Hawassa University, College of Medicine and Health Sciences, School of Nursing, Hawassa, Ethiopia; Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
Hawassa University, College of Medicine and Health Sciences, School of Nursing, Hawassa, Ethiopia; Curtin School of Population Health, Curtin University, Kent Street, Bentley WA 6102, Australia.
Psychiatry Res. 2022 May;311:114493. doi: 10.1016/j.psychres.2022.114493. Epub 2022 Mar 8.
Displaced people are prone to develop mental health problems due to resettlement in new environments, traumatic events and forced migration. Depression is a mental health problem repeatedly observed among displaced people such as refugees, migrants, asylum seekers and internally displaced persons (IDPs). Therefore, estimating the global pooled prevalence of depression as well as pinpointing its determinants may support policymakers and health care workers to mitigate the disease burden and improve the psychological well-being of displaced people.
PubMed, EMBASE, CINAHIL, Psych-INFO, and SCOPUS databases were searched for English written relevant observational studies conducted between 1984 and 2020. The methodological quality of studies was assessed using the Newcastle Ottawa Scale (NOS). Heterogeneity across studies was checked using the Q- and I test. Publication bias was checked by observing Funnel plot symmetry and using Egger's regression test. STATA 16 was used to combine studies using a random effect model.
Of the 4102 studies identified, 81 studies with an overall sample size of 53,458 were included in the current systematic review and meta-analysis. The pooled prevalence estimate of depression among displaced people was 26.4% (95% CI; 22.2-31.1). Also, three in five IDPs, one in three refugees and asylum seekers and one in four migrants suffer from depression globally. Being female migrant [AOR: 2.46 95% CI: 1.79-3.13, I=34.5%), non-partnered marital status [AOR: 2.29, 95% CI: 1.29-3.30, I= 0.00%], and perceived low social support [AOR: 1.76, 95% CI: 1.00-2.52, I=34.6%] were significant determinants of depression among displaced people.
Overall, around 1 in 4 displaced people suffer from depression and exceed the prevalence of depression reported by community samples in different nations and demonstrate a need for culturally fitting and targeted responses from migrant/refugee host nations and their serving clinicians.
由于在新环境中的重新安置、创伤事件和被迫迁移，流离失所者容易出现心理健康问题。抑郁症是一种在难民、移民、寻求庇护者和国内流离失所者（IDP）等流离失所者中反复观察到的心理健康问题。因此，估计全球抑郁症的总体患病率，并确定其决定因素，可以帮助政策制定者和卫生保健工作者减轻疾病负担，改善流离失所者的心理健康。
检索了 1984 年至 2020 年期间发表的英文相关观察性研究的 PubMed、EMBASE、CINAHIL、Psych-INFO 和 SCOPUS 数据库。使用纽卡斯尔-渥太华量表（NOS）评估研究的方法学质量。使用 Q 和 I 检验检查研究之间的异质性。通过观察漏斗图对称性和使用 Egger 回归检验检查发表偏倚。使用 STATA 16 采用随机效应模型对研究进行合并。
在确定的 4102 项研究中，纳入了 81 项研究，总样本量为 53458 人，进行了本次系统评价和荟萃分析。流离失所者中抑郁症的总患病率估计为 26.4%（95%CI；22.2-31.1）。此外，全球有三分之二的国内流离失所者、三分之一的难民和寻求庇护者以及四分之一的移民患有抑郁症。女性移民[优势比（AOR）：2.46，95%可信区间（CI）：1.79-3.13，I=34.5%]、非伴侣婚姻状况[AOR：2.29，95%CI：1.29-3.30，I=0.00%]和感知低社会支持[AOR：1.76，95%CI：1.00-2.52，I=34.6%]是流离失所者抑郁症的显著决定因素。
总体而言，约有 1/4 的流离失所者患有抑郁症，其患病率超过了不同国家社区样本报告的抑郁症患病率，并表明移民/难民收容国及其服务临床医生需要采取文化适宜和有针对性的应对措施。
