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Location of Nizip District of Gaziantep Province in Turkey and Jarabulus District of Aleppo in Syria
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Objectives:
To compare frequencies of some mental health disorders between Syrian refugees living in Turkey and internally displaced persons in Syria, and to identify factors associated with posttraumatic stress disorder and major depressive disorder.
Methods:
We carried out a field survey in May 2017 among 540 internally displaced persons in Sy...
Context in source publication
Context 1
... chose Nizip for com- parison in view of its geographical and cultural proximity. Nizip and Jarabulus are on one of the busiest routes between Turkey and Syria, located on either side of the Karkamıs¸borderKarkamıs¸Karkamıs¸border crossing (Figure 1). These settings allowed us to compare mental disorders among conflict-affected people from the same country living in different contexts (refugees or IDPs) and economic conditions, or in the actual conflict area, but still in geographically and culturally close areas. ...
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Background:
Turkey is the leading refugee-hosting country in the world. However, there are few studies which investigate mental wellbeing of refugee children in Turkey.
Objective:
The paper aims to examine the prevalence of emotional and behavioural problems and associated risk factors among Syrian refugee minors in Turkey.
Methods:
The research...
Citations
... Studies show that postmigration conditions seem to play the biggest role (Tekeli-Yesil et al., 2018), showing that mental health disorders were found to be less in the Syrian IDPs compared to the refugees living in Turkey. Therefore, focusing on the right intervention in the aftermath of the traumatic event and the efficient usage of resources is crucial. ...
As the Syrian crisis has reached its 10th year, this paper explores posttraumatic growth and the related factors among Syrian refugees in Turkey, with the aim of having a better understanding of the predictors of PTG and the risk factors that may play a role in the inhibition of the growth. In this cross-sectional study, 217 displaced Syrian refugees completed the Post Traumatic Growth Inventory (PTGI), Harvard Trauma Questionnaire (HTQ), Brief COPE, General Self-Efficacy Scale (GSES), PTSD Checklist for DSM-5 (PCL-5), and sociodemographic information form by a self-reported online survey. Risk and protective factors were associated in bivariate analysis with growth p < 0.05 and were retained in multiple regression models to control the confound-ers. Participants' 60.7% were females, and the mean age was 32.6 ± 9.4 years. Growth was found to be highest in the Personal Strengths, New Possibilities and Appreciation of Life, Relating to Others, and Spiritual Change. While the consistency of job education, economic status, education level, number of children, level of self-efficacy, level of Turkish, active coping style, religious coping, and self-distraction (p < 0.05) were protective factors, the number of traumatic events, and the PTSD symptoms and self-blame were risk factors (p < 0.05) in multiple analysis. However, no significant relationship was found for the variables of marital status, taking support, self-distraction, emotional and instrumental support, positive reframing, planning, cultural perception, working type, and age (p > 0.05). In conclusion, the findings have provided valuable insight into the domains of the growth among Syrian refugees and discussed both clinical and research-based future recommendations that could be made to improve the mental health of the refugees based on the obtained results.
... Findings from hierarchical regression analyses in Turkish camps demonstrated that post-displacement living difficulties had a more substantial impact on mental health outcomes compared to pre-displacement traumatic events (53). When comparing the mental health of Syrian refugees in Turkey with internally displaced individuals in Syria, a study found a higher prevalence of major depressive disorder among Turkish refugees (56). Notably, post-displacement factors were identified as stronger predictors of depression and PTSD than pre-displacement events (56). ...
... Studies comparing the prevalence of mental disorders in Syrian refugees across different countries reveal that those who resettled in high income countries, such as Sweden or Germany, experience lower levels of PTSD (33), anxiety symptoms, and depressive symptoms (57) compared to those living in Turkey. In addition, higher prevalence rates of panic disorder, PTSD, and generalized anxiety disorder were found among internally displaced refugees in Syria than those in Turkey (56). This difference may be linked to the availability of better living conditions in Turkey, including secure and stable housing, access to clean water and sanitation, and a safer environment, as evidenced by 74.4% expressing satisfaction with their living conditions in Turkey (58). ...
