Long-term mental health of war-refugees: a systematic literature review
Open accessAbstract
BACKGROUND: There are several million war-refugees worldwide, majority of whom stay in the recipient countries for years. However, little is known about their long-term mental health. This review aimed to assess prevalence of mental disorders and to identify their correlates among long-settled war-refugees. METHODS: We conducted a systematic review of studies that assessed current prevalence and/or factors associated with depression and anxiety disorders in adult war-refugees 5 years or longer after displacement. We searched Medline, Embase, CINAHL, PsycINFO, and PILOTS from their inception to October 2014, searched reference lists, and contacted experts. Because of a high heterogeneity between studies, overall estimates of mental disorders were not discussed. Instead, prevalence rates were reviewed narratively and possible sources of heterogeneity between studies were investigated both by subgroup analysis and narratively. A descriptive analysis examined pre-migration and post-migration factors associated with mental disorders in this population. RESULTS: The review identified 29 studies on long-term mental health with a total of 16,010 war-affected refugees. There was significant between-study heterogeneity in prevalence rates of depression (range 2.3-80%), PTSD (4.4-86%), and unspecified anxiety disorder (20.3-88%), although prevalence estimates were typically in the range of 20% and above. Both clinical and methodological factors contributed substantially to the observed heterogeneity. Studies of higher methodological quality generally reported lower prevalence rates. Prevalence rates were also related to both which country the refugees came from and in which country they resettled. Refugees from former Yugoslavia and Cambodia tended to report the highest rates of mental disorders, as well as refugees residing in the USA. Descriptive synthesis suggested that greater exposure to pre-migration traumatic experiences and post-migration stress were the most consistent factors associated with all three disorders, whilst a poor post-migration socio-economic status was particularly associated with depression. CONCLUSIONS: There is a need for more methodologically consistent and rigorous research on the mental health of long-settled war refugees. Existing evidence suggests that mental disorders tend to be highly prevalent in war refugees many years after resettlement. This increased risk may not only be a consequence of exposure to wartime trauma but may also be influenced by post-migration socio-economic factors.
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The selection of covariates was based on knowledge from existing literature investigating factors predicting treatment outcome and refugee mental health.
“The selection of cova riates was based on knowledge from existing literature investigating factors predicting treatment outcome and refugee mental health (Van Wyk et al., 2012; Bogic et al., 2015; Sonne et al., 2016).”
From Refugees versus persons family reunified to a refugee: A comparison of sociodemographic factors, trauma history, baseline psychopathology and treatment effectiveness (2023) · cites this paper as Bogic et al., 2015
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- Authors
- Bogic, M., Njoku, A., & Priebe, S.
- Affiliations
- Horizon Health Network (CA)
- Queen Mary University of London (GB)
- Venue
- BMC International Health and Human Rights
- Published
- 2015-10-28
- Volume
- 15
- Issue
- 1
- Pages
- 29-29
- ISSN
- 1472-698X (ISSN-L)
- PMC
- PMC4624599
- OpenAlex
- W1948339546
- Cited by
- 1,166
- References
- 111
- Citations by year
- 2026: 84 · 2025: 158 · 2024: 133 · 2023: 145 · 2022: 159 · 2021: 105 · 2020: 163 · 2019: 88 · 2018: 70 · 2017: 44 · 2016: 14 · 2013: 1
- FWCI
- 6.12
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC International Health and Human Rights (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion)
- Funders
- Queen Mary University of London
- 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
- war refugees, long-term mental health, depression, anxiety disorders, post-traumatic stress disorder, prevalence of mental disorders, pre-migration trauma, post-migration stressors, socioeconomic status, resettlement, Cambodian refugees
- MeSH terms
- War Exposure, Armed Conflicts, Adult, Anxiety Disorders, Depression, Humans, Mental Health, Refugees, Risk Factors, Social Class, Stress, Psychological, Time Factors, Internationality
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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