Gender differences in the mental health of unaccompanied refugee minors in Europe: a systematic review
Open accessAbstract
Objectives: Our aim was to summarise the current evidence regarding gender differences in the mental health of unaccompanied refugee minors (URM) and to identify gaps in research. Setting: We focused on quantitative studies presenting primary data from Organisation for Economic Co-Operation and Development(OECD)countries. Language was restricted to English or German. Participants: To be eligible, a study had to involve (former) URM who immigrated to an OECD country. Design: We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The databases MEDLINE, CINAHL, LIVIVO, PSYNDEX and PsycINFO were searched from 1990 to 2017. Studies were judged for eligibility by two independent reviewers each. We narratively summarised our results. Results: 9 primary studies, all from Europe, examined gender differences in the mental health of URM. The majority of the included studies found female URM to be more often affected by post-traumatic or depressive symptoms than their male counterparts. There is only weak evidence regarding other mental health outcomes. Two studies each conducted gender-specific analyses on anxiety and externalising behaviour, but no statistically significant differences between female and male URM were detected. Conclusions: Female gender is associated with a higher vulnerability towards certain mental health problems among URM residing in Europe. However, the lack of representative studies using reliable diagnostic methods indicates that the findings so far should be treated with caution. Further research is needed to clarify the role of gender for mental health in URM and to examine underlying mechanisms.
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Female unaccompanied minors are still extremely underrepresented in the current literature and gender differences in unaccompanied minors are under-researched.
“Despite this knowledge, female UM are still extremely underrepresented in the current literature and gender differences in UM are under-researched [87].”
From Examining cognitive behavioral therapy interventions for unaccompanied minors: a systematic review and qualitative research synthesis. (2025) · cites this paper as [87]
The Discussion (‘Challenges for further research’) says that no included study explicitly focused on gender differences and that the numbers of girls were low. This supports the claim for research on unaccompanied minors’ mental health, but the review does not establish that girls and gender differences are under-researched across the literature on unaccompanied minors generally. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe methodological drawbacks observed in this study have been reported in previous literature between 2018 and 2021.
“As the methodological drawbacks observed in this study have been reported in previous literature between 2018 and 2021 [45, 80, 84, 87] it is alarming that significant strides towards addressing these limitations have yet to be addressed.”
From Examining cognitive behavioral therapy interventions for unaccompanied minors: a systematic review and qualitative research synthesis. (2025) · cites this paper as [87]
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“Nevertheless, researchers often approach UMs with a focus on diagnoses such as post-traumatic stress disorder (PTSD) and depression (e.g. Ascher et al., 2019; Mohwinkel et al., 2018).”
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“…without a refugee background are likely to have different histories of pre-migration hardships (Mundy et al., 2020), may face different strains in the new country (Hollander et al., 2011; Mohwinkel et al., 2018), and may experience different obstacles to learning and succeeding in the new country.”
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“The populations of forced migrants and SGM are both heterogeneous, as research suggest disproportional prevalence and severity of health burdens between subgroups (Mohwinkel et al. 2018; Blackmore et al. 2020; Plöderl and Tremblay 2015).”
Family Matters: Older Refugee Minors in Vienna and Factors for Resiliency
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Mejorando la acogida de niñas y adolescentes que migran solas
Martín-González, A. P., & Monterde, C. G. (2024) · Cuadernos de Trabajo Social · doi:10.5209/cuts.93039 · Cited by 1 · see citing works
Carolo, D., Gouveia, S., & Lebre, P. (2022) · Preprints.org · doi:10.20944/preprints202208.0363.v1 · Cited by 1 · see citing works
Carolo, D., Carvalho, R., Batalha, C., Gouveia, S., & Lebre, P. (2023) · Preprints.org · doi:10.20944/preprints202208.0363.v2 · Cited by 1 · see citing works
Situación sanitaria de la población refugiada en los campos de desplazados de Grecia
Sánchez, V. D. P., & Pardo, C. G. (2020) · Revista de Investigación y Educación en Ciencias de la Salud (RIECS) · doi:10.37536/riecs.2020.5.2.230
“En cuanto a la ansiedad no parece haber diferencias entre sexos [45].”
