Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Palle Juul Jensens Boulevard 175, 8200 Aarhus N, Aarhus, Denmark.
Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus, Denmark.
BMC Psychiatry. 2022 May 27;22(1):363. doi: 10.1186/s12888-022-03982-4.
Refugees are forced migrants but there is a large variation in the distance that refugees cover and there is a paucity in the evidence of how this may affect refugees' health and health care needs.
We investigated the association between long-distance migration and post-traumatic stress disorder (PTSD), a serious psychiatric disorder associated with deteriorating mental and somatic health.
Included from 2016-2019 were adult Syrian refugees in Lebanon and Denmark that arrived up to 12 months prior to inclusion. PTSD was assessed using the Harvard Trauma Questionnaire and the estimate of association was obtained by multiply imputing missing data and adjusting for confounding by propensity score-weighting with covariates age, sex, socioeconomic status, trauma experience and general mental well-being, reporting the bootstrap 95-percentile confidence interval (95% CI). Additionally, a number of sensitivity analyses were performed.
Included were 599 participants in Lebanon (mean age 35 years old, 73% being female) and 133 participants in Denmark (mean age 30 years old, 47% being female). After multiply imputing missing data and propensity score-weighted adjustment for confounding, migration to Denmark instead of Lebanon was associated with an increase in PTSD prevalence of 9 percentage point (95% CI [-1; 19] percentage point).
Long-distance migration may be associated with an increase in PTSD prevalence in refugees. The migration could be an important factor to consider when assessing refugees' and asylum seekers' health. Practitioners should consider "long-distance migration" in refugee health screenings and in particular when assessing the risk of post-traumatic stress disorder. Future research should be designed to ultimately lead to studies of relevant interventions to lower the risk of post-traumatic stress disorder in refugees.
难民是被迫移民，但他们迁移的距离差异很大，而关于这如何影响难民的健康和医疗需求的证据却很少。
我们调查了长途迁移与创伤后应激障碍（PTSD）之间的关联，PTSD 是一种与精神和身体健康恶化相关的严重精神疾病。
纳入了 2016 年至 2019 年期间在黎巴嫩和丹麦的成年叙利亚难民，他们在纳入前最多到达 12 个月。使用哈佛创伤问卷评估 PTSD，通过多重插补缺失数据并调整倾向评分加权的混杂因素（包括年龄、性别、社会经济地位、创伤经历和一般心理健康）来估计关联，报告 bootstrap 95%置信区间（95%CI）。此外，还进行了一些敏感性分析。
纳入了黎巴嫩的 599 名参与者（平均年龄 35 岁，73%为女性）和丹麦的 133 名参与者（平均年龄 30 岁，47%为女性）。在进行缺失数据多重插补和倾向评分加权调整混杂因素后，与迁移到黎巴嫩相比，迁移到丹麦与 PTSD 患病率增加 9 个百分点（95%CI [-1; 19]个百分点）相关。
长途迁移可能与难民 PTSD 患病率增加有关。在评估难民和寻求庇护者的健康时，迁移可能是一个重要的考虑因素。从业者在进行难民健康筛查时应考虑“长途迁移”，特别是在评估创伤后应激障碍的风险时。未来的研究应旨在最终开展降低难民创伤后应激障碍风险的相关干预措施的研究。
