Department of Epidemiology, New York University School of Global Public Health, New York, NY, United States.
Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY, United States.
Front Public Health. 2023 Jan 16;10:1048649. doi: 10.3389/fpubh.2022.1048649. eCollection 2022.
The Rohingya endured intense trauma in Myanmar and continue to experience trauma related to displacement in Bangladesh. We aimed to evaluate the association of post-displacement stressors with mental health outcomes, adjusting for previously experienced trauma, in the Rohingya refugee population in Cox's Bazar, Bangladesh.
We analyzed data from the Cox's Bazar Panel Survey, a cross sectional survey consisting of 5,020 household interviews and 9,386 individual interviews completed in 2019. Using logistic regression, we tested the association between post-displacement stressors such as current exposure to crime and conflict and two mental health outcomes: depression and post-traumatic stress disorder (PTSD). In adjusted analyses, we controlled for past trauma, employment status, receiving an income, food security, and access to healthcare and stratified by gender.
The prevalence of depressive symptoms was 30.0% ( = 1,357) and PTSD 4.9% ( = 218). Most (87.1%, = 3,938) reported experiencing at least one traumatic event. Multiple post-displacement stressors, such as current exposure to crime and conflict (for men: OR = 2.23, 95% CI = 1.52-3.28, < 0.001; for women: OR = 1.92, 95% CI = 1.44-2.56, < 0.001), were associated with higher odds of depressive symptoms in multivariable models. Trauma (OR = 4.98, 95% CI = 2.20-11.31, < 0.001) was associated with increased odds of PTSD. Living in a household that received income was associated with decreased odds of PTSD (OR = 0.74, 95% CI = 0.55-1.00, = 0.05).
Prevalence of depressive symptoms was high among Rohingya refugees living in Cox's Bazar. Adjusting for past trauma and other risk factors, exposure to post-displacement stressors was associated with increased odds of depressive symptoms. There is a need to address social determinants of health that continue to shape mental health post-displacement and increase mental healthcare access for displaced Rohingya.
罗兴亚人在缅甸经历了强烈的创伤，并且在孟加拉国继续遭受与流离失所相关的创伤。我们旨在评估在孟加拉国 Cox's Bazar 的罗兴亚难民群体中，与流离失所相关的应激源与心理健康结果之间的关联，同时调整先前经历过的创伤。
我们分析了 Cox's Bazar 面板调查的数据，这是一项横断面调查，包括 2019 年完成的 5020 户家庭访谈和 9386 个人访谈。我们使用逻辑回归测试了当前面临的犯罪和冲突等流离失所后应激源与两种心理健康结果（抑郁和创伤后应激障碍）之间的关联。在调整分析中，我们控制了过去的创伤、就业状况、收入状况、粮食安全以及获得医疗保健的机会，并按性别进行了分层。
抑郁症状的患病率为 30.0%（=1357），创伤后应激障碍的患病率为 4.9%（=218）。大多数人（87.1%，=3938）报告至少经历过一次创伤性事件。多种流离失所后应激源，如当前面临的犯罪和冲突（对男性而言：OR=2.23，95%CI=1.52-3.28，<0.001；对女性而言：OR=1.92，95%CI=1.44-2.56，<0.001），与多变量模型中抑郁症状的高几率相关。创伤（OR=4.98，95%CI=2.20-11.31，<0.001）与创伤后应激障碍的高几率相关。生活在有收入的家庭中的人患创伤后应激障碍的几率较低（OR=0.74，95%CI=0.55-1.00，=0.05）。
居住在 Cox's Bazar 的罗兴亚难民中，抑郁症状的患病率很高。在调整过去的创伤和其他风险因素后，接触流离失所后的应激源与抑郁症状的几率增加相关。需要解决继续影响流离失所后心理健康的社会决定因素，并增加流离失所的罗兴亚人的精神保健机会。
