Risk of mental disorders in refugees and native Danes: a register-based retrospective cohort study.
BACKGROUND
Refugees are vulnerable to mental health disorders because of migration trauma. However, register-based prevalence studies are missing.


OBJECTIVE
To investigate the risk of mental disorders among refugees compared with that among native Danes.


METHODS
Refugees (n = 29,139), who received residence permission in Denmark from 1.1.1993 to 31.12.1999 were matched 1:4 on age and sex with native Danes (n = 116,556). Civil registration numbers were linked to the Danish Psychiatric Central Register to obtain data on ICD-10 diagnosis upon discharge for all first-time psychiatric hospital contacts for refugees (n = 2,120) and native Danes (n = 5,044) between 1.1.1994 and 31.12.2003. Treated prevalence was then calculated using a Poisson regression model.


RESULTS
Refugee men (RR = 2.02; 95%CI = 1.75-2.34) and refugee women (RR = 1.49; 95%CI = 1.29-1.72) had higher overall risks of having a first-time psychiatric contact for mental disorders than did native Danes; specific risks of psychotic, affective and neurotic disorders were even higher. The results were most striking for refugee men, and for refugees from the former Yugoslavia, Iraq and the Middle East.


CONCLUSIONS
Refugees have high rates of various mental disorders. Healthcare services should target refugees' mental health from arrival in the receiving country.
Norredam
Marie
M
Department of Health Services Research, Institute of Public Health, University of Copenhagen, Østre Farimagsgade 5, Building 5, 1014, Copenhagen K, Denmark. m.norredam@pubhealth.ku.dk
Garcia-Lopez
A
A
Keiding
N
N
Krasnik
A
A
D000328:Adult; D017677:Age Distribution; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology / Q000208:ethnology; D054242:Emigrants and Immigrants / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D044382:Population Groups / Q000523:psychology / Q000706:statistics & numerical data*; D015995:Prevalence; D012036:Refugees / Q000523:psychology / Q000706:statistics & numerical data*; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012306:Risk; D012307:Risk Factors; D012737:Sex Factors