Mental health and resilience among Eritrean refugees at arrival and one-year post-registration in Switzerland: a cohort study.
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ABSTRACT: Objective
Eritrea is the most frequent country of origin among asylum seekers in Switzerland. On their journey through the desert and across the Mediterranean Sea, Eritrea refugees are often exposed to traumatizing experiences. The aim of this study is to assess the mental health status and resilience of Eritrean migrants in Switzerland upon arrival and one-year post-arrival, using standardized mental health screening and resilience assessment tools.Results
At baseline, 107 refugees (11.2% female, median age 25) were interviewed: 52 (48.6%) screened positive for Post-Traumatic Stress Disorder (score ≥ 30), 10.3% for anxiety (≥ 10) and 15.0% for depression (≥ 10); 17.8% scored as risk/hazardous drinkers (≥ 8). The majority (94.4%) had a high resilience score (≥ 65). For one-year follow-up, 48 asylum seekers could be reached. In interviews 18 (38%) of these reported imprisonment in a transit country and 28 (58%) that they had witnessed the death of a close person along the migration route. At the one year assessment, rates of risky/hazardous alcohol use remained unchanged, rates of positive PTSD screening tended to be lower (50.0% (24/48) at baseline vs 25.0% (12/48) at follow-up), as were rates of positive screening for anxiety (8.3% vs 4.2%) and depression (14.6 vs 6.3%).
SUBMITTER: Chernet A
PROVIDER: S-EPMC8299667 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundDepression is among the top mental health problems with a major contribution to the global burden of disease. This study aimed at identifying the latent factor structure and construct validity of the Center for Epidemiologic Studies Depression (CES-D) Scale.Participants and settingA cross-sectional survey of 562 adults aged 18 years and above who were randomly selected from the Eritrean refugee community living in the Mai-Aini refugee camp, Ethiopia.MeasuresThe CES-D Scale, Primary Care PTSD (PC-PTSD) screener, premigration and postmigration living difficulties checklist, Oslo Social Support Scale (OSS-3), Sense of Coherence Scale (SoC-13), Coping Style Scale and fast alcohol screening test (FAST) were administered concurrently. Confirmatory factor analysis was employed to test prespecified factor structures of CES-D.ResultFirst-order two factors with second-order common factor structure of CES-D (correlated error terms) yielded the best fit to the data (Comparative Fit Index =0.975; root mean square error of approximation=0.040 [90% CI 0.032 to 0.047]). The 16 items defining depressive affect were internally consistent (Cronbach's α=0.932) and internal consistency of the 4 items defining positive affect was relatively weak (Cronbach's α=0.703). These two latent factors have a weaker standardised covariance estimate of 33% (24% for women and 40% for men), demonstrating evidence of discriminant validity. CES-D is significantly associated with measures of adversities, specifically, premigration living difficulties (r=0.545, p<0.001) and postmigration living difficulties (r=0.47, p<0.001), PC-PTSD (r=0.538, p<0.001), FAST (r=0.197, p<0.001) and emotion-oriented coping (r=0.096, p˂0.05) providing evidence of its convergent validity. It also demonstrated inverse association with measures of resilience factors, specifically, SoC-13 (r=-0.597, p<0.001) and OSS-3 (r=-0.319, p<0.001). The two correlated factors model of CES-D demonstrated configural, metric, scalar, error variance and structural covariance invariances (p>0.05) for both men and women.ConclusionsUnlike previous findings among Eritreans living in USA, second-order two factors structure of CES-D best fitted the data for Eritrean refugees living in Ethiopia; this implies that it is important to address culture for the assessment and intervention of depression.
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