The Mental Health Costs of Armed Conflicts—A Review of Systematic Reviews Conducted on Refugees, Asylum-Seekers and People Living in War Zones
Abstract
:1. Introduction
2. Methods
2.1. Eligibility Criteria
2.2. Sources of Information and Search Strategy
2.3. Selection and Data Collection Process
3. Results
3.1. Systematic Reviews and/or Metanalyses Relating to Adult Populations
3.2. Systematic Reviews and/or Meta-Analyses Relating to Children/Adolescents
4. Discussion
5. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Authors, Year of Publication (Reference Number) | Study Type | Number and Time Frame of Papers Considered | Psychopathological Conditions Considered | Study Samples (N, Type of Populations Considered) |
---|---|---|---|---|
Fazel M, et al., 2005 [10] | Systematic review | 20/1996–2002 | prevalence of PTSD, major depression, generalised anxiety and psychotic disorders | N = 6743 refugees resettled in high-income western countries |
Porter M and Haslam N, 2005 [11] | Meta-analysis | 56/1959–2002 | Comparison of measures of psychopathology among refugees versus non-refugees | N = 22,221 refugees and N = 45,074 non refugees |
Steel Z et al., 2009 [12] | Systematic review and meta-analysis | 161/1980–2009 | Prevalence rates of PTSD and depression and associated factors | N = 81,866 refugees and other conflict-affected persons |
Bogic M et al., 2015 [14] | Systematic review | 29/1993–2013 | Prevalence rates of anxiety disorders, depressive disorders, PTSD | 16,010 war-affected refugees evaluated 5 years or more after displacement |
Ba I and Bhopal RS, 2017 [15] | Systematic review | 20/1981–2014 | Prevalence rates of mental disorders | N = 42,289 civilians exposed to war-related sexual violence |
Morina N et al., 2018 [16] | Systematic review | 38/1996–2016 | Prevalence rates of common mental disorders | N = 39,518 internally displaced and refugee adults from 21 countries |
Morina N et al., 2018 [17] | Systematic review and meta-analysis | 33/1994–2015 | Prevalence rates of PTSD and depression | N = 24,896 survivors who had lived in a war zone up to 25 years prior to the time of the survey |
Charlson F et al., 2018 [18] | Systematic review and meta-analysis | 129/2000–2017 | Prevalence rates of depression, anxiety disorders, PTSD, bipolar disorder *, schizophrenia * | Representative samples of a general population exposed to conflicts over the previous ten years who resided in their country of origin, were displaced, or had resettled in a neighbouring low-income or middle-income country N = 93.129 subjects included in 70 surveys on depression N = 89,285 subjects studied in 96 surveys on PTSD N = 53,959 subjects evaluated in 38 surveys on anxiety disorders |
Hoppen TH, Morina H, 2019 [19] | Meta-Analysis | 21/1994–2016 | Extrapolation of the absolute number of PTSD and/or MD suffering subjects | N = 7764 war survivors who had lived in an area of conflict up to 25 year prior to the time of the survey |
Blackmore R et al., 2020 [20] | Systematic review and meta-analysis | 26/2003–2020 | Prevalence rates of depression, PTSD, anxiety disorders, schizophrenia | 5143 adult refugees and asylum seekers |
Ng LC et al., 2020 [21] | Systematic review and meta-analysis | 25/2004–2019 | Prevalence rates of PTSD | Population representative samples, including refugees (N = 58,887 subjects) living in Sub-Saharan regions |
Henkelman JR et al., 2020 [22] | Systematic review and meta-analysis/meta-regression | 66/1988–2019 | Prevalence rates of diagnosed and self-reported anxiety, depression, PTSD | 14,882 adult and child/adolescent refugees in high-income countries |
Hoppen TH et al., 2021 [23] | Systematic review and meta-analysis | 20/1994–2015 | Prevalence rates of PTSD and major depression | Representative samples from countries with a recent history of war (1989/2019): N = 15,420 subjects included in surveys on PTSD, N = 9836 subjects included in surveys on MD and N = 1131 subjects included in surveys on PTSD + MD |
Stein J et al., 2021 [24] | Systematic review and meta-analysis | 118/2004–2020 | Prevalence rates of PTSD | N = 40,188 refugees or internally displaced people from the Eastern Mediterranean Region (EMR) exposed to violent conflict, war and associated human rights abuses |
Scoglio AJ and Salhi C, 2021 [25] | Systematic Review | 12/2000–2018 | Mental health symptoms and/or disorders | N = 4341 resettled refugees exposed to violence |
Mesa-Vieira C et al., 2022 [26] | Systematic review and meta-analysis | 34/1994–2022 | Prevalence rates of common mental disorders | N = 15,549 migrants with pre-migration exposure to armed conflict |
