Solfrank Maximilian, Nikendei Christoph, Zehetmair Catharina, Friederich Hans-Christoph, Nagy Ede
Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.
Front Psychiatry. 2023 Dec 20;14:1258140. doi: 10.3389/fpsyt.2023.1258140. eCollection 2023.
Asylum seekers are a particularly vulnerable population due to a wide range of external stressors. Traumatic events and difficult social/economic prospects can lead to an elevated susceptibility for substance use disorders. The aim of the present study was to determine whether asylum seekers suffering from mental or physical distress present higher levels of substance use disorder (SUD) in a state reception center in Germany and whether there are identifiable risk or protective factors.
We performed a hierarchical logistic regression on data of = 238 people who had applied for asylum in Germany to analyze the SUD variance explanation by (1) sociodemographic, (2) flight-specific, and (3) psychometric (ERQ, SOC-9 L, SCL-K9) variables. On level (4), we included the location of data collection (walk-in clinic or accommodation,) as an indicator of individual's need for a psychologist's or General practitioner's help in order to assess for the participant's (mental) distress.
Low educational level, lower sense of coherence, and mental distress (location of data collection in the psychosocial or general medical outpatient clinic) were associated with SUD. Those suffering from SUD seemed to be less aware of external stressors as SUD was also associated with low levels of reported post-migratory stress.
The association of SUD with psychological distress and lower education reaffirms the concept that some vulnerable groups are at a higher risk for substance-related difficulties. Strengthening the sense of coherence with targeted interventions might enable at-risk groups to cope better with forthcoming burdens and help with abstaining from current or future consumption.
由于面临诸多外部压力源,寻求庇护者是特别脆弱的群体。创伤性事件以及艰难的社会/经济前景会导致物质使用障碍的易感性增加。本研究的目的是确定在德国一个国家接待中心,患有精神或身体困扰的寻求庇护者是否存在更高水平的物质使用障碍(SUD),以及是否存在可识别的风险或保护因素。
我们对238名在德国申请庇护者的数据进行了分层逻辑回归分析,以通过(1)社会人口统计学、(2)与逃亡相关的以及(3)心理测量学(情绪调节问卷、社会支持量表 - 9项、症状自评量表 - 9项)变量来分析物质使用障碍的方差解释。在第(4)层,我们纳入了数据收集地点(门诊诊所或住所),作为个体是否需要心理学家或全科医生帮助的指标,以便评估参与者的(精神)困扰程度。
低教育水平、较低的连贯感以及精神困扰(数据收集地点为心理社会或普通医疗门诊诊所)与物质使用障碍相关。患有物质使用障碍的人似乎对外部压力源的感知较少,因为物质使用障碍也与较低水平的移民后压力报告相关。
物质使用障碍与心理困扰和低教育水平之间的关联再次证实了这样一个概念,即一些弱势群体面临与物质相关问题的风险更高。通过有针对性的干预措施增强连贯感,可能使高危群体更好地应对即将到来的负担,并有助于戒除当前或未来的物质使用。