Psychology Department, Royal Holloway, University of London, Egham Hill, Egham TW20 0EX, UK.
The Oxford Institute of Clinical Psychology Training and Research, The Oxford Centre for Psychological Health, University of Oxford, Isis Education Centre, Warneford Hospital, Oxford OX3 7JX, UK.
Schizophr Res. 2023 Oct;260:99-112. doi: 10.1016/j.schres.2023.08.011. Epub 2023 Aug 25.
As we face the largest refugee crisis since World War Two, research is increasingly examining the impact of forced displacement. The risk of non-affective psychosis in refugees is evidenced to be significantly greater than non-refugees, and the role of pre-, peri- and post-migratory trauma and dissociation is increasingly implicated.
To determine the prevalence of non-affective psychosis in refugee populations.
PRISMA guidelines were followed. Three key databases (PubMed, PsychINFO and Web of Science), Google scholar and study references were searched. The full-text of 62 studies were screened and 23 studies were eligible for inclusion. A narrative synthesis was undertaken and the Quality Assessment Tool for Quantitative Studies was used to assess methodological quality. (PROSPERO registration CRD42019152170).
The results were widely heterogeneous. The combined weighted average prevalence of non-affective psychosis in refugee populations was 0.9 %. Psychosis prevalence for individual psychotic symptoms was 28.4 %; 0.5 % for schizophrenia; 1.0 % for psychosis; 0.6 % for mixed psychotic disorders and 2.9 % for psychotic episodes.
Variations in examined populations, diagnostic and prevalence classifications, and study designs and methodologies likely contributed to heterogeneity across the data. The findings highlight a greater need to provide more specialist mental health services and trauma-focused interventions, as well as transculturally sensitive assessment and treatment to address refugee vulnerability to psychosis. Future research should examine psychosis prevalence longitudinally and in refugees-only, address methodological bias and further examine the role of trauma and dissociation in refugee psychosis prevalence.
随着我们面临自第二次世界大战以来最大的难民危机，研究越来越多地关注被迫流离失所的影响。难民中非情感性精神病的风险明显高于非难民，并且越来越多的证据表明，前、围产期和迁徙后创伤和分离的作用。
确定难民群体中非情感性精神病的患病率。
遵循 PRISMA 指南。在三个主要数据库（PubMed、PsychINFO 和 Web of Science）、Google 学术和研究参考文献中进行了搜索。筛选了 62 项研究的全文，有 23 项研究符合纳入标准。进行了叙述性综合分析，并使用定量研究质量评估工具（QUAlity Assessment Tool for Quantitative Studies，QUATh）评估方法学质量。（PROSPERO 注册 CRD42019152170）。
结果差异很大。难民群体中非情感性精神病的合并加权平均患病率为 0.9%。个别精神病症状的精神病患病率为 28.4%；精神分裂症为 0.5%；精神病为 1.0%；混合性精神病障碍为 0.6%；精神病发作为 2.9%。
被检查人群、诊断和患病率分类以及研究设计和方法的差异可能导致数据的异质性。这些发现强调了更需要提供更多的专业心理健康服务和以创伤为重点的干预措施，以及跨文化敏感的评估和治疗，以解决难民易患精神病的问题。未来的研究应在难民中纵向检查精神病的患病率，解决方法学偏见，并进一步研究创伤和分离在难民精神病患病率中的作用。
