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Published in: Social Psychiatry and Psychiatric Epidemiology 12/2009

01-12-2009 | Original Paper

Risk of mental disorders in refugees and native Danes: a register-based retrospective cohort study

Authors: Marie Norredam, A. Garcia-Lopez, N. Keiding, A. Krasnik

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 12/2009

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Abstract

Background

Refugees are vulnerable to mental health disorders because of migration trauma. However, register-based prevalence studies are missing.

Aims

To investigate the risk of mental disorders among refugees compared with that among native Danes.

Method

Refugees (n = 29,139), who received residence permission in Denmark from 1.1.1993 to 31.12.1999 were matched 1:4 on age and sex with native Danes (n = 116,556). Civil registration numbers were linked to the Danish Psychiatric Central Register to obtain data on ICD-10 diagnosis upon discharge for all first-time psychiatric hospital contacts for refugees (n = 2,120) and native Danes (n = 5,044) between 1.1.1994 and 31.12.2003. Treated prevalence was then calculated using a Poisson regression model.

Results

Refugee men (RR = 2.02; 95%CI = 1.75–2.34) and refugee women (RR = 1.49; 95%CI = 1.29–1.72) had higher overall risks of having a first-time psychiatric contact for mental disorders than did native Danes; specific risks of psychotic, affective and neurotic disorders were even higher. The results were most striking for refugee men, and for refugees from the former Yugoslavia, Iraq and the Middle East.

