Are migrants diagnosed with a trauma-related disorder at risk of premature mortality? A register-based cohort study in Denmark.
Migrants
Mortality
Psychosis
Refugees
Traumatic stress disorders
Journal
Journal of migration and health
ISSN: 2666-6235
Titre abrégé: J Migr Health
Pays: England
ID NLM: 101774615
Informations de publication
Date de publication:
2023
2023
Historique:
received:
16
12
2020
revised:
06
07
2023
accepted:
06
07
2023
medline:
27
7
2023
pubmed:
27
7
2023
entrez:
27
7
2023
Statut:
epublish
Résumé
Mental illness is common among refugees displaced by conflict and war. While evidence points to the relatively good health in terms of longevity of migrants resettled in the destination country, less is known about the mortality of the most vulnerable migrants with a trauma-related diagnosis alone and those with an additional comorbid psychotic disorder. This study aimed to provide an overview of the number and mortality of foreign-born individuals diagnosed with Post-Traumatic Stress Disorder or Enduring Personality Change after a Catastrophic Event (PTSD/EPCACE), a psychotic disorder or both. A nationwide register-based cohort study, including residents in Denmark, followed from 1 January 1995 to 31 December 2016. The exposure was PTSD/EPCACE and psychotic disorders as well as region of origin. Relative all-cause mortality was estimated using Cox proportional hazards regression models and calculated for migrants with one or both groups of disorders compared to those from the same region without the disorder. During the study period, 6,580,000 individuals (50.4% women) were included in the cohort. Of these 1,249,654 (50.5% women) died during follow-up. For men and women from the former Yugoslavia, the Middle East and Northern Africa, a PTSD/EPCACE diagnosis alone or with comorbid psychotic disorder was not associated with increased mortality after adjusting for region of origin. A psychotic disorder alone, however, was associated with an increased mortality rate. Despite the severity of many refugees' traumatic experiences, a diagnosis of a trauma-related psychiatric disorder did not appear to increase the mortality rates.
Sections du résumé
Background
UNASSIGNED
Mental illness is common among refugees displaced by conflict and war. While evidence points to the relatively good health in terms of longevity of migrants resettled in the destination country, less is known about the mortality of the most vulnerable migrants with a trauma-related diagnosis alone and those with an additional comorbid psychotic disorder. This study aimed to provide an overview of the number and mortality of foreign-born individuals diagnosed with Post-Traumatic Stress Disorder or Enduring Personality Change after a Catastrophic Event (PTSD/EPCACE), a psychotic disorder or both.
Methods
UNASSIGNED
A nationwide register-based cohort study, including residents in Denmark, followed from 1 January 1995 to 31 December 2016. The exposure was PTSD/EPCACE and psychotic disorders as well as region of origin. Relative all-cause mortality was estimated using Cox proportional hazards regression models and calculated for migrants with one or both groups of disorders compared to those from the same region without the disorder.
Results
UNASSIGNED
During the study period, 6,580,000 individuals (50.4% women) were included in the cohort. Of these 1,249,654 (50.5% women) died during follow-up. For men and women from the former Yugoslavia, the Middle East and Northern Africa, a PTSD/EPCACE diagnosis alone or with comorbid psychotic disorder was not associated with increased mortality after adjusting for region of origin. A psychotic disorder alone, however, was associated with an increased mortality rate.
Conclusion
UNASSIGNED
Despite the severity of many refugees' traumatic experiences, a diagnosis of a trauma-related psychiatric disorder did not appear to increase the mortality rates.
Identifiants
pubmed: 37496744
doi: 10.1016/j.jmh.2023.100197
pii: S2666-6235(23)00047-8
pmc: PMC10365948
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100197Informations de copyright
© 2023 The Author(s).
Déclaration de conflit d'intérêts
The authors confirm that they have no conflict of interest to report.
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