背景:寻求庇护者,移民,来自非洲国家的难民可能有巨大的健康需求,对世界各地的接受国产生了经济影响。由于暴力等因素,这些社区患精神疾病的风险更高,剥夺,移民后的挑战。
目的:本研究的目的是检查文献以确定患病率,预测因子,以及寻求庇护者心理健康(MH)障碍的经济影响,移民,来自非洲国家的难民。
方法:在本范围审查中,我们遵循了PRISMA和CoCoPop的指导方针。横截面研究评估工具(AXIS)的修订版用于评估横截面研究的研究质量,而评估清单用于基于关键评估技能计划(CASP)的定性研究。纳入标准包括以英文发表的同行评审文章,以及基于可信机构和组织的官方报告的文章。排除标准包括未经同行评审或未经可信来源来源的出版物,不符合研究主题或语言标准的出版物,混合人口(包括非洲人和非非洲人),和研究摘要,reviews,新闻文章,关于研究协议的评论,病例报告,信件,和指导方针。
方法:在Medline(通过PubMed)进行了系统搜索,EMBASE,APAPsycINFO,WebofScience和EBSCO,确定2000年1月1日至2024年1月31日发表的相关文章。
结果:共有38项研究符合纳入标准,包括22个来自非洲国家和三个定性研究。就作出贡献的国家数量而言,乌干达是最大的(n=7),其次是意大利(n=4)。研究最多的条件,使用多个诊断工具,是创伤后应激障碍(PTSD,n=19)和抑郁(n=17)。这些研究都揭示了这些群体中心理健康障碍的发生率升高,这些都与移民有关,与难民有关的因素,和创伤性事件。这些群体大多数由年轻男性主导。有,然而,未成年人和妇女遭受各种形式的暴力,尤其是性暴力。此外,精神疾病,比如创伤后应激障碍和抑郁症,不仅是持久的,但也可以传播给儿童。根据我们的纳入标准,我们的评论发现,只有一项研究检查了这些人群中MH疾病的经济影响,留下了巨大的知识差距。根据这项随机对照试验,减少心理障碍的干预可以帮助年轻人留在学校,提高他们的质量调整寿命年(QALY),并为每获得一个QALY赚取7260美元的增量成本效益比(ICER)。
结论:寻求庇护者,移民,来自非洲国家的难民可能会遇到MH的需求,根据这份范围审查。除了带来持续的挑战,这些疾病也可以传播给后代。除了对这些群体的纵向研究之外,精神疾病的经济影响研究是必要的。
BACKGROUND: Asylum seekers, migrants, and refugees from African countries may have significant health needs, resulting in economic implications for receiving countries around the world. The risk of mental illness is higher in these communities because of factors like violence, deprivation, and post-immigration challenges.
OBJECTIVE: The purpose of this study was to examine the literature to determine the prevalence, predictors, and economic impacts of mental health (MH) disorders among asylum seekers, migrants, and refugees from African countries.
METHODS: In this scoping
review, we followed the guidelines from PRISMA and CoCoPop. A modified version of the Appraisal Tool for Cross-Sectional Studies (AXIS) was used to assess study quality for cross-sectional studies, while an appraisal list was used for qualitative studies based on the Critical Appraisal Skills Programme (CASP). Inclusion criteria included peer-reviewed articles published in English, and articles based on official reports from credible institutions and organizations. Among the exclusion criteria were publications that were not peer reviewed or had not been sourced by credible sources, publications that did not meet the study topic or language criteria, mixed populations (including Africans and non-Africans), and research abstracts, reviews, news articles, commentary on study protocols, case reports, letters, and guidelines.
METHODS: A systematic search was carried out in Medline (via PubMed), EMBASE, APA PsycINFO, Web of Science and EBSCO, to identify relevant articles that were published between 1 January 2000 and 31 January 2024.
RESULTS: A total of 38 studies met the inclusion criteria, including 22 from African countries and three qualitative studies. In terms of number of countries contributing, Uganda was the largest (n = 7), followed by Italy (n = 4). The most studied conditions, using multiple diagnostic tools, were Post-Traumatic Stress Disorder (PTSD, n = 19) and depression (n = 17). These studies all revealed elevated rates of mental health disorders among these groups, and these were related to migration, refugee-related factors, and traumatic events. Most of these groups are dominated by young males. There is, however, a prominent presence of minors and women who have suffered a variety of forms of violence, in particular sexual violence. Furthermore, mental illnesses, such as PTSD and depression, are not only persistent, but can also be transmitted to children. In accordance with our inclusion criteria, our
review found only one study that examined the economic impact of MH disorders in these groups, leaving a significant knowledge gap. According to this randomized controlled trial, intervention to reduce psychological impairment can help young people stay in school, improve their quality-adjusted life year (QALY), and earn an incremental cost-effectiveness ratio (ICER) of $7260 for each QALY gained.
CONCLUSIONS: Asylum seekers, migrants, and refugees from African countries are likely to experience MH needs, according to this scoping
review. As well as posing persistent challenges, these disorders can also be transmissible to offspring. In addition to longitudinal studies of these groups, economic impact studies of mental illnesses are necessary.