School of Psychology, University of New South Wales, Sydney, NSW, Australia.
Department of Sociology, Koc University, Istanbul, Türkiye.
Epidemiol Psychiatr Sci. 2024 Nov 5;33:e59. doi: 10.1017/S2045796024000696.
Forcibly displaced people, such as refugees and asylum-seekers (RAS), are at higher risk of mental disorders, mainly post-traumatic stress disorder (PTSD), depression and anxiety. Little is known about the complex relationships between these mental disorders among culturally and linguistically diverse RAS. To investigate this, the present study applied a novel network analytical approach to examine and compare the central and bridge symptoms within and between PTSD, depression and anxiety among Afghan and Syrian RAS in Türkiye.
A large-scale online survey study with 785 Afghan and 798 Syrian RAS in Türkiye was conducted in 2021. Symptoms of PTSD (the short form of Post-Traumatic Stress Disorders Checklist [PCL-5]), depression and anxiety (Hopkins Symptoms Checklist-25) [HSCL-25]) were measured via self-administrated validated instruments. We conducted network analysis to identify symptoms that are most strongly connected with other symptoms (central symptoms) and those that connect the symptoms of different disorders (bridge symptoms) in R Studio using the qgraph package.
Overall, Afghans and Syrians differed in terms of network structure, but not in network strength. Results showed that feeling blue, feeling restless and spells of terror or panic were the most central symptoms maintaining the overall symptom structure of common mental disorders among Afghan participants. For Syrian participants, worrying too much, feeling blue and feeling tense were identified as the central symptoms. For both samples, anger and irritability and feeling low in energy acted as a bridge connecting the symptoms of PTSD, depression and anxiety.
The current findings provide insights into the interconnectedness within and between the symptoms of common mental disorders and highlight the key symptoms that can be potential targets for psychological interventions for RAS. Addressing these symptoms may aid in tailoring existing evidence-based interventions and enhance their effectiveness. This contributes to reducing the overall mental health burden and improving well-being in this population.
被迫流离失所的人，如难民和寻求庇护者（RAS），患精神障碍的风险更高，主要是创伤后应激障碍（PTSD）、抑郁和焦虑。对于文化和语言多样化的 RAS 中这些精神障碍之间的复杂关系知之甚少。为了研究这一点，本研究应用一种新颖的网络分析方法，检查和比较在土耳其的阿富汗和叙利亚 RAS 中 PTSD、抑郁和焦虑之间的核心和桥梁症状。
2021 年在土耳其对 785 名阿富汗和 798 名叙利亚 RAS 进行了一项大规模的在线调查研究。通过自我管理的验证工具测量 PTSD（创伤后应激障碍检查表的简短形式[PCL-5]）、抑郁和焦虑（霍普金斯症状检查表-25 [HSCL-25]）的症状。我们在 R Studio 中使用 qgraph 包进行网络分析，以识别与其他症状（核心症状）联系最紧密的症状以及连接不同疾病症状（桥梁症状）的症状。
总体而言，阿富汗人和叙利亚人在网络结构方面存在差异，但在网络强度方面没有差异。结果表明，感到忧郁、烦躁不安和恐惧或恐慌发作是维持阿富汗参与者常见精神障碍整体症状结构的最核心症状。对于叙利亚参与者，过度担忧、忧郁和紧张被确定为核心症状。对于两个样本，愤怒和易怒以及精力不足充当了将 PTSD、抑郁和焦虑症状联系起来的桥梁。
目前的研究结果提供了对常见精神障碍症状之间的相互联系的深入了解，并强调了可以作为 RAS 心理干预潜在目标的关键症状。解决这些症状可能有助于调整现有的循证干预措施并提高其效果。这有助于减轻该人群的整体心理健康负担并改善福祉。
