Variations in psychiatric morbidity between traumatized Norwegian, refugees and other immigrant patients in Oslo

Nord J Psychiatry. 2020 Aug;74(6):390-399. doi: 10.1080/08039488.2020.1714724. Epub 2020 Jan 21.

Abstract

Background: There is a lack of clinical studies that focus on different psychiatric disorders after trauma and the relationship with migration status.Purpose: To examine differences in psychiatric morbidity in traumatized patients referred to psychiatric treatment in Southern Oslo.Materials and methods: Hundred and ten patients with trauma background attending an outpatient clinic in Southern Oslo were studied. Forty-four of the participants (40%) were ethnic Norwegians, 25 (22.7%) had refugee background and 41 (37.3%) were first- or second-generation immigrants without refugee background. Thorough diagnostic assessment was done by experienced psychiatrists through several structured clinical interviews and self-report questionnaires.Results: Ninety-eight patients (89%) were diagnosed with at least one Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) disorder. There was a clear difference in the presentation of certain psychiatric disorders between the groups. Ethnic Norwegian patients were more likely to have anxiety disorders: agoraphobia, social phobia and panic disorder than non-refugee immigrant patients. They also had higher rates of alcohol abuse/dependence. Somatoform pain disorder was more common in both the refugee and other-immigrant groups than among the ethnic Norwegian patients. The refugee patients had significantly more major depressive disorder, post-traumatic stress disorder (PTSD) and both co-occurring.Conclusion: Trauma is frequently associated with depression, anxiety disorders, somatoform pain disorder and PTSD in a clinical population. The clinical presentation and comorbidity of these disorders seem to vary significantly between traumatized patients with Norwegian, refugee and non-refugee immigrant backgrounds. After a major trauma, refugees may be at greater risk for both PTSD and depression than other immigrants and the native population.

Keywords: Immigrants; comorbidity; diagnostics; refugees; trauma.

MeSH terms

  • Adolescent
  • Adult
  • Agoraphobia / epidemiology
  • Agoraphobia / psychology
  • Comorbidity
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / psychology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Emigrants and Immigrants / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Norway / epidemiology
  • Panic Disorder / epidemiology
  • Panic Disorder / psychology
  • Population Groups / psychology*
  • Refugees / psychology*
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Stress Disorders, Post-Traumatic / psychology*
  • Surveys and Questionnaires
  • Young Adult