The association between long-distance migration and PTSD prevalence in Syrian refugees

Andreas Halgreen Eiset; Michaelangelo P Aoun; Monica Stougaard; Annemarie Graa Gottlieb; Ramzi S Haddad; Morten Frydenberg; Wadih J Naja

doi:10.1186/s12888-022-03982-4

The association between long-distance migration and PTSD prevalence in Syrian refugees

BMC Psychiatry. 2022 May 27;22(1):363. doi: 10.1186/s12888-022-03982-4.

Authors

Andreas Halgreen Eiset^{1

2}, Michaelangelo P Aoun³, Monica Stougaard⁴, Annemarie Graa Gottlieb⁴, Ramzi S Haddad³, Morten Frydenberg⁵, Wadih J Naja^{3

6}

Affiliations

¹ Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Palle Juul Jensens Boulevard 175, 8200 Aarhus N, Aarhus, Denmark. eiset@clin.au.dk.
² Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus, Denmark. eiset@clin.au.dk.
³ Faculty of Medical Sciences, Lebanese University, P.O. Box 6573/14, Badaro, Museum, Beirut, Lebanon.
⁴ Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Palle Juul Jensens Boulevard 175, 8200 Aarhus N, Aarhus, Denmark.
⁵ Consultant Biostatistician, Høgemosevej 19A, Olsted, 8380, Trige, Denmark.
⁶ King Hussein Cancer Center, Queen Rania St 202, Amman, Jordan.

Abstract

Background: Refugees are forced migrants but there is a large variation in the distance that refugees cover and there is a paucity in the evidence of how this may affect refugees' health and health care needs.

Objective: We investigated the association between long-distance migration and post-traumatic stress disorder (PTSD), a serious psychiatric disorder associated with deteriorating mental and somatic health.

Methods: Included from 2016-2019 were adult Syrian refugees in Lebanon and Denmark that arrived up to 12 months prior to inclusion. PTSD was assessed using the Harvard Trauma Questionnaire and the estimate of association was obtained by multiply imputing missing data and adjusting for confounding by propensity score-weighting with covariates age, sex, socioeconomic status, trauma experience and general mental well-being, reporting the bootstrap 95-percentile confidence interval (95% CI). Additionally, a number of sensitivity analyses were performed.

Results: Included were 599 participants in Lebanon (mean age 35 years old, 73% being female) and 133 participants in Denmark (mean age 30 years old, 47% being female). After multiply imputing missing data and propensity score-weighted adjustment for confounding, migration to Denmark instead of Lebanon was associated with an increase in PTSD prevalence of 9 percentage point (95% CI [-1; 19] percentage point).

Conclusions: Long-distance migration may be associated with an increase in PTSD prevalence in refugees. The migration could be an important factor to consider when assessing refugees' and asylum seekers' health. Practitioners should consider "long-distance migration" in refugee health screenings and in particular when assessing the risk of post-traumatic stress disorder. Future research should be designed to ultimately lead to studies of relevant interventions to lower the risk of post-traumatic stress disorder in refugees.

Keywords: Cross-sectional studies; Emigration and immigration; Human migration; PTSD; Post-traumatic stress disorder; Propensity score; Refugees.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Female
Humans
Male
Mental Health
Prevalence
Refugees* / psychology
Stress Disorders, Post-Traumatic* / epidemiology
Stress Disorders, Post-Traumatic* / psychology
Syria