The prevalence of major depressive disorder and anxiety disorders among asylum seekers in South Florida

Abstract

The rapidly growing population of asylum seekers in the United States often seeks asylum following persecution and severe traumatic events. Asylum evaluations play an influential role in the process by objectively documenting human rights abuses. The purpose of this study was to describe the prevalence of major depressive disorder (MDD) and anxiety disorders among asylum seekers and analyze differences in the severity of disease by time and sub-group. Data was collected from a retrospective review of medical affidavits written from 2017 to 2020 following asylum evaluations in South Florida. Decision trees were utilized to make diagnoses for each individual's current mental health status in the U.S. and retrospectively for while in their home country. These diagnoses were recorded according to the Global Burden of Disease study criteria and utilizing validated mental health screeners. The prevalence of MDD was found to significantly decrease from 75.8% in patients' home countries to 46.7% in the U.S. Similarly, prevalence of anxiety disorders significantly fell from 85.8% to 64.2%. Gender and being a victim of sexual assault were significantly associated with severity of MDD and anxiety disorders. This reduction in the burden of mental health disease after relocation to the United States demonstrate the benefit of asylum not only as a human right, but also as a mental health intervention. Through their connection with higher application success rates and referrals to follow-up care, physician-performed asylum evaluations can thus be linked to improved health outcomes.

Keywords: Asylum; Depression; Human rights; Mental health; PTSD.