Angst, Depressionen und posttraumatische Belastungsstörungen bei Flüchtlingen – eine Bestandsaufnahme

Zusammenfassung

Einleitung

Angst, Depressionen und Posttraumatische Belastungssymptome und Störungen gehören zu den häufigsten psychischen Belastungen bei Flüchtlingen.

Methoden

Wir führten einen systematischen Review durch. Zunächst wurden Schlüsselwörter für die systematische Suche in PUBMED festgelegt. Dann führten wir eine systematische Suche anhand der festgelegten Suchbegriffe in PUBMED durch. Eingeschlossen wurden: Originalartikel seit 2009 zu Flüchtlingen, die 1) nicht in psychiatrischen Einrichtungen lebten, 2) höchstens 5 Jahre im Zufluchtsland lebten, 3) auf Zufallsstichproben basierten und 4) über quantitative Daten zu Angst, Depression und PTBS berichteten sowie 5)>100 Studienteilnehmende hatten. Zusätzlich suchten wir manuell nach Studien in den Referenzlisten.

Ergebnisse

Wir identifizierten an Hand der Suchstrategie insgesamt n=1 877 Studien. Von diesen erfüllten 15 Studien die Einschlusskriterien. 52% der Flüchtlinge kamen aus Afrika (Somalia, Kongo, Ruanda, Liberia, Sierra Leone, Togo), 33% aus Asien (Syrien, Bhutan, Vietnam, Kambodscha, Irak) und 16% der Flüchtlinge kamen aus mehr als einem Kontinent. In diesen Studien wurden insgesamt n=6 769 Flüchtlinge hinsichtlich ihrer psychischen Gesundheit untersucht. Die Anzahl der Teilnehmer variierte von n=117 bis n=1 422 (Median: n=366). Die Prävalenzrate variierte bei posttraumatischer Belastungsstörung von 5–71% (Mittelwert: 32%), bei Depression von 11–54% (Mittelwert 35%). Flüchtlinge aus Ländern mit massiven Menschenrechtsverletzungen zeigten mehr psychopathologische Symptome als die aus Ländern ohne massive Menschenrechtsverletzungen.

Diskussion

Die Heterogenität der Prävalenzraten ist zum einen auf methodische Unterschiede zurückzuführen, zum anderen auf Unterschiede in den Flüchtlingspopulationen.

Schlussfolgerungen

Der Bedarf an psychosozialer und medizinischer Versorgung von Flüchtlingen aus Ländern mit hohen Menschenrechtsverletzungen sollte dringend mithilfe repräsentativer Studien überprüft werden und Versorgungsangebote entsprechend des Bedarfs und der Bedürfnisse entwickelt werden um eine Lebensperspektive im Zufluchtsland Deutschland aufzubauen.

Abstract

Introduction

Anxiety, depression and posttraumatic stress disorder are the main psychopathological symptoms shown by refugees.

Methods

We conducted a systematic review. First, we identified key-words for a systematic search in PUBMED. We included original articles since 2009 with 1) a non-clinical sample of refugees, 2) refugees living at maximum 5 years in the host country, 4) with the outcomes anxiety, depression, and PTSD and 5) a sample with >100 participants. Then we read titles, abstracts and fulltexts.

Results

We identified 1 877 studies. Based on this screening procedure, we included in our review 15 studies. 52% of the refugees are from Africa (Somalia, Congo, Rwanda, Liberia, Sierra-Leon and Togo), 33% from Asia (Syria, Bhutan, Vietnam, Cambodia, Iraq) and 16% are from more than one continent. In those studies n=6 769 refugees participated in the studies. The number of participants varied from n=117 to n=1,422 (Median: n=366 refugees). Prevalence rates for PTBS varied from 5–71% (mean prevalence rate: 32%) rates for depression varied from 11–54% (mean prevalence rate: 35%). Sensitivity analyses suggest that refugees, which come from countries with intense human rights violations according to the Political Terror Scale, have an increased rate of psychopathological symptoms.

Discussion

Heterogeneity of prevalence rate is related both 1) to methodological and 2) to difference in the refugee populations according to the human rights violations in the countries of origin of refugees. It is necessary to include further databases in a systematic review.

Outlook

There is an urgent need for representative studies on refugees needs for psychosocial and medical care, especially for those refugees coming from countries with intense human rights violations. Psychosocial and medical services for these refugees are urgently needed to enhance and enable a perspective in the host country Germany.

Schlüsselwörter

Flüchtlinge - Asylsuchenden - Angst - Depression - posttraumatische Belastungsstörungen

Key words

refugees - asylum seekers - anxiety - depression - PTSD

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