Severity profiles of posttraumatic stress, depression, anxiety, and somatization symptoms in treatment seeking traumatized refugees

Ruud A Jongedijk; Dorien D Eising; Niels van der Aa; Rolf J Kleber; Paul A Boelen

doi:10.1016/j.jad.2020.01.077

Severity profiles of posttraumatic stress, depression, anxiety, and somatization symptoms in treatment seeking traumatized refugees

J Affect Disord. 2020 Apr 1:266:71-81. doi: 10.1016/j.jad.2020.01.077. Epub 2020 Jan 20.

Authors

Ruud A Jongedijk¹, Dorien D Eising², Niels van der Aa³, Rolf J Kleber⁴, Paul A Boelen⁵

Affiliations

¹ ARQ Centrum'45, Rijnzichtweg 35, 2342 AX Oegstgeest, the Netherlands; ARQ National Psychotrauma Centre, Nienoord 10, Diemen, 1112XE, the Netherlands. Electronic address: r.jongedijk@centrum45.nl.
² ARQ Centrum'45, Rijnzichtweg 35, 2342 AX Oegstgeest, the Netherlands. Electronic address: d.eising@arq.org.
³ ARQ Centrum'45, Rijnzichtweg 35, 2342 AX Oegstgeest, the Netherlands; ARQ National Psychotrauma Centre, Nienoord 10, Diemen, 1112XE, the Netherlands. Electronic address: n.van.der.Aa@centrum45.nl.
⁴ ARQ National Psychotrauma Centre, Nienoord 10, Diemen, 1112XE, the Netherlands; Utrecht University, Department of Clinical Psychology, Heidelberglaan 1, 3584 CS Utrecht, the Netherlands. Electronic address: r.kleber@uu.nl.
⁵ ARQ Centrum'45, Rijnzichtweg 35, 2342 AX Oegstgeest, the Netherlands; ARQ National Psychotrauma Centre, Nienoord 10, Diemen, 1112XE, the Netherlands; Utrecht University, Department of Clinical Psychology, Heidelberglaan 1, 3584 CS Utrecht, the Netherlands. Electronic address: P.A.Boelen@uu.nl.

PMID: 32056948
DOI: 10.1016/j.jad.2020.01.077

Abstract

Background: Western countries are facing many challenges hosting refugees from several regions in the world. Many of them are severely traumatized and suffer from a variety of mental health symptoms, which complicates the identification and treatment of refugees at risk. This study examined subgroups based on a broad range of psychopathology, and several predictors, including trauma characteristics and gender.

Methods: Participants were 1147 treatment-seeking, traumatized refugees. Latent profile analysis was conducted to identify different subgroups based on levels of posttraumatic stress disorder (PTSD), depression, anxiety, and somatic symptoms. Multinomial logistic regression was used to identify predictors of subgroup membership.

Results: Three distinct subgroups were identified, reflecting Moderate (10.2%), Severe (43.0%), and Highly Severe (45.9%) symptom severity levels, respectively. Symptom severity of all psychopathology dimensions was distributed equally between the subgroups. Participants in the Severe and Highly Severe Symptoms subgroups reported more types of traumatic events compared to the Moderate subgroup. In particular, traumatic events associated with human right abuses, lack of human needs and separation from others predicted subgroup membership, as did gender.

Limitations: The results are confined to treatment-seeking, traumatized refugee populations.

Conclusions: Distinguishable symptom severity profiles of PTSD, depression, anxiety and somatic complaints could be identified in this large treatment-seeking refugee population, without qualitative differences in symptom distribution. Instead of focusing on specific mental disorders, classification based on overall symptom severity is of interest in severely traumatized patients. This knowledge will help to identify individuals at risk and to enhance existing treatment programs for specific patient groups.

Keywords: Comorbidity; Latent profile analysis; Posttraumatic stress disorder; Predictors; Refugee; Subtype.

MeSH terms

Anxiety
Anxiety Disorders / epidemiology
Depression
Humans
Refugees*
Stress Disorders, Post-Traumatic* / epidemiology
Stress Disorders, Post-Traumatic* / therapy