Emma Björkenstam1, Magnus Helgesson2, Marie Norredam3, Marit Sijbrandij4, Christopher Jamil de Montgomery5, Ellenor Mittendorfer-Rutz2. 1. Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden. Electronic address: emma.bjorkenstam@ki.se. 2. Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden. 3. Danish Research Centre for Migration, Ethnicity, and Health (MESU), Section for Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark; Section of Immigrant Medicine, Department of Infectious Diseases, University Hospital Hvidovre, Copenhagen, Denmark. 4. Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, the Netherlands. 5. Danish Research Centre for Migration, Ethnicity, and Health (MESU), Section for Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark.
Abstract
BACKGROUND: Studies investigating risks of common mental disorders (CMDs) in refugee youth are sparse. The current study examined health care use due to CMDs in unaccompanied and accompanied refugee youth and Swedish-born, and the role of education and residency duration. METHODS: This longitudinal cohort study included 746,517 individuals (whereof 36,347 refugees) between 19 and 25 years, residing in Sweden in 2009. Refugees were classified as unaccompanied/accompanied. Risk estimates of CMDs, measured as health care use and antidepressant treatment, between 2010-2016 were calculated as adjusted hazard ratios (aHR) with 95% confidence intervals (CI). Highest attained education in 2009, and residency duration were examined as potential modifiers. RESULTS: Compared to Swedish-born youth, refugees had a lower risk of treated major depressive and anxiety disorders (aHR): 0.67 (95% CI 0.63-0.72) and 0.67 (95% CI 0.63-0.71) respectively), but a higher risk for posttraumatic stress disorders (PTSD). Compared to Swedish-born, unaccompanied had a nearly 6-fold elevated risk for PTSD (aHR: 5.82, 95% CI 4.60-7.34) and accompanied refugees had a 3-fold risk of PTSD (aHR: 3.08, 95% CI 2.54-3.74). Rates of PTSD decreased with years spent in Sweden. The risk of CMDs decreased with increasing education. LIMITATIONS: The study lacked information on pre-migration factors. There may further be a potential misclassification of untreated CMDs. CONCLUSION: Refugees had a lower risk of treated depressive and anxiety disorders but a higher risk for PTSD. In refugees, the rates of anxiety disorders increased slightly over time whereas the rates of PTSD decreased. Last, low education was an important predictor for CMDs.
BACKGROUND: Studies investigating risks of common mental disorders (CMDs) in refugee youth are sparse. The current study examined health care use due to CMDs in unaccompanied and accompanied refugee youth and Swedish-born, and the role of education and residency duration. METHODS: This longitudinal cohort study included 746,517 individuals (whereof 36,347 refugees) between 19 and 25 years, residing in Sweden in 2009. Refugees were classified as unaccompanied/accompanied. Risk estimates of CMDs, measured as health care use and antidepressant treatment, between 2010-2016 were calculated as adjusted hazard ratios (aHR) with 95% confidence intervals (CI). Highest attained education in 2009, and residency duration were examined as potential modifiers. RESULTS: Compared to Swedish-born youth, refugees had a lower risk of treated major depressive and anxiety disorders (aHR): 0.67 (95% CI 0.63-0.72) and 0.67 (95% CI 0.63-0.71) respectively), but a higher risk for posttraumatic stress disorders (PTSD). Compared to Swedish-born, unaccompanied had a nearly 6-fold elevated risk for PTSD (aHR: 5.82, 95% CI 4.60-7.34) and accompanied refugees had a 3-fold risk of PTSD (aHR: 3.08, 95% CI 2.54-3.74). Rates of PTSD decreased with years spent in Sweden. The risk of CMDs decreased with increasing education. LIMITATIONS: The study lacked information on pre-migration factors. There may further be a potential misclassification of untreated CMDs. CONCLUSION: Refugees had a lower risk of treated depressive and anxiety disorders but a higher risk for PTSD. In refugees, the rates of anxiety disorders increased slightly over time whereas the rates of PTSD decreased. Last, low education was an important predictor for CMDs.
Authors: Cansu Alozkan Sever; Pim Cuijpers; Ellenor Mittendorfer-Rutz; Richard A Bryant; Katie S Dawson; Emily A Holmes; Trudy Mooren; Marie Louise Norredam; Marit Sijbrandij Journal: Eur J Psychotraumatol Date: 2021-08-05
Authors: Ridwanul Amin; Syed Rahman; Thomas E Dorner; Emma Björkenstam; Magnus Helgesson; Marie L Norredam; Marit Sijbrandij; Cansu Alozkan Sever; Ellenor Mittendorfer-Rutz Journal: Eur J Public Health Date: 2020-12-11 Impact factor: 3.367
Authors: S Rahman; S Filatova; L Chen; E Björkenstam; H Taipale; E Mittendorfer-Rutz Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2021-07-23 Impact factor: 4.328