Researchers have documented multiple stressors and mental health problems along the journey of refugees as they are displaced to seek refuge in nearby and remote host countries. This article examines published research on Syrian refugees to propose a framework to conceptualize Syrian refugees’ pre- and post-stressors and their collective impact on their mental health. The proposed framework provides a comprehensive understanding of the interconnected pathways between pre-displacement stressors, post-displacement stressors, and mental health outcomes for Syrian refugees. Pre-displacement stressors are best captured by the concept of trauma centrality and emotional suppression. Post-displacement stressors, categorized under financial, political, and social themes, have a direct impact on the mental health of the refugees, but could also play a partial mediating role on the impact of pre-displacement stressors on mental health. The framework suggests a direct pathway between the experience of war-related traumatic events and mental health and introduces the country of residence as a potential moderator of the severity of mental health. The latter is primarily influenced by local policies and the host communities’ acceptance of refugees. We believe that the proposed framework can guide the work of researchers, policymakers, and practitioners concerned with the mental health and well-being of Syrian refugees. Additionally, although based on the experience of Syrian refugees, it presents a holistic perspective that could be adapted in other refugee settings.
... Syrian refugee depression rates surged to 44% from 6.5% pre-war [23]. Stress perceived more from family separation and seeking refuge abroad was less pronounced in participants staying with families in their home country, benefiting from protective factors like familiar routines and family networks [24]. Consequently, the majority were classified as normal on the stress scale, emphasizing the role of daily stressors in shaping resilience to psychological distress among internally displaced versus externally displaced war-affected children. ...
Background: The Syrian conflict has had a negative impact on the psychological and overall health of adolescents. However, little is known about the oral health of those who are internally displaced.
Aims: The purpose of this study was to investigate the relationship between mental health state and self-reported oral health and habits in Syrian adolescents.
Methods: A total of 99 adolescents living in Syria were included in the study. The participants were given four questionnaires: the International Trauma Questionnaire (ITQ), the Depression Anxiety Stress Scale-21 (DASS-21), the Epworth Sleepiness Scale (ESS), and the World Health Organization (WHO) Oral Health Questionnaire for Children (2013). The relationship between self-reported oral and mental health was evaluated.
Results: Adolescents with symptoms of mental disturbances or abnormal sleep conditions were statistically more likely to self-report the health of their teeth and gums as below average, less likely to brush their teeth regularly, and reported more frequent smoking (p<0.05). Moreover, symptoms of mental disturbances and abnormal sleep conditions were statistically more likely in adolescents living in rural areas and whose parents’ education did not exceed secondary school (p<0.05).
Conclusion: Syrian adolescents reported mental disturbances, which were reflected in their poor oral health and habits. These findings confirm the need for psychiatric and oral health care programs for Syrians who remain in areas of conflict.
... The participants reported dealing with language barriers, stigma and discrimination, which caused them to feel anger, anxiety and fear. The language barrier is a major obstacle that refugees experience and is described widely in the literature (Doğan et al., 2019;Hendrickx et al., 2020;Javanbakht et al., 2019;Kiselev, Pfaltz, Haas, et al., 2020;Tekkeli-Yesil et al., 2018). Doğan et al. (2019) found that Syrians living in Turkiye could use the services in a limited way because of the language barrier and experience problems making appointments. ...
... Being a refugee increases the risk of mental disorders because of various negative factors, such as exposure to psychological and physical violence due to migration, traumatic memories and economic problems. Trauma-related disorders, anxiety disorders and depressive disorders are pervasive among refugees; thus, refugees are in great need of mental health services (Acartürk et al., 2021;Hendrickx et al., 2020;Javanbakht et al., 2019;Kiselev, Pfaltz, Haas, et al., 2020;Mesa-Vieira et al., 2022;Tekkeli-Yesil et al., 2018); however, they use these services less frequently than the general population (Kallakorpi et al., 2019;Kiselev, Pfaltz, Haas, et al., 2020;. In this study, the participants stated that they did not receive mental health services in their own countries but received these services in Turkiye. ...
... Nevertheless, they also experienced economic, transportation and bureaucratic difficulties and could not always book healthcare appointments. Refugees often leave their country and their existing lives behind, and they have to go on with their lives in a new geography while experiencing economic problems (Doğan et al., 2019;Javanbakht et al., 2019;Tekkeli-Yesil et al., 2018). In addition, refugees worldwide deal with bureaucratic difficulties, which cause them to experience more stress. ...
