Prevalence and predictors of common mental disorders among Syrian refugees in Istanbul, Turkey: a cross-sectional study

Soc Psychiatry Psychiatr Epidemiol. 2021 Mar;56(3):475-484. doi: 10.1007/s00127-020-01941-6. Epub 2020 Aug 12.

Abstract

Purpose: The war in Syria has created the greatest refugee crisis in the twenty-first century. Turkey hosts the highest number of registered Syrian refugees, who are at increased risk of common mental disorders because of their exposure to war, violence and post-displacement stressors. The aim of this paper is to examine the prevalence and predictors of anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms among Syrian refugees living in Turkey.

Methods: A cross-sectional survey of adult Syrian refugees was conducted between February and May 2018 in Istanbul (Sultanbeyli district). Participants (N = 1678) were randomly selected through the registration system of the district municipality. The Hopkins Symptoms Checklist (HSCL-25) was used to measure anxiety and depression and the Posttraumatic Stress Disorder (PTSD) Checklist (PCL-5) assessed posttraumatic stress. Descriptive and multivariate regression analyses were used.

Results: The prevalence of symptoms of anxiety, depression and PTSD were 36.1%, 34.7% and 19.6%, respectively. Comorbidity was high. Regression analyses identified several socio-demographic, health and post-displacement variables that predicted common mental disorders including: being female, facing economic difficulties, previous trauma experience, and unmet need for social support, safety, law and justice. A lifetime history of mental health treatment and problems accessing adequate healthcare were associated with depression and anxiety but not with PTSD.

Conclusions: Mental disorder symptoms are highly prevalent among Syrian refugees in Turkey. The association with post-displacement factors points to the importance of comprehensive health and social services that can address these social, economic and cultural stressors.

Keywords: Anxiety; Depression; Posttraumatic stress disorders; Syrian refugees.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Female
  • Humans
  • Mental Disorders* / epidemiology
  • Prevalence
  • Refugees*
  • Stress Disorders, Post-Traumatic* / epidemiology
  • Syria / epidemiology
  • Turkey / epidemiology