Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review.
Open accessAbstract
Background About 13 million people are classified as refugees worldwide, and many more former refugees have been granted citizenship in their new countries. However, the prevalence of post-traumatic stress disorder, major depression, or psychotic illnesses in these individuals is not known. We did a systematic review of surveys about these disorders in general refugee populations in western countries.Methods We searched for psychiatric surveys that were based on interviews of unselected refugee populations and that included current diagnoses of post-traumatic stress disorder, major depression, psychotic illnesses, or generalised anxiety disorder. We did computer-assisted searches, scanned reference lists, searched journals, and corresponded with authors to determine prevalence rates of these mental disorders and to explore potential sources of heterogeneity, such as diagnostic criteria, sampling methods, and other characteristics.Findings 20 eligible surveys provided results for 6743 adult refugees from seven countries, with substantial variation in assessment and sampling methods. In the larger studies, 9% (99% CI 8-10%) were diagnosed with post-traumatic stress disorder and 5% (4-6%) with major depression, with evidence of much psychiatric comorbidity. Five surveys of 260 refugee children from three countries yielded a prevalence of 11% (7-17%) for post-traumatic stress disorder. Larger and more rigorous surveys reported lower prevalence rates than did studies with less optimum designs, but heterogeneity persisted even in findings from the larger studies.Interpretation Refugees resettled in western countries could be about ten times more likely to have post-traumatic stress disorder than age-matched general populations in those countries. Worldwide, tens of thousands of refugees and former refugees resettled in western countries probably have post-traumatic stress disorder.
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Refugees have higher rates of mental disorders such as depression, PTSD, anxiety disorders, and psychotic symptoms compared to non-refugee migrants.
“Several reviews have found that refugees have higher rates of mental disorders such as depression, post-traumatic stress disorder (PTSD), anxiety disorders (Fazel et al., 2005; Porter and Haslam, 2005) and psychotic symptoms compared to non-refugee migrants (Heeren et al., 2014; Hollander et al., 2016).”
From The assessment of grief in refugees and post-conflict survivors: a narrative review of etic and emic research (2018) · cites this paper as Fazel et al., 2005
Several reviews of refugee health have consistently found higher rates of distress and disorder across both physical and mental health conditions.
“Several reviews of refugee health have consistently found higher rates of distress and disorder across both physical and mental health conditions (Fazel et al., 2005; Porter and Haslam, 2005).”
From The assessment of grief in refugees and post-conflict survivors: a narrative review of etic and emic research (2018) · cites this paper as Fazel et al., 2005
Evidence suggests that migrants and refugees experience higher rates of mental illness than host populations.
“Evidence suggests that migrants and refugees experience higher rates of mental illness than host populations [14,16,17].”
From Pregnant migrant and refugee women’s perceptions of mental illness on the Thai-Myanmar border: a qualitative study (2015) · cites this paper as [17]
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- Authors
- Fazel, M., Wheeler, J., & Danesh, J.
- Affiliations
- Warneford Hospital (GB)
- University of Cambridge (GB)
- Corresponding author
- Fazel, Mina
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2005-04
- Volume
- 365
- Issue
- 9467
- Pages
- 1309-1314
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2167399205
- Cited by
- 2,292
- References
- 56
- Citations by year
- 2026: 72 · 2025: 105 · 2024: 150 · 2023: 135 · 2022: 147 · 2021: 185 · 2020: 287 · 2019: 159 · 2018: 156 · 2017: 137 · 2016: 131 · 2015: 127 · 2014: 103 · 2013: 70 · 2012: 72
- FWCI
- 4.88
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- refugees, severe mental illness, post-traumatic stress disorder, major depressive disorder, psychosis, generalized anxiety disorder, psychiatric comorbidity, refugee children, prevalence, resettled refugees, Western countries
- MeSH terms
- Anxiety Disorders, Mental Disorders, Depressive Disorder, Emigration and Immigration, Humans, Psychotic Disorders, Refugees, Stress Disorders, Post-Traumatic, Prevalence, Developed Countries
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