Aim: This study examined the experiences of Syrian refugees in a community center in Turkiye as they access mental health services and receive psychiatric nursing care.
Design: A qualitative design was adopted in the study.
Methods: Data were collected from southern Turkiye between November and December 2021. The researchers conducted three semi-structured focus group interviews. Colaizzi's phenomenological method was followed to analyze the qualitative data. A total of 19 Syrian refugees participated in the focus group interviews.
Results: Three key themes related to immigrants’ experiences of receiving mental health services and nursing care were identified: barriers to receiving mental health services, coping with negative experiences in Turkiye, and satisfaction with mental health services. The participants identified the barriers they experienced while receiving health services as those pertaining to language, discrimination, and stigmatization. They also mentioned the methods of coping with these negative experiences in Turkiye. Despite their negative experiences, they expressed satisfaction with the mental health services they received, especially psychiatric nursing care.
Conclusions: This study determined that Syrian refugees face barriers in accessing and receiving mental health services. They stated that mental health professionals in Turkiye approach them with empathy, particularly those in psychiatric nursing. Healthcare professionals may be trained in culturally sensitive care to increase awareness.
Impact: Studies have frequently examined the experiences of nurses providing care to refugees, but few have focused on evaluating nursing care from the perspective of refugees. Syrian refugees have reported various obstacles in accessing and receiving mental healthcare services. Health professionals, especially psychiatric nurses in mental health psychosocial support centers, must facilitate the processes to eliminate these obstacles.
Reporting Method: The consolidated criteria for reporting qualitative research (COREQ) was used.
Patient Contribution: Ethical and institutional permission, verbal and written informed consent were obtained from the participants who were followed up at the institution and agreed to participate.
Keywords: Health; Immigrant; Mental Health; Nurses; Psychiatric Nursing; Refugees
... Of the available studies, the incidence of suicidality among refugees appears to vary greatly, estimated at 3.4 to 34% according to a 2010 review (Vijayakumar & Jotheeswaran, 2010) and even as high as 91% in a study of Afghan refugee women (Rahman & Hafeez, 2003). Since that review in 2010, suicidality rates continue to vary greatly between studies (Nam et al., 2021;Norredam et al., 2013;NPR, 2017;Rahman & Hafeez, 2003;Tekeli-Yesil et al., 2018;UNHCR, 2021). Most research has focused on small groups of specific refugee communities within specific host countries (Nam et al., 2021;Norredam et al., 2013;NPR, 2017;Rahman & Hafeez, 2003;Tekeli-Yesil et al., 2018;UNHCR, 2021;Vijayakumar & Jotheeswaran, 2010). ...
... Since that review in 2010, suicidality rates continue to vary greatly between studies (Nam et al., 2021;Norredam et al., 2013;NPR, 2017;Rahman & Hafeez, 2003;Tekeli-Yesil et al., 2018;UNHCR, 2021). Most research has focused on small groups of specific refugee communities within specific host countries (Nam et al., 2021;Norredam et al., 2013;NPR, 2017;Rahman & Hafeez, 2003;Tekeli-Yesil et al., 2018;UNHCR, 2021;Vijayakumar & Jotheeswaran, 2010). In Denmark, a large population-based study reported suicide rates being lower among male refugees than males in the general population, but there was no difference among women (Norredam et al., 2013). ...
... Individual interviews and oral reports indicated for years that the suicide rate among Syrian refugees was high (NPR, 2017;UNHCR, 2021) and in 2017 Al Ibraheem et al. reported that 11.3% of Syrian participants in their study stated that they had a plan or history of attempting suicide, a rate which is over two times greater than that in the United States of America (Al Ibraheem et al., 2017). These findings were followed later in 2018 by Tekeli-Yesil et al. who reported that more than 50% of their sample were at high risk for suicide (Tekeli-Yesil et al., 2018). Research on Syrian refugee suicidal ideation in adults has been sparse and there have been no research studies focused on Syrian refugee children. ...
