新冠疫情对重新安置难民心理健康的长期影响以及性别和孤独感的调节作用：来自BNLA队列研究的结果
The long-term impact of COVID-19 on mental health and the moderation effect of sex and loneliness amongst resettled refugees: findings from BNLA cohort study.
作者信息
Zheng Meng, Slewa-Younan Shameran, Nguyen Thomas P, Rioseco Pilar, Renzaho Andre M N, Chen Wen
机构信息
Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Zhongshan Road 2, Guangzhou 510080, China.
Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China.
出版信息
Lancet Reg Health West Pac. 2025 Mar 11;56:101516. doi: 10.1016/j.lanwpc.2025.101516. eCollection 2025 Mar.
BACKGROUND
Vulnerability to mental health problems is well-established in refugees, attributed to the interplay between pre-and post-migration stressors. COVID-19 pandemic was recognized as a universal stressor with potential to further impact refugees' mental health. This longitudinal study sought to investigate the mental health impact of COVID-19 and its moderators in resettled refugees in Australia.
METHODS
Data from Waves 1 (2013-2014, pre-pandemic), 5 (2017-2018, pre-pandemic) and 6 (2023, post-pandemic) of the Building a New Life in Australia were utilized in this study. High risk of severe mental illness (HR-SMI) and post-traumatic stress disorder (PTSD) were measured by K6 and PTSD-8 scales. Using generalized linear mixed model, we examined the mental health impacts of COVID-19 pandemic and moderation effect of sex and loneliness. The difference in changes in predicted probability of HR-SMI and PTSD across Waves 1 to 5 and Waves 5 to 6 between moderator-based subgroups were calculated.
FINDINGS
A total of 2399 resettled refugees participated. The weighted prevalence of HR-SMI (Δ6-5 5.0%) or PTSD (Δ6-5 3.2%) was increased after the pandemic, different from the trend from Waves 1 to 5 (HR-SMI stable trend; PTSD decreased trend). Compared to Wave 5, Wave 6 had a significant effect on HR-SMI (AOR 1.54 [95% CI 1.17-2.04]), especially among females (2.04 [95% CI 1.16-3.56]); causing an additional 8.82% change in predicted probability than males. A significant effect of Wave 6 on PTSD was only found in respondents with loneliness (2.17 [95% CI 1.17-4.05]), causing an additional 14.92% change in predicted probability than those without loneliness.
INTERPRETATION
Rates of mental illness increased among resettled refugees in Australia from prepandemic to four years post-COVID-19 and were moderated by loneliness and being female. This highlights the need for ongoing, targeted psycho-social support for specific refugee sub-groups.
FUNDING
Guangdong Basic and Applied Basic Research Foundation (2022B1515020094).
背景
难民中存在心理健康问题的易感性，这归因于移民前和移民后应激源之间的相互作用。2019冠状病毒病大流行被认为是一种普遍的应激源，有可能进一步影响难民的心理健康。这项纵向研究旨在调查2019冠状病毒病对澳大利亚重新安置难民心理健康的影响及其调节因素。
方法
本研究使用了“在澳大利亚建立新生活”项目第1波（2013 - 2014年，大流行前）、第5波（2017 - 2018年，大流行前）和第6波（2023年，大流行后）的数据。通过K6量表和创伤后应激障碍-8量表测量严重精神疾病高风险（HR-SMI）和创伤后应激障碍（PTSD）。我们使用广义线性混合模型，研究了2019冠状病毒病大流行对心理健康的影响以及性别和孤独感的调节作用。计算了基于调节因素的亚组在第1波至第5波和第5波至第6波之间HR-SMI和PTSD预测概率变化的差异。
结果
共有2399名重新安置的难民参与。大流行后，HR-SMI（Δ6 - 5为5.0%）或PTSD（Δ6 - 5为3.2%）的加权患病率有所上升，这与第1波至第5波的趋势不同（HR-SMI呈稳定趋势；PTSD呈下降趋势）。与第5波相比，第6波对HR-SMI有显著影响（调整后比值比1.54 [95%置信区间1.17 - 2.04]），尤其是在女性中（2.04 [95%置信区间1.16 - 3.56]）；预测概率的变化比男性多8.82%。仅在有孤独感的受访者中发现第6波对PTSD有显著影响（2.17 [95%置信区间1.17 - 4.05]），预测概率的变化比没有孤独感的受访者多14.92%。
解读
从大流行前到2019冠状病毒病后四年，澳大利亚重新安置难民中的精神疾病发病率有所上升，且受孤独感和女性身份的调节。这凸显了针对特定难民亚群体持续提供有针对性的心理社会支持的必要性。
资助
广东省基础与应用基础研究基金（2022B1515020094）
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