Risk factors for mental disorders in women survivors of human trafficking: a historical cohort study

BMC Psychiatry

Siân Oram²  Carolina Trigub⁴  Viorel I Gorceag¹  Martin Prince²  Nicolae V Ostrovschi³  Melanie Abas² 

[1] United Nations Population Fund, Chisinau, Republic of Moldova;Institute of Psychiatry, Kings College London, London, UK;N. Testemitanu Medical and Pharmaceutical University, Chisinau, Moldova;ProGENEVA, Chisinau, Republic of Moldova

关键词: Women’s mental health;    Violence;    Trauma;    Human trafficking;    PTSD;    Depression;   

Others  :  1123989
DOI  :  10.1186/1471-244X-13-204

 received in 2012-12-07, accepted in 2013-07-23,  发布年份 2013

【 摘 要 】

Background

Previous studies have found high levels of symptoms of depression, anxiety, and post-traumatic stress disorder among women survivors of human trafficking. No previous research has described risk factors for diagnosed mental disorders in this population.

Methods

A historical cohort study of women survivors of trafficked women aged 18 and over who returned to Moldova and registered for assistance with the International Organisation for Migration (IOM). Women were approached by IOM social workers and, if they gave informed consented to participate in the study, interviewed by the research team. At 2–12 months post-return to Moldova, a psychiatrist assessed DSM-IV mental disorders blind to information about women’s pre-trafficking and post-trafficking experiences using the Structured Clinical Interview for DSM-IV (SCID). A backwards stepwise selection procedure was used to create a multivariable regression model of risk factors for DSM-IV mental disorder measured at an average of 6 months post-return.

Results

120/176 (68%) eligible women participated. At an average of 6 months post-return, 54% met criteria for any DSM-IV mental disorder: 35.8% of women had PTSD (alone or co-morbid), 12.5% had depression without PTSD and 5.8% had another anxiety disorder. Multivariable regression analysis found that childhood sexual abuse (Adjusted Odds Ratio [AOR] 4.68, 95% CI 1.04-20.92), increased number of post-trafficking unmet needs (AOR 1.80; 95% CI 1.28-2.52) and post-trafficking social support (AOR 0.64; 95% CI 0.52-0.79) were independent risk factors for mental disorder, and that duration of trafficking showed a borderline association with mental disorder (AOR 1.12, 95% CI 0.98-1.29).

Conclusions

Assessment for mental disorders should be part of re-integration follow-up care for women survivors of human trafficking. Mental disorders at that time, most commonly PTSD and depression, are likely to be influenced by a range of predisposing, precipitating and maintaining factors. Care plans for survivors of trafficking must be based on individual needs, and must apply clinical guidelines for the treatment of PTSD and of depression. Evidence is needed on the effectiveness of therapy for PTSD in survivors of human trafficking.

【 授权许可】

   
2013 Abas et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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