History of adverse events in childhood is one of the strongest predictors of developing negative mental health outcomes with suicidality being the most devastating consequence. Syrian refugee children are at very high risk of developing mental illness, however, the prevalence and significance of suicidal thoughts among this population remains undocumented. A total of 339 Syrian refugee children and adolescents aged 10 to 17 years and their parents living in Jordan were surveyed to assess resilience, depression and suicidality. Demographics and parental depression were correlated with child suicidality. Multivariate logistic regression analyses were used to determine the predictors of suicidality within this population. A total of 94 (27.7%) children reported suicidal statements. In the multivariate analyses we found that younger children were more likely to state suicidal ideation than older children. Of the children who stated suicidal ideation, 49 were in primary school, 19 in pre-secondary and 26 in upper-secondary school. In the multivariate analyses, mild (OR 2.633 (95% CI 1.283, 5.709)) and high (OR 6.987 (95% CI 3.532, 14.614)) depression levels among the surveyed children were predictive of suicidality. Experiencing bullying was also predictive of suicidality (OR 2.181 (95% CI 1.179, 4.035)) when compared to those who did not report any bullying. We report high rates of suicidal ideation among Syrian refugee children, especially in children with exposure to pre-existing depression or bullying. Prevention through raising awareness, education and early detection of depression are needed to address suicidality in this and other vulnerable populations of children.
... Risk factors for PTSD in individuals who have had traumatic war experiences are considered by researchers in terms of the following aspects: sociodemographic factors (Catani, 2018;Kurapov et al., 2022a;Rizkalla & Segal, 2018), psychological conditions (Rybinska et al., 2022), mental disorders present (Rizkalla & Segal, 2018;Kakaje et al., 2021), place of residence (Tekeli-Yesil et al., 2018), and psychological flexibility (Meyer et al., 2018). In particular, sociodemographic factors that may increase the risk of PTSD include variables such as gender, age, language, marital status, education level, and income (Catani, 2018;Kurapov et al., 2022a;Rizkalla & Segal, 2018). ...
... According to Rizkalla & Segal (2018) and Kakaje et al. (2021), the likelihood of developing PTSD due to war experiences is increased in those with affective disorders and other types of mental disorders. Some researchers have also shown that refugees and internally displaced persons who have been forced to leave their places of residence are more likely to develop PTSD when confronted with military conflicts (Kakaje et al., 2021;Tekeli-Yesil et al., 2018). In this regard, the risks of PTSD during a war and after the end of military conflicts increase for younger people, those who are married, those with low levels of frustration, and those with insufficient psychological flexibility. ...
This research focuses on the assessment of post-traumatic growth (PTG) in an ongoing crisis situation-namely, the war in Ukraine. This research was designed as a cross-sectional correlational study and was conducted 6 months after the beginning of the Rus-sian invasion of Ukraine. The authors focused on the following sociodemographic aspects: gender, age, marital status, number of children, place of current residence (either within or outside Ukraine), subjective evaluation of financial state, satisfaction with current living conditions, and current employment status. Personal life-experiences of traumatic events were assessed using the Life Events Checklist (LEC-5); PTG was assessed using the Post-Traumatic Growth Inventory (PTGI). The study included 706 participants (age M = 32.1); 155 males and 541 females. Using one-and two-way ANOVA, we answered the following research questions: To what extent do individuals living in war-torn areas exhibit indications of PTG? Can sociodemographic variables serve as reliable predictors of PTG? How do levels of PTG differ between individuals residing in Ukraine and those living abroad? What is the relationship between PTG and war-related trauma? It was found that people living in war-torn areas exhibit moderate levels of PTG. Women are more prone to PTG than men; younger and older participants show higher levels of PTG, while middle-aged participants exhibit lower levels; and financial security increases PTG. Presence in Ukraine increases personal strength, while living outside of Ukraine increases the possibilities for new PTG strategies. Trauma exposure during the war does not increase levels of PTG.
... 10,104-108 9.2-38.8 10,107,108 Note: Observed prevalence as reported in selected studies identified in our structure review (published from 2015-2021). ...
Background: Syrian refugees have a high burden of mental health symptoms and face challenges in accessing mental health and psychosocial support (MHPSS). This study assesses health system responsiveness (HSR) to the MHPSS needs of Syrian refugees, comparing countries in Europe and the Middle East to inform recommendations for strengthening MHPSS systems.
Methods: A mixed-methods rapid appraisal methodology guided by an adapted WHO Health System Framework was used to assess HSR in eight countries (Egypt, Germany, Jordan, Lebanon, Netherlands, Sweden, Switzerland, and Türkiye). Quantitative and qualitative analysis of primary and secondary data was used. Data collection and analysis were performed iteratively by multiple researchers. Country reports were used for comparative analysis and synthesis.