Conclusions

Refugees have high rates of various mental disorders. Healthcare services should target refugees’ mental health from arrival in the receiving country.
Literature
1.
go back to reference United Nations High Commissioner for Refugees (2006) Asylum levels and trends in industrialized countries. Overview of asylum applications lodged in European and Non-European industrialized countries in 2006. 23-7-2007, Geneva United Nations High Commissioner for Refugees (2006) Asylum levels and trends in industrialized countries. Overview of asylum applications lodged in European and Non-European industrialized countries in 2006. 23-7-2007, Geneva
2.
go back to reference The Danish Immigration Service (2006) Facts and Figures, Copenhagen, The Danish Immigration Service The Danish Immigration Service (2006) Facts and Figures, Copenhagen, The Danish Immigration Service
3.
go back to reference United Nations (1951) United Nations Refugee Convention, Article 1, United Nations United Nations (1951) United Nations Refugee Convention, Article 1, United Nations
4.
5.
go back to reference Hondius AJ, van Willigen LH, Kleijn WC, van der Ploeg HM (2000) Health problems among Latin-American and middle-eastern refugees in The Netherlands: relations with violence exposure and ongoing sociopsychological strain. J Trauma Stress 13(4):619–634CrossRefPubMed Hondius AJ, van Willigen LH, Kleijn WC, van der Ploeg HM (2000) Health problems among Latin-American and middle-eastern refugees in The Netherlands: relations with violence exposure and ongoing sociopsychological strain. J Trauma Stress 13(4):619–634CrossRefPubMed
6.
go back to reference Laban CJ, Gernaat HB, Komproe IH, van dT I, de Jong JT (2005) Postmigration living problems and common psychiatric disorders in Iraqi asylum seekers in the Netherlands. J Nerv Ment Dis 193(12):825–832CrossRefPubMed Laban CJ, Gernaat HB, Komproe IH, van dT I, de Jong JT (2005) Postmigration living problems and common psychiatric disorders in Iraqi asylum seekers in the Netherlands. J Nerv Ment Dis 193(12):825–832CrossRefPubMed
7.
go back to reference Lindencrona F, Ekblad S, Hauff E (2008) Mental health of recently resettled refugees from the Middle East in Sweden: the impact of pre-resettlement trauma, resettlement stress and capacity to handle stress. Soc Psychiatry Psychiatr Epidemiol 43(2):121–131CrossRefPubMed Lindencrona F, Ekblad S, Hauff E (2008) Mental health of recently resettled refugees from the Middle East in Sweden: the impact of pre-resettlement trauma, resettlement stress and capacity to handle stress. Soc Psychiatry Psychiatr Epidemiol 43(2):121–131CrossRefPubMed
8.
go back to reference Norredam M, Mygind A, Krasnik A (2006) Access to health care for asylum seekers in the European Union–a comparative study of country policies. Eur J Public Health 16(3):286–290CrossRefPubMed Norredam M, Mygind A, Krasnik A (2006) Access to health care for asylum seekers in the European Union–a comparative study of country policies. Eur J Public Health 16(3):286–290CrossRefPubMed
9.
go back to reference Favaro A, Maiorani M, Colombo G, Santonastaso P (1999) Traumatic experiences, posttraumatic stress disorder, and dissociative symptoms in a group of refugees from former Yugoslavia. J Nerv Ment Dis 187(5):306–308CrossRefPubMed Favaro A, Maiorani M, Colombo G, Santonastaso P (1999) Traumatic experiences, posttraumatic stress disorder, and dissociative symptoms in a group of refugees from former Yugoslavia. J Nerv Ment Dis 187(5):306–308CrossRefPubMed
10.
go back to reference Hermansson AC, Timpka T, Thyberg M (2002) The mental health of war-wounded refugees: an 8-year follow-up. J Nerv Ment Dis 190(6):374–380CrossRefPubMed Hermansson AC, Timpka T, Thyberg M (2002) The mental health of war-wounded refugees: an 8-year follow-up. J Nerv Ment Dis 190(6):374–380CrossRefPubMed
11.
go back to reference Lie B (2002) A 3-year follow-up study of psychosocial functioning and general symptoms in settled refugees. Acta Psychiatr Scand 106(6):415–425CrossRefPubMed Lie B (2002) A 3-year follow-up study of psychosocial functioning and general symptoms in settled refugees. Acta Psychiatr Scand 106(6):415–425CrossRefPubMed
12.
go back to reference Steel Z, Silove D, Phan T, Bauman A (2002) Long-term effect of psychological trauma on the mental health of Vietnamese refugees resettled in Australia: a population-based study. Lancet 360(9339):1056–1062CrossRefPubMed Steel Z, Silove D, Phan T, Bauman A (2002) Long-term effect of psychological trauma on the mental health of Vietnamese refugees resettled in Australia: a population-based study. Lancet 360(9339):1056–1062CrossRefPubMed
13.
go back to reference Turner SW, Bowie C, Dunn G, Shapo L, Yule W (2003) Mental health of Kosovan Albanian refugees in the UK. Br J Psychiatry 182:444–448CrossRefPubMed Turner SW, Bowie C, Dunn G, Shapo L, Yule W (2003) Mental health of Kosovan Albanian refugees in the UK. Br J Psychiatry 182:444–448CrossRefPubMed
14.
