Associations Between Post-migration Stressors and Psychiatric Disorders in Adult Refugees in European High Income Countries. A Systematic Review

Background: Refugees and asylum seekers have a high prevalence of psychiatric disorders such as posttraumatic stress disorder (PTSD), anxiety and depression. Associations between the number of traumatic events and psychiatric disorders have been reported in literature, but knowledge on the influence of post-migration stressors on mental health outcomes in host countries remains scarce. Method: Four databases in the field of public and mental health were systematically searched. From a total of 2,456 studies found, 1,777 were included for title and abstract screening and 61 full texts were separately screened for eligibility by 2 authors. Out of these studies, 23 studies were included in this systematic review. A narrative synthesis was undertaken. Results: The overall findings showed that post-migration stressors have a significant impact on mental health outcomes. Especially uncertain legal status, missing social support and unemployment were shown to negatively influence mental health, but results vary among the different psychiatric disorders, i.e. post-traumatic stress disorder, depression and anxiety. Discussion: Post-migration stressors can contribute to the high prevalence rates of psychiatric disorders in refugees in European high-income countries. However, results must be interpreted with caution because of the heterogeneous study populations included and the variety of post-migration stressors. None of the studies considered the effect of mental disorders on the perceived severity of post-migration stressors.