Results: We found numerous constraints in HSR: i) Too few appropriate mental health providers and services; ii) Travel-related barriers impeding access to services, widening rural-urban inequalities in the distribution of mental health workers; iii) Cultural, language, and knowledge-related barriers to timely care likely caused by insufficient numbers of culturally sensitive providers, costs of professional interpreters, somatic presentations of distress by Syrian refugees, limited mental health awareness, and stigma associated to mental illness; iv) High out-of-pocket costs for psychological treatment and transportation to services reducing affordability, particularly in middle-income countries; v) Long waiting times for specialist mental health services; vi) Information gaps on the mental health needs of refugees and responsiveness of MHPSS systems in all countries. Six recommendations are provided.
Conclusions: All eight host countries struggle to provide responsive MHPSS to Syrian refugees. Strengthening the mental health workforce (in terms of quantity, quality, diversity, and distribution) is urgently needed to enable Syrian refugees to receive culturally appropriate and timely care and improve mental health outcomes. Increased financial investment in mental health and improved health information systems are crucial.
... Während die 12-Monats-Prävalenz von Depressionen in der deutschen Allgemeinbevölkerung bei etwa sieben Prozent liegt (Hapke et al., 2017;Jacobi et al., 2014) und damit bereits als eine der häufigsten psychischen Erkrankungen gilt, wurden in Studien zu syrischen Geflüchteten sogar vier bis achtfach so hohe Punktprävalenzen gefunden (35-65%) (Acarturk et al., 2018;Javanbakht et al., 2019;M'Zah et al., 2019;Naja et al., 2016;Peconga & Høgh Thøgersen, 2020;Poole et al., 2018;Tekeli-Yesil et al., 2018). Dabei konnten hohe Zusammenhänge mit erlebten Traumata als auch postmigratorischen Stressoren wie mangelnden Sprachkenntnissen, schlechten Wohnverhältnissen und fehlender sozialer Unterstützung gefunden werden (Ahmad et al., 2020;Kaya et al., 2019). ...
... Prävalenzraten im Bereich von 26 bis 60% hervor (Fuhr et al., 2019;Javanbakht et al., 2019;M'Zah et al., 2019;Peconga & Høgh Thøgersen, 2020;Tekeli-Yesil et al., 2018), die damit erneut deutlich über der Prävalenz von 15% in der deutschen Allgemeinbevölkerung liegen. ...
Hintergrund: Mit Zuspitzung der Lage im vom Bürgerkrieg geplagten Land Syrien suchten in den Jahren 2014-2016 Hunderttausende Menschen Zuflucht in Deutschland. Durch die Flucht, die traumatischen Erlebnisse in der Heimat und zusätzliche psychosoziale Stressoren im Aufnahmeland ist ein großer Teil der syrischen Geflüchteten psychisch stark belastet. Besonders das häufige Vorkommen von posttraumatischen Belastungsstörungen (PTBS), Depressionen und Angststörungen wurde bereits in querschnittlichen Untersuchungen belegt. Wenig bekannt ist jedoch darüber, wie sich die Prävalenz dieser Erkrankungen als auch der Zusammenhang mit psychosozialen Faktoren mit steigender Dauer im Aufnahmeland verändern (Fragestellung Teilstudie I). Auch über das Vorliegen von somatischem Distress, einer häufigen Reaktion auf psychosoziale Belastungen, und dessen Assoziationen mit bedeutenden prä- und postmigratorischen Faktoren liegen bei syrischen Geflüchteten kaum Daten vor (Fragestellung Teilstudie II). Zudem existiert in Deutschland bis heute keine flächendeckende Erfassung der psychischen Gesundheit ankommender Geflüchteter, weshalb in Teilstudie III die Eignung des Refugee Health Screeners (RHS) als ökonomisches Screening- Instrument zur Identifizierung von vulnerablen syrischen Geflüchteten überprüft werden sollte. Methode: Für die hier durchgeführten Analysen wurde ein prospektives register-basiertes Studiendesign mit zwei Messzeitpunkten entworfen. Beim ersten Messzeitpunkt im Jahr 2017 nahmen 200 der zum damaligen Zeitpunkt 518 beim Jobcenter Erlangen registrierten syrischen Geflüchteten mit Aufenthaltsgenehmigung teil. Zum zweiten