Mental health of asylum seekers: a cross-sectional study of psychiatric disorders.
BACKGROUND
Asylum procedures are known to be protracted, stretching to over ten years in many host countries. International research shows high levels of distress for asylum seekers. Little is known about actual psychiatric morbidity in this population, especially during the first few years postmigration.


METHODS
The mental health status of two groups of asylum seekers was assessed: Group 1 (n = 43) had arrived in Switzerland 2.9 (SD 1.1) months prior to assessment, while Group 2 (n = 43) had arrived 15.5 (SD 3.2) months prior to assessment. Psychiatric disorders were diagnosed using the Mini International Neuropsychiatric Interview (MINI). Symptom severity of posttraumatic stress disorder (Posttraumatic Diagnostic Scale), anxiety (Hopkins Symptom Checklist), depression (Hopkins Symptom Checklist), and pain (Verbal Rating Scale) were assessed using self-report questionnaires. Postmigratory factors such as German language proficiency and social contacts were also assessed. Interviews were conducted with the assistance of trained interpreters.


RESULTS
Four out of ten participants met diagnostic criteria for at least one DSM-IV disorder. Groups did not differ with respect to psychiatric morbidity or symptom levels. Major depression (31.4%) and PTSD (23.3%) were diagnosed most frequently. The number of experienced traumatic event types was highly correlated with psychiatric morbidity.


CONCLUSIONS
Psychiatric morbidity in asylum seekers in the first two years after arrival is high, with no indication of a decrease in mental distress over time. Traumatic experiences seem to play a major role in morbidity during this time. Considering the magnitude of clinically relevant distress, a short psychological screening upon arrival with a focus on traumatic experiences may be warranted.
Department of Psychiatry and Psychotherapy, University Hospital Zurich, Culmannstrasse 8, Zurich, Switzerland.
Martina
M
Heeren
Julia
J
Mueller
Ulrike
U
Ehlert
Ulrich
U
Schnyder
Nadia
N
Copiery
Thomas
T
Maier
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D008603:Mental Health; D008875:Middle Aged; D012036:Refugees / Q000523:psychology* / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology; D011795:Surveys and Questionnaires