10.6084/M9.FIGSHARE.21295585.V1
Marianna Purgato
Marianna
Purgato
Federico Tedeschi
Federico
Tedeschi
University of Verona
Giulia Turrini
Giulia
Turrini
University of Verona
Ceren Acartürk
Ceren
Acartürk
Minna Anttila
Minna
Anttila
University of Turku
Jura Augustinavicious
Jura
Augustinavicious
Josef Baumgartner
Josef
Baumgartner
Richard Bryant
Richard
Bryant
UNSW Sydney
Rachel Churchill
Rachel
Churchill
University of York
Zeynep Ilkkursun
Zeynep
Ilkkursun
Eirini Karyotaki
Eirini
Karyotaki
Thomas Klein
Thomas
Klein
Markus Koesters
Markus
Koesters
Tella Lantta
Tella
Lantta
University of Turku
Marx R. Leku
Marx R.
Leku
Michela Nosè
Michela
Nosè
Giovanni Ostuzzi
Giovanni
Ostuzzi
Mariana Popa
Mariana
Popa
Eleonora Prina
Eleonora
Prina
Marit Sijbrandij
Marit
Sijbrandij
Vrije Universiteit Amsterdam
Amsterdam UMC Location VUmc
Ersin Uygun
Ersin
Uygun
Maritta Välimäki
Maritta
Välimäki
University of Turku
Hong Kong Polytechnic University
Central South University
Lauren Walker
Lauren
Walker
University of York
Johannes Wancata
Johannes
Wancata
Ross G. White
Ross G.
White
Queen's University Belfast
Pim Cuijpers
Pim
Cuijpers
Vrije Universiteit Amsterdam
Amsterdam UMC Location VUmc
Babeș-Bolyai University
Wietse Tol
Wietse
Tol
University of Copenhagen
Corrado Barbui
Corrado
Barbui
University of Verona
Trajectories of psychosocial symptoms and wellbeing in asylum seekers and refugees exposed to traumatic events and resettled in Western Europe, Turkey, and Uganda
<p><b>Background:</b> Longitudinal studies examining mental health trajectories in refugees and asylum seekers are scarce.</p> <p><b>Objectives:</b> To investigate trajectories of psychological symptoms and wellbeing in refugees and asylum seekers, and identify factors associated with these trajectories.</p> <p><b>Method:</b> 912 asylum seekers and refugees from the control arm of three trials in Europe (<i>n</i> = 229), Turkey (<i>n</i> = 320), and Uganda (<i>n</i> = 363) were included. We described trajectories of psychological symptoms and wellbeing, and used trauma exposure, age, marital status, education, and individual trial as predictors. Then, we assessed the bidirectional interactions between wellbeing and psychological symptoms, and the effect of each predictor on each outcome controlling for baseline values.</p> <p><b>Results:</b> Symptom improvement was identified in all trials, and for wellbeing in 64.7% of participants in Europe and Turkey, versus 31.5% in Uganda. In Europe and Turkey domestic violence predicted increased symptoms at post-intervention (<i>ß</i> = 1.36, 95% CI 0.17–2.56), whilst murder of family members at 6-month follow-up (<i>ß</i> = 1.23, 95% CI 0.27–2.19). Lower wellbeing was predicted by murder of family member (<i>ß</i> = −1.69, 95% CI −3.06 to −0.32), having been kidnapped (<i>ß</i> = −1.67, 95% CI −3.19 to −0.15), close to death (<i>ß</i> = −1.38, 95% CI −2.70 to −0.06), and being in the host country ≥2 years (<i>ß</i> = −1.60, 95% CI −3.05 to −0.14). In Uganda at post-intervention, having been kidnapped predicted increased symptoms (<i>ß</i> = 2.11, 95% CI 0.58–3.65), and lack of shelter (<i>ß</i> = −2.51, 95% CI −4.44 to −0.58) and domestic violence predicted lower wellbeing (<i>ß</i> = −1.36, 95% CI −2.67 to −0.05).</p> <p><b>Conclusion:</b> Many participants adapt to adversity, but contextual factors play a critical role in determining mental health trajectories.</p> <p></p><p>Psychological symptoms improved in all participants and the trajectories went in similar directions. For wellbeing, the majority of participants in Western Europe and Turkey improved over time, while this proportion was smaller in Uganda.</p><p>Asylum seekers and refugees have the capacity to adapt to traumatic events and ongoing adversity, but contextual factors play a critical role in determining mental health trajectories.</p><p>Future interventions should focus on reinforcing wellbeing and ‘positive’ psychological outcomes, and targeting the social determinants of mental health.</p><p></p> <p>Psychological symptoms improved in all participants and the trajectories went in similar directions. For wellbeing, the majority of participants in Western Europe and Turkey improved over time, while this proportion was smaller in Uganda.</p> <p>Asylum seekers and refugees have the capacity to adapt to traumatic events and ongoing adversity, but contextual factors play a critical role in determining mental health trajectories.</p> <p>Future interventions should focus on reinforcing wellbeing and ‘positive’ psychological outcomes, and targeting the social determinants of mental health.</p>
Neuroscience
Biotechnology
Sociology
Science Policy
111714 Mental Health
Taylor & Francis
2022
2022-10-07
2023-01-16
Journal contribution
60562 Bytes
10.1080/20008066.2022.2128270
10.6084/m9.figshare.21295585
CC BY 4.0