Messzeitpunkt, 1,5 Jahre später, im Jahr 2019, erschienen noch 108 der anfangs 200 syrischen Geflüchteten und bildeten somit die Gesamtstichprobe für den längsschnittlichen Vergleich aus Teilstudie I. Zusätzlich kamen weitere acht syrische Geflüchtete, die beim ersten Messzeitpunkt nicht teilgenommen hatten und somit nur für die Querschnittsuntersuchungen aus Teilstudie II und III einbezogen wurden. Anhand von Selbstbeurteilungsfragebögen wurden zu beiden Messzeitpunkten soziodemographische und migrationsspezifische Daten, posttraumatische Belastungssymptome (PTBS; Essener Trauma- Inventar), depressive Symptome (Patient Health Questionnaire-9) und Angstsymptome (Skala zur generalisierten Angst, GAD-7) erhoben. Zum zweiten Messzeitpunkt wurden zusätzliche Fragebögen zu postmigratorischen Belastungsfaktoren (Barcelona Immigration Stress Scale) und somatischem Distress (PHQ-15) als auch ein Screener zur psychischen Gesundheit Geflüchteter (Refugee Health Screener-15) eingesetzt, dessen psychometrische Eigenschaften es zu untersuchen galt. Ergebnisse: Die längsschnittliche Auswertung aus Teilstudie I ergab, dass zum Zeitpunkt der ersten Erhebung im Jahr 2017 26,9% der 108 Teilnehmer*innen die Kriterien einer klinisch relevanten Depressionssymptomatik, 16,7% die einer Angstsymptomatik und 13,9% die einer PTBS erfüllten. Zum zweiten Messzeitpunkt im Jahr 2019 gaben sogar 30,6% auffällige depressive Symptome an, 15,7% überschritten den Cut-off für eine Angststörung und 13,0% den für eine PTBS. Dabei ergaben sich für keine der psychischen Belastungen signifikante Veränderungen zwischen den Messzeitpunkten. In multiplen Regressionsanalysen erreichten höhere wahrgenommene Diskriminierung, eine höhere Anzahl traumatischer Erlebnisse und eine kürzere Dauer der verbleibenden Aufenthaltserlaubnis die messzeitpunktunabhängig stärksten Zusammenhänge mit psychischer Belastung. In Teilstudie II wurde fast die Hälfte der 116 Teilnehmer*innen als Risikogruppe für somatischen Distress identifiziert (PHQ-15 ≥ 6). Darüber hinaus berichteten 24,1% von moderater bis schwerer Belastung durch somatische Symptome (PHQ-15 score ≥ 10). Die Faktoren, die damit die robustesten Zusammenhänge aufwiesen, waren: weibliches Geschlecht, Anzahl der Arztbesuche, Anzahl der traumatischen Erlebnisse, genereller psychosozialer Stress sowie komorbid vorliegende depressive und Angstsymptome. Insgesamt wurden häufige Komorbiditäten unter den untersuchten psychischen Erkrankungen gefunden. In den Analysen aus Teilstudie III wies der RHS sehr gute psychometrische Eigenschaften auf und detektierte klinisch relevante psychische Probleme im Zusammenhang mit Depressionen, Ängsten, Somatisierung und PTBS zuverlässig. Schlussfolgerungen: Die Ergebnisse dieser Arbeit weisen auf das hohe Risiko syrischer Geflüchteter hin, in Deutschland unter klinisch relevanten Symptomen mindestens einer psychischen Erkrankung zu leiden. Trotz steigender Aufenthaltsdauer in Deutschland scheint dieses Risiko zunächst auf einem konstant hohen Niveau zu verbleiben. Die Datenlage bekräftigt somit die Wichtigkeit therapeutischer Interventionen und präventiver Maßnahmen zur Reduktion der Symptomlast und Vermeidung chronischer Krankheitsverläufe in dieser Geflüchteten-Population. Dabei sollten sich therapeutische Maßnahmen nicht ausschließlich auf vergangene traumatische Ereignisse, sondern insbesondere auch auf postmigratorische Stressoren wie erlebte Diskriminierung fokussieren. Bezüglich des aufgedeckten hohen Risikos für somatischen Distress gilt es zudem, Mediziner*innen für diese Thematik zu sensibilisieren und Betroffene auf eine mögliche psychische Komponente somatischer Symptome aufmerksam zu machen. Ein frühzeitiges Screening zur Identifizierung von vulnerablen syrischen Geflüchteten, z.B. durch den RHS, könnte in Kombination mit einer angemessenen Prävention und Behandlung nicht nur die Lebensqualität und Integration syrischer Geflüchteter deutlich verbessern, sondern auch die begleitenden Gesundheitsausgaben senken.
