创伤特征和性别在内的多个预测因素,对亚组进行了考察。
研究对象为1147名寻求治疗的受创伤难民。进行潜在剖面分析,以根据创伤后应激障碍(PTSD)、抑郁、焦虑和躯体症状的水平识别不同亚组。使用多项逻辑回归来识别亚组成员的预测因素。
识别出三个不同的亚组,分别反映中度(10.2%)、重度(43.0%)和极重度(45.9%)的症状严重程度水平。所有精神病理学维度的症状严重程度在各亚组间分布均匀。与中度亚组相比,重度和极重度症状亚组的参与者报告了更多类型的创伤事件。特别是,与侵犯人权、缺乏人类需求以及与他人分离相关的创伤事件预测了亚组成员身份,性别也是如此。
研究结果仅限于寻求治疗的受创伤难民群体。
在这个庞大的寻求治疗的难民群体中,可以识别出PTSD、抑郁、焦虑和躯体不适的不同症状严重程度概况,且症状分布没有质的差异。对于严重受创伤的患者,基于总体症状严重程度的分类比关注特定精神障碍更有意义。这些知识将有助于识别有风险的个体,并加强针对特定患者群体的现有治疗方案。