Mental health of migrants with pre-migration exposure to armed conflict: a systematic review and meta-analysis.

Mesa-Vieira, Cristina; Haas, Andreas D; Buitrago-Garcia, Diana; Roa-Diaz, Zayne M; Minder, Beatrice; Gamba, Magda; Salvador, Dante Jr; Gomez, Daniel; Lewis, Meghann; Gonzalez-Jaramillo, Wendy C; Pahud de Mortanges, Aurélie; Buttia, Chepkoech; Muka, Taulant; Trujillo, Natalia; Franco, Oscar H (2022). Mental health of migrants with pre-migration exposure to armed conflict: a systematic review and meta-analysis. The lancet. Public health, 7(5), e469-e481. Elsevier 10.1016/S2468-2667(22)00061-5

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BACKGROUND

Exposure to armed conflict has been associated with negative mental health consequences. We aimed to estimate the prevalence of generalised anxiety disorder, major depressive disorder, and post-traumatic stress disorder among migrants exposed to armed conflict.

METHODS

In this systematic review and meta-analysis, we searched online databases (Cochrane Library, Embase, LILACS, PsycInfo [via Ovid], PubMed, and Web of Science Core Collection) for relevant observational studies published between Jan 1, 1994, and June 28, 2021. We included studies that used standardised psychiatric interviews to assess generalised anxiety disorder, major depressive disorder, or post-traumatic stress disorder among migrants (refugees or internally displaced persons; aged ≥18 years) with pre-migration exposure to armed conflict. We excluded studies in which exposure to armed conflict could not be ascertained, studies that included a clinical population or people with chronic diseases that can trigger the onset of mental disease, and studies published before 1994. We used a random effects model to estimate each mental health disorder's pooled prevalence and random effects meta-regression to assess sources of heterogeneity. Two independent reviewers assessed the risk of bias for each study using the Joanna Briggs Institute Checklist for Prevalence Studies. The protocol was registered with PROSPERO, CRD42020209251.

FINDINGS

Of the 13 935 studies identified, 34 met our inclusion criteria; these studies accounted for 15 549 migrants. We estimated a prevalence of current post-traumatic stress disorder of 31% (95% CI 23-40); prevalence of current major depressive disorder of 25% (17-34); and prevalence of generalised anxiety disorder of 14% (5-35). Younger age was associated with a higher prevalence of current post-traumatic stress disorder (odds ratio 0·95 [95% CI 0·90-0·99]), lifetime post-traumatic stress disorder (0·88 [0·83-0·92]), and current generalised anxiety disorder (0·87 [0·78-0·97]). A longer time since displacement was associated with a lower lifetime prevalence of post-traumatic stress disorder (0·88 [0·81-0·95]) and major depressive disorder (0·81 [0·77-0·86]). Migrating to a middle-income (8·09 [3·06-21·40]) or low-income (39·29 [11·96-129·70]) country was associated with increased prevalence of generalised anxiety disorder.

INTERPRETATION

Migrants who are exposed to armed conflict are at high risk of mental health disorders. The mental health-care needs of migrants should be assessed soon after resettlement, and adequate care should be provided, with particular attention paid to young adults.

FUNDING

Marie Skłodowska-Curie Actions (Horizon 2020-COFUND), MinCiencias (Colombia), and Swiss National Science Foundation.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
13 Central Units > Administrative Director's Office > University Library of Bern

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Mesa Vieira, Cristina; Haas, Andreas; Buitrago Garcia, Diana Carolina; Roa Díaz, Zayne Milena; Minder, Beatrice; Gamba Rincon, Magda Rocio; Salvador, Dante Jr.; Buttia, Chepkoech; Muka, Taulant and Franco Duran, Oscar Horacio

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services
000 Computer science, knowledge & systems > 020 Library & information sciences

ISSN:

2468-2667

Publisher:

Elsevier

Funders:

[164] Marie Skłodowska-Curie Actions (European Commission) ; [4] Swiss National Science Foundation

Language:

English

Submitter:

Pubmed Import

Date Deposited:

02 May 2022 07:16

Last Modified:

05 May 2022 15:28

Publisher DOI:

10.1016/S2468-2667(22)00061-5

PubMed ID:

35487232

BORIS DOI:

10.48350/169636

URI:

https://boris.unibe.ch/id/eprint/169636

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