Studies Conducted in Areas Where Refugees Have Settled

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Clinic-Based Studies

Mollica et al. [4], studying an Indo-Chinese group of patients in their clinic, found that 36% suffered from affective disorders, 1.9% from PTSD, 58% from affective disorders and PTSD, and 7.3% from other psychiatric disorders. Kinzie et al. [5] found that, out of 322 Indo-Chinese patients surveyed, 81% suffered from depression, 16% suffered from schizophrenia and 75% fulfilled a current diagnosis of PTSD. Lavik et al. [6] found PTSD in 48%, affective disorders in 16%, adjustment disorders in 10% and anxiety disorder in 6% of the group of refugees surveyed by them in an outpatient clinic in Oslo, Norway. These studies have been summarized in Table 8.1.

Community-Based Studies

Besides clinic-based studies, there have been many community-based studies of refugees. Sundquist [7] found that 18.3% of Latin-American refugees had some psychological distress compared with 2.8% of the control population of Swedes. Cheung [8] found 12.1% of the 223 Cambodian refugees surveyed by him to be suffering from PTSD. Sack et al. [9] conducted a community survey including 209 randomly selected Khmer youths and a parent from two communities. With standardized instruments like the

Table 8.1 Clinic-based studies of mental disorders in refugees (in countries where the refugees had settled)

Country Subjects and methods

Prevalence (%)


USA 52 Indo-Chinese refugees Life Events and Social

History Questionnaire, HSCL-25, DIS Follow-up USA 322 Indo-Chinese refugees DSM-III Cross-sectional Norway 231 refugees from different countries Cross-sectional BPRS, HSCL-25, PTSS-10

36 (affective disorder) 1.9 (PTSD)

58 (PTSD and affective disorder)

81 (depression) 16 (schizophrenia) 75 (PTSD) 48(PTSD) 16 (dysthymia and depression) 10 (adjustment disorder) 6 (anxiety disorder) 20 (other mental disorder)

HSCL-25: Hopkins Symptom Checklist, 25 items; DIS: Diagnostic Interview Schedule; BPRS: Brief Psychiatric Rating Scale; PTSS-10: Post-Traumatic Stress Symptoms 10-item checklist.

Diagnostic Interview for Children and Adolescents (DICA) [10] and the Schedule for Affective Disorders and Schizophrenia for School Age Children (KSADS) [11], it was found that, whereas among the youths the point prevalence was 18.2% for PTSD and 11% for depressive disorders, the parents showed a much higher point prevalence—53.2% PTSD and 22.2% depression in mothers and 29.4% PTSD and 23.4% depression in fathers. Comorbidity was also higher among the parents than in their children. In Thailand, Allden et al. [12] studied 104 Burmese political prisoners and found that 38% had elevated scores for depression and 23% for PTSD. Drozdek [13] found PTSD in 44% of the Bosnian refugees surveyed by him. In a prospective study over a 2-year period, Beiser and Hyman [14] found the prevalence of depression to decrease from 6.4% to 3.1%, in 1348 South East Asian refugees settled in Vancouver. The prevalence of mental disorders among a group of Central American refugees in the USA was also found to be very high—PTSD 68%, generalized anxiety disorder 8%, social phobia 12% and simple phobia 16% [15]. Holtz [16] found that 41.4% and 14.3% of a group of Tibetan nuns and students in India suffered from anxiety and depressive symptoms, respectively. Blair [17], while conducting a survey on Cambodian adults settled in the Salt Lake City (USA) region, found PTSD and major depression to be present in 45% and 51% of the surveyed group, respectively. These studies have been summarized in Table 8.2.

Table 8.2 Community-based studies of mental disorders in refugees (in countries where the refugees had settled)


Subjects and methods

Prevalence (%)



338 Latin American



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