title: A systematic review of resilience and mental health outcomes of conflict-driven adult forced migrants.
abstract: BACKGROUND
  The rising global burden of forced migration due to armed conflict is increasingly recognised as an important issue in global health. Forced migrants are at a greater risk of developing mental disorders. However, resilience, defined as the ability of a person to successfully adapt to or recover from stressful and traumatic experiences, has been highlighted as a key potential protective factor. This study aimed to review systematically the global literature on the impact of resilience on the mental health of adult conflict-driven forced migrants.
  
  
  METHODS
  Both quantitative and qualitative studies that reported resilience and mental health outcomes among forcibly displaced persons (aged 18+) by way of exploring associations, links, pathways and causative mechanisms were included. Fourteen bibliographic databases and seven humanitarian study databases/websites were searched and a four stage screening process was followed.
  
  
  RESULTS
  Twenty three studies were included in the final review. Ten qualitative studies identified highlighted family and community cohesion, family and community support, individual personal qualities, collective identity, supportive primary relationships and religion. Thirteen quantitative studies were identified, but only two attempted to link resilience with mental disorders, and three used a specific resilience measure. Over-reliance on cross-sectional designs was noted. Resilience was generally shown to be associated with better mental health in displaced populations, but the evidence on this and underlying mechanisms was limited.
  
  
  CONCLUSIONS
  The review highlights the need for more epidemiological and qualitative evidence on resilience in forcibly displaced persons as a potential avenue for intervention development, particularly in resource-poor settings.
authors.affiliation: Department of Psychological Medicine, Institute of Psychiatry, King's College London, PO Box 92, De Crespigny Park, London SE5 8AF, UK.
authors.forename: Chesmal
authors.initials: C
authors.lastname: Siriwardhana
authors.affiliation: King's College London School of Medicine, London, UK.
authors.forename: Shirwa Sheik
authors.initials: SS
authors.lastname: Ali
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Bayard
authors.initials: B
authors.lastname: Roberts
authors.affiliation: Department of Psychological Medicine, Institute of Psychiatry, King's College London, PO Box 92, De Crespigny Park, London SE5 8AF, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Stewart
keywords: Adult resilience; Forced migration; Mental health