Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
Department of Neuroscience, Uppsala University, Uppsala, Sweden.
Psychol Med. 2022 May;52(7):1365-1375. doi: 10.1017/S0033291720003190. Epub 2020 Sep 11.
The study aimed to examine differences in, and characteristics of psychiatric care utilization in young refugees who came to Sweden as unaccompanied or accompanied minors, compared with that of their non-refugee immigrant and Swedish-born peers.
This register-linkage cohort study included 746 688 individuals between 19 and 25 years of age in 2009, whereof 32 481 were refugees (2896 unaccompanied and 29 585 accompanied) and 32 151 non-refugee immigrants. Crude and multivariate Cox regression models yielding hazard ratios (HR) and 95% confidence intervals (CI) were conducted to investigate subsequent psychiatric care utilization for specific disorders, duration of residence and age at migration.
The adjusted HRs for psychiatric care utilization due to any mental disorder was significantly lower in both non-refugee and refugee immigrants when compared to Swedish-born [aHR: 0.78 (95% CI 0.76-0.81) and 0.75 (95% CI 0.72-0.77, respectively)]. Within the refugee group, unaccompanied had slightly lower adjusted risk estimates than accompanied. This pattern was similar for all specific mental disorders except for higher rates in schizophrenia, reaction to severe stress/adjustment disorders and post-traumatic stress disorder. Psychiatric health care utilization was also higher in immigrants with more than 10 years of residency in Sweden entering the country being younger than 6 years of age.
For most mental disorders, psychiatric health care utilization in young refugees and non-refugee immigrants was lower than in their Swedish-born peers; exceptions are schizophrenia and stress-related disorders. Arrival in Sweden before the age of 6 years was associated with higher rates of overall psychiatric care utilization.
本研究旨在考察与非难民移民和瑞典出生的同龄人相比，前来瑞典的无人陪伴或陪伴未成年难民在精神保健利用方面的差异和特点。
本注册链接队列研究纳入了 2009 年年龄在 19 至 25 岁之间的 746688 人，其中 32481 人为难民（2896 名无人陪伴，29585 名陪伴）和 32151 名非难民移民。采用粗率和多变量 Cox 回归模型得出风险比（HR）和 95%置信区间（CI），以调查特定疾病、居住时间和移民年龄后的精神保健利用情况。
与瑞典出生者相比，无论在非难民移民还是难民移民中，任何精神障碍的精神保健利用调整后的 HR 均显著降低（调整后 HR：0.78（95%CI 0.76-0.81）和 0.75（95%CI 0.72-0.77））。在难民群体中，无人陪伴者的调整后风险估计值略低于陪伴者。除了精神分裂症、严重应激/适应障碍和创伤后应激障碍的发生率较高外，这种模式适用于所有特定的精神障碍。在瑞典居住超过 10 年且入境年龄小于 6 岁的移民中，精神保健的利用率也较高。
对于大多数精神障碍，年轻难民和非难民移民的精神保健利用率低于瑞典出生者；精神分裂症和应激相关障碍除外。6 岁以下入境与整体精神保健利用率较高相关。
