Screening of mental disorders in asylum-seekers from Kosovo.
OBJECTIVE
To determine how the use of trained and ad hoc interpreters during a medical screening interview affects referral to medical and psychiatric care.


METHODS
We reviewed 319 structured interviews conducted by nurses with asylum-seekers from Kosovo during a systematic medical screening at time of entry, consisting of questions about health conditions, past exposure to traumatic events, and posttraumatic symptoms.


RESULTS
The majority (72%) of asylum-seekers were male and the median age was 24 years. Forty-eight per cent were single and 55% declared having relatives already living in Switzerland. Screening interviews resulted in 36% of asylum-seekers being referred to a general practitioner and 6% to a psychiatrist. Relatives served as ad hoc interpreters in 18% of interviews and trained interpreters in 16%. The detection of traumatic events and psychological symptoms significantly improved when trained interpreters were present (traumatic events: no interpreters 55%, ad hoc interpreters 46%, trained interpreters 77%, P = 003; psychological symptoms: 12%, 14%, 33%, respectively, P = 0.001). Adjusted for traumatic events and posttraumatic symptoms, referral to medical care was more frequent when relatives served as ad hoc interpreter (OR: 1.9, 95% CI 1.0-3.6), while interviews conducted with trained interpreters were not significantly associated with increased referral to medical (OR: 1.3, 95% CI 0.6-2.6) and psychiatric care (OR: 2.3, 95% CI 0.7-7.0).


CONCLUSIONS
The use of trained interpreters improved the quality of communication, the detection of severe symptoms and traumatic situations, and facilitated therapeutic orientation of traumatized asylum-seekers.
Eytan
Ariel
A
Department of Psychiatry, Geneva University Hospitals, Belle-Idée, 2 Chemin du Petit-Bel-Air 1225 Geneva, Switzerland. Ariel.Eytan@hcuge.ch
Bischoff
Alexandre
A
Rrustemi
Issah
I
Durieux
Sophie
S
Loutan
Louis
L
Gilbert
Muriel
M
Bovier
Patrick A
PA
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D007802:Language; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009720:Nurse Clinicians; D009733:Nursing Diagnosis; D010552:Personality Assessment; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000451:nursing / Q000523:psychology; D012036:Refugees / Q000523:psychology* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000451:nursing / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000451:nursing / Q000523:psychology; D013557:Switzerland; D014175:Translating; D015022:Yugoslavia / Q000208:ethnology