Common mental disorders in asylum seekers and refugees: umbrella review of prevalence and intervention studies

Common mental disorders in asylum seekers and refugees: umbrella review of prevalence and intervention studies
Received: 8 June 2017 – Accepted: 19 August 2017 – Published: 25 August 2017

  • Giulia TurriniEmail author,
  • Marianna Purgato,
  • Francesca Ballette,
  • Michela Nosè,
  • Giovanni Ostuzzi and
  • Corrado Barbui
Abstract

Background
In recent years there has been a progressive rise in the number of asylum seekers and refugees displaced from their country of origin, with significant social, economic, humanitarian and public health implications. In this population, up-to-date information on the rate and characteristics of mental health conditions, and on interventions that can be implemented once mental disorders have been identified, are needed. This umbrella review aims at systematically reviewing existing evidence on the prevalence of common mental disorders and on the efficacy of psychosocial and pharmacological interventions in adult and children asylum seekers and refugees resettled in low, middle and high income countries.
Methods
We conducted an umbrella review of systematic reviews summarizing data on the prevalence of common mental disorders and on the efficacy of psychosocial and pharmacological interventions in asylum seekers and/or refugees. Methodological quality of the included studies was assessed with the AMSTAR checklist.
Results
Thirteen reviews reported data on the prevalence of common mental disorders while fourteen reviews reported data on the efficacy of psychological or pharmacological interventions. Although there was substantial variability in prevalence rates, we found that depression and anxiety were at least as frequent as post-traumatic stress disorder, accounting for up to 40% of asylum seekers and refugees. In terms of psychosocial interventions, cognitive behavioral interventions, in particular narrative exposure therapy, were the most studied interventions with positive outcomes against inactive but not active comparators.
Conclusions
Current epidemiological data needs to be expanded with more rigorous studies focusing not only on post-traumatic stress disorder but also on depression, anxiety and other mental health conditions. In addition, new studies are urgently needed to assess the efficacy of psychosocial interventions when compared not only with no treatment but also each other. Despite current limitations, existing epidemiological and experimental data should be used to develop specific evidence-based guidelines, possibly by international independent organizations, such as the World Health Organization or the United Nations High Commission for Refugees. Guidelines should be applicable to different organizations of mental health care, including low and middle income countries as well as high income countries.

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LASAR Segall – Peintre expressionniste

Bateau des émigrants
« Navire d’émigrants. 1939-1941 ». Un thème cher à l’artiste, qui a quitté la Lituanie pour le Brésil en 1923.


(1889-1957)
Peintre brésilien d’origine russe, Lasar Segall est, avec Portinari et Di Cavalcanti, un des artistes brésiliens les plus importants de sa génération, tant son œuvre formée à la révolte de l’expressionnisme allemand s’est accordée à la démesure et au pathétique de l’univers brésilien. Juif d’origine russe, Segall se mêle dès 1906 et jusqu’en 1923 (date à laquelle il prend la nationalité brésilienne) à la vie artistique de Berlin et de Dresde, participant à toutes les manifestations importantes du mouvement expressionniste. D’un trait anguleux qui domine tout autre élément plastique et prévaut sur la composition, dans une gamme de couleurs extrêmement sourdes et sobres, Segall met en images un univers famélique et pitoyable, celui des Camps de concentration, du Bateau des émigrants et des Femmes errantes (1939-1941). Homme passionné et meurtri, le peintre, dans ces vastes compositions, se fait, d’une voix éloquente, le porteur d’un message de nostalgie et d’errance, où se lisent les obsessions de sa jeunesse, le tragique de son siècle et l’accablement de la condition et de la misère populaires.

Un musée Lasar-Segall, où est conservée la plus grande partie de l’œuvre de l’artiste, a été ouvert à São Paulo.
Maïten BOUISSET, « SEGALL LASAR – (1889-1957) », Encyclopædia Universalis [en ligne], consulté le 20 août 2017. URL : http://www.universalis.fr/encyclopedie/lasar-segall/



<6>Marin et émigrants sur le pont (Marinheiro e emigrantes no convés)

SEGALL Lasar, Vilna, 1891 – Sao-Paulo, 1957
1928
Inv.2003.35.048
Estampe
Gravure
Dimensions :
Feuille : H. 34,5 – L. 25,5 / Gravure : H. 17,3 – L. 13,6 cm
Gravure à la pointe sèche sur zinc sur papier.
mahJ,
don de Mme Lucy Citti Ferreira épouse Alexandrovitch
Pour toute demande de reproduction veuillez contacter la photothèque.
Description
Prou d’un bateau occupé par des groupes d’émigrants allongés ou debouts et un marin assis au premier plan.
Publication :A gravura de Lasar Segall – Museu Lasar Segall, Sao Paolo :Fondaçao nacional pro-Memoria, 1988, cat. ref. 140
Inscriptions
2/30, au crayon bg