... Beyond pre-migration traumatic events, cross-sectional studies have suggested that the post-migration conditions in the host country may be an important predictor of traumarelated symptoms among refugees [11,[33][34][35][36]. In general, uncertain asylum status, living in shared refugee accommodations, lack of language skills, and integration issues are considered to be risk factors for high and persistent mental health disorders [37]. ...
... The living conditions in Iraqi camps seem to have a negative effect on symptoms. Consistent with several studies that emphasized the post-migration situation for the maintenance of psychological symptoms [11,[33][34][35][36], we found that the refugees were exposed to a range of stressors, adversities, and new traumatic events that were associated with a worsening of symptoms. Iraq is an instable country that is confronted with ongoing conflict. ...
The findings of longitudinal studies on traumatized refugees have shown that factors related to premigration, migration, and post-migration experiences determine changes in mental health over time. The primary aim of this follow-up study was to examine the potential change in the prevalence rates of probable PTSD and depression among Syrian refugees in Iraq. An unselected group of N = 92 Syrian adult refugees was recruited from Arbat camps in Sulaymaniyah Governorate in Iraq’s Kurdistan Region and then interviewed at two different time points between July 2017 and January 2019. Locally validated instruments were used to assess traumatic events and mental health symptoms. The primary results showed no significant change in the mean scores of PTSD and depression symptoms from the first measurement to the second measurement over the course of 18 months. On the individual level, no reliable change was found for either PTSD or depression symptoms in more than three-quarters of the participants (78.3% and 77.2%, respectively). New adversities and traumatic events that occurred over the 18 months between the interviews were significant predictors of increasing trauma-related symptoms. After the flight from conflict settings, trauma-related disorders seem to be chronic for the majority of Syrian refugees. Further longitudinal studies are needed in order to identify specific risk factors that lead to maintaining or worsening mental health symptoms over time, and to explore effective therapeutic intervention methods for this traumatized population.
... These living conditions contributed to an increase in mortality and morbidity. There is empirical evidence that Syrian IDP have higher PTSD than their fellow Syrian refugees in Turkey, while refugees have more depressive disorders (Tekeli-Yesil et al., 2018). Syrian civil war has persisted for over 11 years, making it a source of Type III-c trauma due to its prolonged time scale. ...
This study aimed to validate the Type III continuous traumatic stress model assumptions and use it to assess the effect of intersected traumas of civil war and COVID-19 stressors on internally displaced Syrian people. We recruited 891 Syrians from camps (46.5% females, aged 18–90 years [ M = 30.81, SD = 12.04]). We measured COVID-19 stressors, posttraumatic stress disorder (PTSD), complex PTSD (CPTSD), depression, anxiety, and executive functions to assess the variables related to peri-post Type III mental health syndrome. We measured Type I, II, and III traumas and Type III trauma subtypes. To explore the significance of differences between correlation sizes and the comparative severity of each trauma type, we calculated Fisher z scores. We performed path analysis with trauma Types III and II as correlated independent variables and COVID-19 stressors' impact on peri-post Type III trauma mental health syndrome to check their proliferation and impact. Of the sample, COVID-19 had infected 45.9%, 33.1% fit the diagnostic criteria for CPTSD, and 13.9% fit the diagnostic criteria for PTSD. All trauma types were associated with mental health, cognitive deficits, and COVID-19 severity, with a significantly higher association with trauma Type III. Type III-a subtype (intersected discrimination) had the highest associations with each variable. Type III was bidirectionally correlated with Type II and proliferated to Type I traumas (single past events) and COVID-19 stressors, with Type III having a larger effect size on peri-post Type III trauma mental health syndrome. The clinical and conceptual implications of the findings are discussed.