BackgroundCorrigendum: A new device for the removal of cochlear schwannoma: A temporal bone study
Sudhoff, H. H., Riemann, C., Kim, R., Scholtz, L. U., Pfeiffer, C., Goon, P. K. C., & Todt, I. (2023) · Frontiers in Surgery · doi:10.3389/fsurg.2023.1195473
Mirmohammadkhani, M., Paknazar, M., Asl, N. S., & Paknazar, F. (2023) · Innovative Journal of Pediatrics · doi:10.5812/ijpediatr-126543
“Gender differences can also be important in mental health status (20).”
BackgroundMental Health of Refugee Minors
Emmelkamp, P. M. G. (2023) · Springer eBooks · doi:10.1007/978-3-031-34078-9_2
Eder, L. L., Martin, A., Hapfelmeier, G., & Walg, M. (2024) · Adolescents · doi:10.3390/adolescents4010003
“Among UMR, female UMR seem to reveal a higher vulnerability toward mental health problems in comparison to male UMR [68].”
ResultAvignone, T., Gemignani, M., & Alises, G. F.-P. (2025) · Journal of Ethnic and Migration Studies · doi:10.1080/1369183x.2025.2529501
“…teams is essential to meet the best interest of the child, especially in the mental health and psychosocial support areas, which are critical for unaccompanied migrant girls because of the trauma that they endure during migration (Akiyama et al. 2013; Höhne et al. 2022; Mohwinkel et al. 2018).”
I Can’t Hold On: Understanding the Instability of Female Syrian Care Leavers in Turkey
Tapan, M. G. (2025) · Child and Adolescent Social Work Journal · doi:10.1007/s10560-025-01067-1
“…and access to robust social networks have emerged as key determinants of post-care empowerment and resilience (Dutta, 2017), whereas emotional distress, including depression, anxiety, and trauma, remains prevalent among women experiencing care (Vervliet et al., 2014; Mohwinkel et al., 2018).”
Biology, conflict, and mental health: New Insights on a Critical and Growing Global Issue
Jankovic‐Rankovic, J., & Gettler, L. T. (2026) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2026.107843
Depression in Older Adult Refugees: A Scoping Review
Amanzai, H., Guruge, S., Metersky, K., Catallo, C., Al‐Hamad, A., Yasin, Y. M., Zhuang, Z. C., Wang, B. Q., Stafford, A., Wang, L., et al. (2026) · Journal of Ageing and Longevity · doi:10.3390/jal6010032
“This conflicting evidence reflects patterns in the broader refugee literature, where gender associations with adverse mental health outcomes are often inconsistent [34].”
Frigaux, A., Boulay, C., Najdini, M., Demogeot, N., Filpa, C., Robin, M., & Essadek, A. (2026) · L Évolution Psychiatrique · doi:10.1016/j.evopsy.2026.03.001
The Epidemiology of Posttraumatic Stress Disorder: A Focus on Refugee and Migrant Populations
Moran, J. K. (2026) · Springer eBooks · doi:10.1007/978-3-032-21028-9_1
Tonsing, K. N. (2026) · Journal of Evidence-Based Social Work · doi:10.1080/26408066.2026.2682547
Sahiledengle, B., Osazuwa, E., Berhe, K. T., Duko, B., Osborne, K., Guáqueta, C., & Mwanri, L. (2026) · Mental Health & Prevention · doi:10.1016/j.mhp.2026.200568
- Authors
- Mohwinkel, L.-M., Nowak, A. C., Kasper, A., & Razum, O.
- Affiliations
- Bielefeld University (DE)
- Corresponding author
- Mohwinkel, Lea-Marie
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2018-07
- Volume
- 8
- Issue
- 7
- Pages
- e022389
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC6067370
- OpenAlex
- W2885672889
- Cited by
- 65
- References
- 31
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 10 · 2023: 13 · 2022: 9 · 2021: 9 · 2020: 9 · 2019: 3
- FWCI
- 0.88
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- PUB – Publications at Bielefeld University (Bielefeld University) (submittedVersion, other-oa)
- Funders
- Ministry of Culture and Science of the German Federal State of North Rhine-Westphalia
- Topics
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Sociology and Political Science › Migration and Exile Studies
- Social Sciences › Education › Education and experiences of immigrants and refugees
- Keywords
- unaccompanied refugee children, gender differences, mental health, posttraumatic stress symptoms, depressive symptoms, anxiety, externalizing problems, women's vulnerability, refugee youth
- MeSH terms
- Adolescent, Anxiety, Child, Depression, Europe, Female, Humans, Male, Mental Health, Refugees, Sex Factors, Stress Disorders, Post-Traumatic, Minors, Vulnerable Populations
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