Depression among refugee youth in an outpatient healthcare center-prevalence and associated factors

Lea Schumacher; Jette Echterhoff; Areej Zindler; Dana Barthel

doi:10.3389/fpsyt.2024.1367799

Depression among refugee youth in an outpatient healthcare center-prevalence and associated factors

Front Psychiatry. 2024 Apr 19:15:1367799. doi: 10.3389/fpsyt.2024.1367799. eCollection 2024.

Authors

Lea Schumacher¹, Jette Echterhoff¹, Areej Zindler², Dana Barthel³

Affiliations

¹ Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
² Outpatient Center GmbH, Refugee Outpatient Clinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
³ Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Abstract

Background: Due to armed conflict and other crises, many children worldwide have to flee their home country and are, consequently, at a high risk for mental health problems.

Objective: As the majority of previous research on refugee minors focused on post-traumatic stress disorder (PTSD), we aimed to assess the prevalence and risk factors for depression in a clinical sample of refugee youth.

Methods: Data were collected during the standard diagnostic process in an outpatient refugee clinic in Germany. We assessed the prevalence of depression based on a diagnostic interview and investigated the association between age, gender, duration of flight, accompanying status, number of interpersonal traumatic experiences, residence status, and PTSD diagnosis with a depression diagnosis. More specifically, we conducted a Bayesian logistic regression with these associated factors as predictors and the presence of depression as the outcome. Additionally, we conducted a Bayesian network analysis including all these variables.

Results: The majority of the 575 included refugee children were male (n = 423, 73.6%) and, on average, 15.1 years old (SD = 2.69). Nearly half of the children (n = 243, 42.3%) met the diagnostic criteria for depression, of which most also showed a comorbid PTSD diagnosis. We found strong evidence that age, gender, number of traumatic experiences, and a diagnosis of PTSD were related to depression. The network analysis indicated that only age, gender, and PTSD were directly associated to depression. Flight-related factors were only indirectly associated with depression due to their associations with number of traumatic experiences and PTSD diagnosis.

Conclusion: The high prevalence of depression and its strong associations with PTSD suggest that refugee minors are likely to experience depressive symptoms which might develop from PTSD symptoms. This implies a need for monitoring depressive symptoms in refugee minors, especially when these have a PTSD diagnosis.

Keywords: PTSD; associated factors; depression; prevalence; refugee minors.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. We acknowledge financial support from the Open Access Publication Fund of UKE - Universitätsklinikum Hamburg-Eppendorf.