Lim ICZY et al., 2022 [27] | Meta-analysis | 70/1945–2022 | Prevalence rated of Depression, anxiety and PTSD | People exposed to war/violence Studies on depression N = 80,130 Studies on anxiety N = 36,948 Studies of PTSD N = 67,153 |
Study | Depression | Anxiety Disorders | Post-Traumatic Stress Disorder | Psychotic Disorders |
---|---|---|---|---|
Fazel M, et al., 2005 [10] | 5% * | 4% ** | 9% | 2% |
Steel Z et al., 2009 [12] | 30.8% | N.A. ^ | 30.6% | N.A. ^ |
Bogic et al., 2015 [14] | 2.3–80.0% | 20.3–88.0% | 4.4–86.0% | N.A. ^ |
Blackmore R et al., 2020 [20] | 31.5% | 11% | 31.46% | 1.51% |
Ng LC et al., 2020 [21] | N.A. ^ | N.A. ^ | 22% *** | N.A. ^ |
Stein J et al., 2021 [24] | N.A. ^ | N.A. ^ | 31% | N.A. ^ |
Henkelman JR et al., 2020 [22] | 36% | 30% | 34% | N.A. ^ |
Scoglio AJ and Salhi C, 2021 [25] | 40.2–51.0% | 31.8% | 20–62% ^^ | N.A. ^ |
Mesa-Vieira C et al., 2022 [26] | 25% * | 14% ** | 31% | N.A. ^ |
Study | Depression | Anxiety | Post-Traumatic Stress Disorder | Psychotic Disorder |
---|---|---|---|---|
Ba I and Bhopal RS, 2017 [15] | 8.8–76.5% | 6.9–75% | 3.1–75.9% | N.A. ^ |
Morina et al. [16] | 5.0–80.0% | 1.0–81.0% | 3.0–88% | 1.0–12.0% |
Morina N et al., 2018 [17] | 27.0% | N.A. ^ | 26.0% | N.A. ^ |
Charlson F et al., 2018 [18] * | 10.8% | 21.7% | 15.3% | ** |
Hoppen TH et al., 2021 [19] | 23.1% | N.A. ^ | 26.5% | N.A. ^ |
Lim ICZY et al., 2022 [27] | 28.9% | 30.7% | 23.5% | N.A. ^ |
Authors, Year of Publication (Reference Number) | Study Type | Number and Time Frame of Papers Considered | Psychopathological Conditions Assessed | Study Samples (N, Type of Populations Considered) |
---|---|---|---|---|
Fazel M, et al., 2005 [10] | Systematic review | 5/1996–2002 | Prevalence of depression and PTSD | N = 260 refugee adolescents resettled in high-income western countries |
Attanayake V et al., 2009 [28] | Systematic review and meta-regression analysis | 17/1997–2005 | Prevalence rates of PTSD, depression, anxiety disorders | N = 7920 children exposed to war conflicts |
Dimitry L, 2012 [29] | Systematic review | 71/1989–2010 | Prevalence of mental, behavioural and emotional problems in children and adolescents | N = 52,977 children and adolescents exposed to war conflicts in the Middle East |
Slone M and Mann S, 2016 [30] | Systematic Review | 35/1988–2014 | Prevalence of behavioural and emotional symptoms in children | N = 4365 children exposed to war, armed conflicts and terrorism |
Kien C et al., 2019 [31] | Systematic review | 57/1990–2017 | Prevalence of anxiety disorders, depressive disorders, PTSD, emotional and behavioural problems | N = 24,792 asylum-seeking children and adolescents or refugee minors in European countries |
Henkelman JR et al., 2020 [22] | Systematic review and meta-analysis | 19/1999–2011 | Prevalence rates of diagnosed and self-reported anxiety, depression, PTSD | N = 2150 children and adolescent refugees in high-income countries |
Blackmore R et al., 2020 [32] | Systematic review and metanalysis | 8/2008–2017 | Prevalence of PTSD, depression, anxiety disorders, attention-deficit/hyperactivity disorder, oppositional defiant disorder | N = 779 child and adolescent refugees and asylum seekers |
Study | Depression | Anxiety Dis | PTSD | ADHD | Other |
---|---|---|---|---|---|
Fazel M et al., 2005 [10] | N.A. ^ | N.A. ^ | 11% | N.A. ^ | N.A. ^ |
Attanayake V et al., 2009 [28] | 43% | 27% | 47% | N.A. ^ | N.A. ^ |
Slone M and Mann S, 2016 [30] | N.A. ^ | N.A. ^ | 37.1% +++ | N.A. ^ | 57.1% @@ 14.4% ## 2.9% § |
Dimitry L, 2012 [29] | 25–35% * 11.3% ** N.A. ***^ | 1.4% *°°/1–2 ^^* 40–100 **^^^/28 **” 3.3”, ***/4.3% ***@ | 5–8% * 23–70% ** 10–30% *** | 3% * | 1.8% *° 14% **# 2.5% # |
Kien C et al., 2019 [31] | 20.7% | 15% | 35.5% | N.A. ^ | 25.2% + 5.0% ++ |
Henkelman JR et al., 2020 [22] | 28% | 32% | 52% | N.A. ^ | N.A. ^ |
Blackmore R et al., 2020 [32] | 13.8% | 15.8% | 22.7% | 8.6% | 1.69% ° |
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Carpiniello, B. The Mental Health Costs of Armed Conflicts—A Review of Systematic Reviews Conducted on Refugees, Asylum-Seekers and People Living in War Zones. Int. J. Environ. Res. Public Health 2023, 20, 2840. https://doi.org/10.3390/ijerph20042840
Carpiniello B. The Mental Health Costs of Armed Conflicts—A Review of Systematic Reviews Conducted on Refugees, Asylum-Seekers and People Living in War Zones. International Journal of Environmental Research and Public Health. 2023; 20(4):2840. https://doi.org/10.3390/ijerph20042840
Chicago/Turabian StyleCarpiniello, Bernardo. 2023. "The Mental Health Costs of Armed Conflicts—A Review of Systematic Reviews Conducted on Refugees, Asylum-Seekers and People Living in War Zones" International Journal of Environmental Research and Public Health 20, no. 4: 2840. https://doi.org/10.3390/ijerph20042840