Mattelin Erica, Khanolkar Amal R, Andersson Johan, Kutabi Hania, Korhonen Laura
Barnafrid, Swedish National Center on Violence Against Children, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Save the Children, Sweden.
Department of Population Health Sciences, School of Life Course and Population Sciences, King's College London, UK.
Compr Psychiatry. 2025 Feb;137:152571. doi: 10.1016/j.comppsych.2024.152571. Epub 2025 Jan 4.
Currently, approximately 100 million people are displaced worldwide, including children and young adults. Previous studies showed exposure to violence and posttraumatic stress disorder (PTSD) are common in this sub-population. However, we still lack comprehensive data on well-being, mental health, and the ability to function.
This study included 291 adolescent (aged 12-17 years) and young adult (18-25 years) refugees recruited nationwide in Sweden between 2019 and 2022. Sociodemographic, mental health and well-being-related data (well-being, post-traumatic stress symptoms, psychiatric diagnoses, and functional ability) were collected using semi-structured interviews with structured components. Associations between accompanied status and well-being/depression/suicidal thoughts, generalized anxiety disorder/panic disorder/PTSD symptoms, and functional ability were analyzed using linear and logistic regression, adjusted for age, gender, parental education, asylum status, and region of origin.
Most study participants (mean age 17·9 years) originated from the Middle East and North Africa (70·6 %) or Sub-Saharan Africa (27·0 %). 16·1 % of adolescents and 32·3 % of young adults were unaccompanied. Nearly the entire study sample had experienced violence (92·8 %). However, the sample had a low prevalence of psychiatric diagnoses. For example, only 5·9 % fulfilled the criteria for clinical depression. Self-reported well-being (WHO-5, 71·09 (23·91)) and observer-rated functional ability (GAS/GAF, 81·76 (14·15)) were high. There were no significant differences in diagnosis prevalence by gender. However, significant differences existed between accompanied versus unaccompanied groups. Being an unaccompanied refugee individual was associated with a higher risk of suicidal thoughts, adjusted odds ratio, aOR 5·66 (95 % CI 2·15-14·88), higher rates of post-traumatic stress disorder symptoms β = 0·72 (0·39-1·05), lower mental well-being β = -10·86 95 % CI (-18·23- -3·48) and lower functional ability β = -9·38 (-13·84- -4·92). There were no differences in outcomes by gender except for worse well-being in males (β = 6·83 (1·01-12·66)).
In this sample, we found lower prevalence rates for all psychiatric diagnoses compared to earlier published studies. Being an unaccompanied refugee individual was a risk factor for all adverse outcomes. Future studies need to confirm the relatively low rates of psychiatric diagnoses. Regardless, the results highlight the heterogeneous needs among newly arrived refugees.
目前，全球约有1亿人被迫流离失所，其中包括儿童和年轻人。此前的研究表明，暴力暴露和创伤后应激障碍（PTSD）在这一亚群体中很常见。然而，我们仍然缺乏关于幸福感、心理健康和功能能力的全面数据。
本研究纳入了2019年至2022年期间在瑞典全国招募的291名青少年（12 - 17岁）和青年（18 - 25岁）难民。通过带有结构化组件的半结构化访谈收集社会人口统计学、心理健康和幸福感相关数据（幸福感、创伤后应激症状、精神疾病诊断和功能能力）。使用线性和逻辑回归分析陪伴状态与幸福感/抑郁/自杀念头、广泛性焦虑障碍/惊恐障碍/PTSD症状以及功能能力之间的关联，并对年龄、性别、父母教育程度、庇护状态和原籍地区进行了调整。
大多数研究参与者（平均年龄17.9岁）来自中东和北非（70.6%）或撒哈拉以南非洲（27.0%）。16.1%的青少年和32.3%的青年无人陪伴。几乎整个研究样本都经历过暴力（92.8%）。然而，该样本的精神疾病诊断患病率较低。例如，只有5.9%符合临床抑郁症标准。自我报告的幸福感（WHO-5，71.09（23.91））和观察者评定的功能能力（GAS/GAF，81.76（14.15））较高。按性别划分的诊断患病率没有显著差异。然而，有陪伴与无陪伴群体之间存在显著差异。作为无人陪伴的难民个体与自杀念头风险较高相关，调整后的优势比，aOR为5.66（95%CI 2.15 - 14.88），创伤后应激障碍症状发生率较高，β = 0.72（0.39 - 1.05），心理健康状况较差，β = -10.86，95%CI（-18.23 - -3.48），功能能力较低，β = -9.38（-13.84 - -4.92）。除男性幸福感较差（β = 6.83（1.01 - 12.66））外，按性别划分的结果没有差异。
在这个样本中，我们发现所有精神疾病诊断的患病率均低于早期发表的研究。作为无人陪伴的难民个体是所有不良后果的一个风险因素。未来的研究需要证实精神疾病诊断的相对低发生率。无论如何，结果突出了新抵达难民中存在的异质性需求。