go back to reference Leao TS, Sundquist J, Frank G, Johansson LM, Johansson SE, Sundquist K (2006) Incidence of schizophrenia or other psychoses in first- and second-generation immigrants: a national cohort study. J Nerv Ment Dis 194(1):27–33CrossRefPubMed Leao TS, Sundquist J, Frank G, Johansson LM, Johansson SE, Sundquist K (2006) Incidence of schizophrenia or other psychoses in first- and second-generation immigrants: a national cohort study. J Nerv Ment Dis 194(1):27–33CrossRefPubMed
15.
go back to reference Mitter PR, Krishnan S, Bell P, Stewart R, Howard RJ (2004) The effect of ethnicity and gender on first-contact rates for schizophrenia-like psychosis in Bangladeshi, Black and White elders in Tower Hamlets, London. Int J Geriatr Psychiatry 19(3):286–290CrossRefPubMed Mitter PR, Krishnan S, Bell P, Stewart R, Howard RJ (2004) The effect of ethnicity and gender on first-contact rates for schizophrenia-like psychosis in Bangladeshi, Black and White elders in Tower Hamlets, London. Int J Geriatr Psychiatry 19(3):286–290CrossRefPubMed
16.
go back to reference World Health Organisation (2003) List of memberstates by WHO region and mortality stratum. World Health Reports, pp 182–184 World Health Organisation (2003) List of memberstates by WHO region and mortality stratum. World Health Reports, pp 182–184
17.
go back to reference Singh SP, Burns T (2006) Race and mental health: there is more to race than racism. BMJ 333(7569):648–651CrossRefPubMed Singh SP, Burns T (2006) Race and mental health: there is more to race than racism. BMJ 333(7569):648–651CrossRefPubMed
18.
go back to reference Crosby SS, Norredam M, Paasche-Orlow MK, Piwowarczyk L, Heeren T, Grodin MA (2006) Prevalence of torture survivors among foreign-born patients presenting to an urban ambulatory care practice. J Gen Intern Med 21(7):764–768CrossRefPubMed Crosby SS, Norredam M, Paasche-Orlow MK, Piwowarczyk L, Heeren T, Grodin MA (2006) Prevalence of torture survivors among foreign-born patients presenting to an urban ambulatory care practice. J Gen Intern Med 21(7):764–768CrossRefPubMed
19.
go back to reference Mollica RF, McInnes K, Poole C, Tor S (1998) Dose–effect relationships of trauma to symptoms of depression and post-traumatic stress disorder among Cambodian survivors of mass violence. Br J Psychiatry 173:482–488CrossRefPubMed Mollica RF, McInnes K, Poole C, Tor S (1998) Dose–effect relationships of trauma to symptoms of depression and post-traumatic stress disorder among Cambodian survivors of mass violence. Br J Psychiatry 173:482–488CrossRefPubMed
20.
go back to reference Momartin S, Silove D, Manicavasagar V, Steel Z (2004) Comorbidity of PTSD and depression: associations with trauma exposure, symptom severity and functional impairment in Bosnian refugees resettled in Australia. J Affect Disord 80(2–3):231–238CrossRefPubMed Momartin S, Silove D, Manicavasagar V, Steel Z (2004) Comorbidity of PTSD and depression: associations with trauma exposure, symptom severity and functional impairment in Bosnian refugees resettled in Australia. J Affect Disord 80(2–3):231–238CrossRefPubMed
21.
go back to reference Kivling-Boden G, Sundbom E (2002) The relationship between post-traumatic symptoms and life in exile in a clinical group of refugees from the former Yugoslavia. Acta Psychiatr Scand 105(6):461–468CrossRefPubMed Kivling-Boden G, Sundbom E (2002) The relationship between post-traumatic symptoms and life in exile in a clinical group of refugees from the former Yugoslavia. Acta Psychiatr Scand 105(6):461–468CrossRefPubMed
22.
go back to reference Sundquist J, Johansson SE (1996) The influence of exile and repatriation on mental and physical health. A population-based study. Soc Psychiatry Psychiatr Epidemiol 31(1):21–28PubMed Sundquist J, Johansson SE (1996) The influence of exile and repatriation on mental and physical health. A population-based study. Soc Psychiatry Psychiatr Epidemiol 31(1):21–28PubMed
23.
go back to reference Fenta H, Hyman I, Noh S (2007) Health service utilization by Ethiopian immigrants and refugees in Toronto. J Immigr Minor Health 9(4):349–357CrossRefPubMed Fenta H, Hyman I, Noh S (2007) Health service utilization by Ethiopian immigrants and refugees in Toronto. J Immigr Minor Health 9(4):349–357CrossRefPubMed
24.
go back to reference Steel Z, Silove D, Chey T, Bauman A, Phan T, Phan T (2005) Mental disorders, disability and health service use amongst Vietnamese refugees and the host Australian population. Acta Psychiatr Scand 111(4):300–309CrossRefPubMed Steel Z, Silove D, Chey T, Bauman A, Phan T, Phan T (2005) Mental disorders, disability and health service use amongst Vietnamese refugees and the host Australian population. Acta Psychiatr Scand 111(4):300–309CrossRefPubMed
Metadata
Title
Risk of mental disorders in refugees and native Danes: a register-based retrospective cohort study
Authors
Marie Norredam
A. Garcia-Lopez
N. Keiding
A. Krasnik
Publication date
01-12-2009
Publisher
D. Steinkopff-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 12/2009
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-009-0024-6

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