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高危儿童:一项全国性横断面研究,调查2014年至2018年期间在瑞典重新安置的来自叙利亚、伊拉克和阿富汗的难民未成年人的创伤后应激症状。

Children at risk: A nation-wide, cross-sectional study examining post-traumatic stress symptoms in refugee minors from Syria, Iraq and Afghanistan resettled in Sweden between 2014 and 2018.

作者信息

Solberg Øivind, Nissen Alexander, Vaez Marjan, Cauley Prue, Eriksson Anna-Karin, Saboonchi Fredrik

机构信息

Division for Implementation and Treatment Research, Norwegian Centre for Violence and Traumatic Stress Studies, P.box 181, 0409 Oslo, Nydalen Norway.

Department of Health Science, Swedish Red Cross University College, Stockholm, Sweden.

出版信息

Confl Health. 2020 Oct 2;14:67. doi: 10.1186/s13031-020-00311-y. eCollection 2020.

Abstract

BACKGROUND

The objective of the present study was to assess nation-wide, representative prevalence estimates for symptom-defined posttraumatic stress disorder (PTSD) within populations of refugee minors from Afghanistan, Syria and Iraq resettled in Sweden.

METHODS

A nation-wide, cross-sectional, questionnaire study with a stratified sample of refugee minors, aged 16-18 years, from Afghanistan, Iraq and Syria, resettled in Sweden between 2014 and 2018 ( = 5071) was conducted. The response rate was 22.3%, leaving  = 1129 refugee minors (boys 53.1% / girls 46.9%) in the final sample. Symptom-defined prevalences of PTSD were measured using CRIES-8 with ≥17 as cut-off. Data were analyzed using frequency distributions, and strata-specific PTSD prevalences with 95% confidence intervals (95% CIs), were estimated. The association between migratory status on arrival (unaccompanied vs. accompanied) and PTSD was estimated using crude and adjusted odds ratios (OR) utilizing logistic regression analyses with 95% CIs.

RESULTS

Overall, the weighted PTSD prevalence was 42% (95% CI 38.9-45.1), with minors from Afghanistan presenting the highest prevalence (56.9, 95% CI 51.5-62.2), compared to minors from Iraq (36.8, 95% CI 28.9-45.4) and Syria (33.4, 95% CI 29.4-37.6). Unaccompanied minors from Afghanistan had higher odds of PTSD compared to accompanied minors from Afghanistan (OR = 1.92, 95% CI 1.08-3.40). Gender differences were non-significant.

CONCLUSIONS

High prevalences of symptom-defined PTSD among refugee minors in general and in unaccompanied minors from Afghanistan in particular, were revealed. Findings calls for continued efforts to support this especially vulnerable group.

摘要

背景

本研究的目的是评估在瑞典重新安置的来自阿富汗、叙利亚和伊拉克的未成年难民群体中,症状定义的创伤后应激障碍(PTSD)在全国范围内具有代表性的患病率估计值。

方法

对2014年至2018年期间在瑞典重新安置的年龄在16 - 18岁之间、来自阿富汗、伊拉克和叙利亚的未成年难民进行了一项全国性的横断面问卷调查研究(n = 5071)。回复率为22.3%,最终样本中有n = 1129名未成年难民(男孩53.1%/女孩46.9%)。使用CRIES - 8量表,以≥17分为临界值来测量症状定义的PTSD患病率。数据采用频率分布进行分析,并估计了各层特定的PTSD患病率及其95%置信区间(95%CI)。采用逻辑回归分析,利用粗比值比和调整后的比值比(OR)及其95%CI来估计抵达时的迁移状态(无人陪伴与有人陪伴)与PTSD之间的关联。

结果

总体而言,加权后的PTSD患病率为42%(95%CI 38.9 - 45.1),与来自伊拉克(36.8,95%CI 28.9 - 45.4)和叙利亚(33.4,95%CI 29.4 - 37.6)的未成年难民相比,来自阿富汗的未成年难民患病率最高(56.9,95%CI 51.5 - 62.2)。与有人陪伴的阿富汗未成年难民相比,无人陪伴的阿富汗未成年难民患PTSD的几率更高(OR = 1.92,95%CI 1.08 - 3.40)。性别差异不显著。

结论

研究发现,未成年难民群体,特别是来自阿富汗的无人陪伴未成年难民中,症状定义的PTSD患病率较高。研究结果呼吁持续努力支持这一特别脆弱的群体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f210/7531165/6b896878067d/13031_2020_311_Fig1_HTML.jpg

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