Depressivität, Angst und posttraumatische Belastungsstörung bei Arbeitsmigranten, Asylbewerbern und Flüchtlingen

Zusammenfassung

Hintergrund Weltweit gab es im Jahr 2006 etwa 200 Millionen transnationale Migranten. Migranten werden unterschieden in „freiwillige”, insbesondere Arbeitsmigranten oder sogenannte „Gastarbeiter” und „unfreiwillige” Migranten, insbesondere Flüchtlinge und Asylbewerber. Depressivität, Angst und posttraumatische Belastungsstörung sind häufige Syndrome in der Allgemeinbevölkerung, die Studienergebnisse in Bezug auf Migranten sind heterogen. Ziele Ziel dieses Reviews ist es, die Prävalenzraten von Depressivität, Angst (Syndrome und Störungen) und posttraumatischer Belastungsstörung (PTBS) bei Arbeitsmigranten und Flüchtlingen zu beschreiben und zu vergleichen sowie zu untersuchen, ob ein Zusammenhang zwischen den Prävalenzraten und der Studienqualität vorliegt.Methode Wir suchten zunächst systematisch Studien in den elektronischen Datenbanken EMBASE und MEDLINE von im Zeitraum von 1994 - 2007 veröffentlichten Originalstudien. Die Studien, die die Ein- und Ausschlusskriterien erfüllten, wurden systematisch beschrieben und nach 15 Qualitätskriterien bewertet. Ergebnisse Die systematische Literatursucher ergab 348 Ergebnisse, von diesen erfüllten 37 Studien mit 35 untersuchten Populationen die Einschlusskriterien, die Studien beziehen sich auf n = 24 681 Migranten (Arbeitsmigranten: n = 16 971; Flüchtlinge: n = 7710). Die Studiengröße variiert zwischen einem Minimum von n = 55 Teilnehmer und einem Maximum von n = 4558 Teilnehmer (mediane Teilnehmerzahl: n = 338). Die Prävalenzraten der untersuchten Studien liegen für Depressivität zwischen 3 % und 47 % (Arbeitsmigranten) bzw. zwischen 3 % und 81 % (Flüchtlinge); für Angst zwischen 6 % und 44 % (Arbeitsmigranten) bzw. zwischen 5 % und 90 % (Flüchtlinge) und für PTBS zwischen 4 % und 86 %. Keine Studie erfüllt die 15 von uns aufgestellten Qualitätskriterien. Zusammenfassung und Ausblick Migranten sind eine heterogene Gruppe mit unterschiedlichen Prävalenzraten von Depressivität, Angst und posttraumatische Belastungsstörung. Dringend benötigt zur realistischen Abschätzung des Versorgungsbedarfes werden bevölkerungsrepräsentative Studien.

Abstract

Background In 2006 there were about 200 millions of transnational „voluntary” migrants like labor migrants and „involuntary migrants” like refugees and asylum seekers worldwide. Depression, anxiety and posttraumatic stress disorder (PTSD) is the most prevalent psychiatric disorders in general populations and is reported to be highly prevalent among migrants. Aims We aimed to assess and compare syndromes and symptoms of depression and anxiety in labor migrants and refugees; and to examine whether the prevalence rates are associated with study methods' and study quality. Methods We systematically searched in the databases MEDLINE and EMBASE for studies published from 1994 - 2007. Studies fulfilling the inclusion criteria are 1) systematically described: 2) and evaluated with 15 quality criteria. Results The literature search generated 348 results; and 37 fulfilled our inclusion criteria (35 populations) with n = 24 681 migrants (labor migrants: n = 16 971; refugees: n = 7710). Size of studies varies from a minimum of n = 55 participants to a maximum of n = 4558 participants (Median: n = 338). Prevalence rates for depression vary between 3 % and 47 % (labor migrants) and between 3 % and 81 % (refugees); for anxiety between 6 % and 44 % (labor migrants) and between 5 % and 90 % (refugees) and for PTSD between 4 % and 86 %. No study fullfilled all 15 quality criteria.Conclusion and outlook Migrants are a heterogeneous group and prevalence rates vary widely between studies. There is a need of high-quality representative studies on migrants' mental health to adequately plan health and social care.

Key words

migrants - refugees - prevalence - depression - anxiety - posttraumatic stress disorder

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1 Alle Daten zu Migranten sind aus der Publikation „Global Estimates” der Vereinten Nationen [1].