Prevalence of psychological distress detected by the PROTECT and PHQ4 questionnaires and subsequent mental health diagnosis. A cross sectional analysis of the outcomes of new arrival health assessments for refugees and asylum seekers in Ireland

IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Bridget Kiely , James Larkin , Kathryn Mullan , Maitiú ó Tuathail , Emma Coughlan , Debbie Marshall , Margaret Fitzgerald , Fiona O'Reilly
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引用次数: 0

Abstract

Background

The mental health needs of refugees and asylum seekers are often unmet. Many screening methods for mental health problems in refugees and asylum seekers have been suggested, but the optimal method for identifying those at risk has not been determined. The PROTECT questionnaire and the Patient Health Questionnaire 4 (PHQ4) are two tools currently being used to identify refugees and asylum seekers at risk of mental health problems in Ireland, but there is limited data on the prevalence of positive scores or risk factors for these to inform health service planning.

Methods

Cross sectional analysis was conducted of anonymous data of all adult asylum seekers or refugees who completed a PHQ4 and PROTECT questionnaire during their nurse conducted arrival health assessment within a one-year period. Data collected include: gender, age category, marital status, family unit, country of origin, refugee/asylum status, medical conditions, mental health conditions, exposure to violence, PROTECT score, PHQ4 score and outcome of GP mental health review. Statistical analysis was completed using R.

Results

440 people completed a PROTECT and PHQ4 questionnaire. 198 people had a GP review based on either a positive PROTECT or PHQ4 score. Among all participants, 9.1 % (n = 40) were diagnosed with depression, 15.0 % (n = 66) were diagnosed with PTSD, 3.8 % (n = 17) had an adjustment disorder and 3.7 % had anxiety.. There was a positive correlation between PHQ-4 score and PROTECT score, (rs = 0.738, p < .001) although the PROTECT score identified more cases of PTSD and depression. Being female (aOR: 2.47 95 % CI: 1.59–3.86) and country of origin Zimbabwe (aOR: 3.19 95 % CI: 1.56–6.53) was associated with a positive PROTECT score. Country of origin was negatively associated with PROTECT score for Syria (aOR: 0.32 95 % CI: 0.15–0.65). There were similar findings for PHQ4.

Conclusions

Rates of depression, anxiety and PTSD were similar to other studies. There was a strong correlation between PHQ4 scores and PROTECT but with PROTECT ultimately identifying more cases of depression and PTSD, suggesting it may be reasonable to use it alone. Whichever screening tool is used, adequate healthcare resources need to be available for further assessment and treatment. Participants from Syria were less likely to have a positive score compared to others and further research is required to understand the reasons for this.
通过PROTECT和PHQ4问卷以及随后的心理健康诊断检测心理困扰的患病率。爱尔兰难民和寻求庇护者新抵达健康评估结果的横断面分析
难民和寻求庇护者的心理健康需求往往得不到满足。对难民和寻求庇护者的精神健康问题提出了许多筛查方法,但尚未确定识别风险人群的最佳方法。保护问卷和患者健康问卷4 (PHQ4)是目前用于确定爱尔兰有精神健康问题风险的难民和寻求庇护者的两种工具,但关于这些人的积极得分或风险因素的普遍程度的数据有限,无法为卫生服务规划提供信息。方法对所有成年寻求庇护者或难民的匿名数据进行横断面分析,这些人在护士进行的一年内抵达健康评估期间完成了PHQ4和PROTECT问卷调查。收集的数据包括:性别、年龄类别、婚姻状况、家庭单位、原籍国、难民/庇护身份、医疗状况、精神健康状况、遭受暴力、PROTECT评分、PHQ4评分和全科医生精神健康审查结果。结果440人完成了PROTECT和PHQ4问卷调查。198人进行了基于PROTECT或PHQ4阳性评分的全科医生检查。在所有参与者中,9.1% (n = 40)被诊断为抑郁症,15.0% (n = 66)被诊断为创伤后应激障碍,3.8% (n = 17)有适应障碍,3.7%有焦虑。PHQ-4评分与PROTECT评分呈正相关(rs = 0.738, p <;.001),尽管PROTECT评分发现了更多的创伤后应激障碍和抑郁症病例。女性(aOR: 2.47 95% CI: 1.59-3.86)和原产国津巴布韦(aOR: 3.19 95% CI: 1.56-6.53)与保护性评分呈正相关。原产国与叙利亚的PROTECT评分呈负相关(aOR: 0.32 95% CI: 0.15-0.65)。PHQ4也有类似的发现。结论抑郁、焦虑和创伤后应激障碍的发生率与其他研究相似。PHQ4评分与PROTECT之间有很强的相关性,但PROTECT最终识别出更多的抑郁症和创伤后应激障碍病例,这表明单独使用它可能是合理的。无论使用哪种筛查工具,都需要有足够的医疗资源用于进一步的评估和治疗。与其他国家的参与者相比,来自叙利亚的参与者获得正面分数的可能性较小,需要进一步研究以了解其原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Migration and Health
Journal of Migration and Health Social Sciences-Sociology and Political Science
CiteScore
5.70
自引率
8.70%
发文量
65
审稿时长
153 days
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