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[移民后应激源对德国难民抑郁症状患病率的影响。对2016年德国联邦就业局 - 联邦移民与难民局 - 社会经济面板调查的分析]

[The effect of postmigration stressors on the prevalence of depressive symptoms among refugees in Germany. Analysis of the IAB-BAMF-SOEP Survey 2016].

作者信息

Nutsch Niklas, Bozorgmehr Kayvan

机构信息

AG2 - Bevölkerungsmedizin und Versorgungsforschung, Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Postfach 10 01 31, 33501, Bielefeld, Deutschland.

Abteilung Allgemeinmedizin und Versorgungsforschung, Sektion Health Equity Studies & Migration, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Deutschland.

出版信息

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2020 Dec;63(12):1470-1482. doi: 10.1007/s00103-020-03238-0. Epub 2020 Oct 25.

Abstract

BACKGROUND

International studies prove the high burden of mental illnesses among refugees. Postmigration stressors in the country of refuge may affect the mental health and result in depression.

OBJECTIVES

The study examines whether postmigration stressors are associated with the prevalence of depressive symptoms among adult refugees in Germany.

METHODS

Secondary data analysis based on cross-sectional data of the IAB-BAMF-SOEP Survey of Refugees 2016 (N = 4465) that is representative for Germany. Depressive symptoms were measured using the Patient Health Questionnaire‑2 (PHQ-2). Unadjusted and adjusted odds ratios (ORs) and confidence intervals (CIs) were calculated with binary logistic regression models to examine associations between depression and sociodemographic, postmigration, and psychosocial factors.

RESULTS

Depressive symptoms show 19.4% of the surveyed refugees. Almost all selected postmigration stressors are significantly associated with depression after adjustment for sociodemographic and psychosocial factors. Unemployment (aOR = 1.48 [1.04-2.12]), loneliness (aOR = 1.14 [1.10-1.18]), and a rejected or undecided asylum application (aOR = 1.34 [1.06-1.70]) increase the odds of depressive symptoms, whereas asylum interviews (aOR = 0.71 [0.56-0.91]) and higher housing satisfaction (aOR = 0.94 [0.91-0.98]) lower the odds of depression.

CONCLUSIONS

Postmigration stress is associated with the occurrence of depressive symptoms. Sociopolitical interventions considering stressful and protective factors of the postmigration phase can reduce the burden of mental disorders in refugee populations.

摘要

背景

国际研究证明难民中精神疾病负担沉重。难民接收国的迁移后应激源可能影响心理健康并导致抑郁。

目的

本研究调查迁移后应激源是否与德国成年难民中抑郁症状的患病率相关。

方法

基于具有德国代表性的2016年德国就业研究所 - 联邦移民与难民局 - 社会经济面板难民调查(N = 4465)的横断面数据进行二次数据分析。使用患者健康问卷 - 2(PHQ - 2)测量抑郁症状。采用二元逻辑回归模型计算未调整和调整后的优势比(OR)及置信区间(CI),以检验抑郁与社会人口统计学、迁移后及心理社会因素之间的关联。

结果

19.4%的受调查难民有抑郁症状。在对社会人口统计学和心理社会因素进行调整后,几乎所有选定的迁移后应激源都与抑郁显著相关。失业(调整后OR = 1.48 [1.04 - 2.12])、孤独感(调整后OR = 1.14 [1.10 - 1.18])以及庇护申请被拒或未决(调整后OR = 1.34 [1.06 - 1.70])会增加抑郁症状的发生几率,而庇护面谈(调整后OR = 0.71 [0.56 - 0.91])和较高的住房满意度(调整后OR = 0.94 [0.91 - 0.98])会降低抑郁的发生几率。

结论

迁移后应激与抑郁症状的发生相关。考虑迁移后阶段应激和保护因素的社会政治干预措施可减轻难民群体的精神障碍负担。

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