Negative impacts of the adaptation process linked to local cultural stress levels in immigrants and development of psychiatric disorders: a systematic review and meta-analysis

Background Current studies underline and enable the international scientific community to reflect on migrant needs to restart, mostly without fluency in the language from the country of destination, without a way of proving his/her knowledges and abilities, with an incomplete family core, without cultural references that until that moment defined him/her as belonging to a specific group, with defined and meaningful habits, full of symbolic representations. Iams Conduct an analysis on the implications of migration in refugees’ mental health, and the link between these implications and Post-traumatic Stress Disorder (PTSD). Method Indexed journals in MEDLINE and LILACS databases hosted in Biblioteca Virtual em Saude (BVS), as well as papers hosted in Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES) Periodicals Portal. Searches were carried using the following DeCS descriptors: “Stress Disorders, Post-Traumatic”, "Refugees” e “Mental Health”. Results The 10 studies included in the present review were carried in Australia, Denmark, Ethiopia, Turkey, Uganda, Israel, South Korea and Papua New Guinea, and were published in 2014 (2), 2015 (6), and 2017 (2). Regarding the subject, 50% of the articles concentrate information regarding PTSD and mental health problems, while the remaining half deals with psychosocial effects of mass conflict on refugees. Meta-analysis concludes that a considerable percentage of refugees suffer from psychiatric disorder, I-squared (variation in ES attributable to heterogeneity) = 96,46%; Estimate of between-study variance Tau^2= 0.02. Test of ES=0 : z= 17.75 p= 0.00. Conclusion Exposure to traumatic events such as public executions and other extreme acts of violence, murder of family members, family and friends’ death due to starvation, homelessness, are closely related to PTSD prevalence in refugees. Acculturation and family’s prolonged estrangement are predictors of depressive symptoms in refugees and both exposure to a new culture and adaptation to new laws and norms of welcoming countries act as stressors and aggravators of depressive symptoms.