Psychological stress, cardiovascular disease and somatic pain in asylum seekers: a retrospective cross-sectional study

Abstract

The refugee experience is a known risk factor for psychological stress, cardiovascular disease (CVD) and somatic pain. However, the prevalence and comorbidity of these health outcomes in asylum seekers is not elucidated. Here we performed a retrospective, cross-sectional study in which the forensic medical evaluations of 453 globally representative US asylum seekers were analyzed. Outcomes included the prevalence of symptoms of psychological stress, CVD, somatic pain and their comorbidity. Symptoms of psychological stress, CVD and somatic pain were documented in 94%, 47% and 50% of participants, respectively; 46% reported both CVD and stress symptoms, and 31% reported all three. Palpitations, presyncope/syncope, stroke symptoms and chest pain were reported in 33%, 25%, 20% and 16% of individuals with CVD symptoms, respectively. Furthermore, both stress symptoms and pain symptoms were each strongly predictive of comorbid CVD symptoms. These findings indicate that asylum seekers experience a high burden of comorbid and interrelated psychological stress, CVD and somatic pain. In this cross-sectional study of forensic medical evaluations in 453 people seeking asylum in the United States, the authors found that the majority of individuals reported psychological stress and nearly half reported cardiovascular disease (CVD) and stress symptoms, indicating a high disease burden of concurrent stress and CVD associated with migration.