Duration of residence and psychotropic drug use in recently settled refugees in Sweden - a register-based study

International Journal for Equity in Health

Anders Hjern¹  Marie Norredam³  Maria Brendler-Lindqvist² 

[1] Centre for Health Equity Studies, Karolinska Institutet/Stockholm University, Stockholm, 106 91, Sweden;Copenhagen School of Medicine, University of Copenhagen, Copenhagen, Denmark;Section of Immigrant Medicine, Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark

关键词: Access;    Acculturation;    Psychotropic drugs;    Mental health;    Migration;    Refugee;   

Others  :  1139408
DOI  :  10.1186/s12939-014-0122-2

 received in 2014-02-09, accepted in 2014-12-02,  发布年份 2014

【 摘 要 】

Introduction

Recently settled refugee populations have consistently been reported to have high rates of mental health problems, particularly Post-traumatic stress disorder, depression, and anxiety disorders. The aim of this study was to investigate psychotropic drug use among young adult refugees according to duration of residence during the first 10 years in Sweden.

Methods

Cross-sectional register study of a national cohort of 43 403 refugees and their families (23–35 years old) from Iraq, Iran, Eritrea, Ethiopia, Somalia and Afghanistan and a comparison population of 1.1 million Swedish-born residents. Logistic regression was used to assess the association between duration of residence in Sweden and the dispensing of at least one psychotropic medication during 2009 in four categories (any drug, neuroleptics, antidepressants and anxiolytics/hypnotics), adjusting for age, gender and domicile.

Results

Rates of dispensed psychotropic drugs among recently settled refugees were low, compared to the Swedish-born, with an increase with duration of residence. For refugee men and women from Iraq/Iran who had resided for 0–3 years the adjusted ORs compared to Swedish natives, were 0.83 (95% CI 0.77-0.90) and 0.48 (0.44-0.53) respectively; for men and women from the Horn of Africa the ORs were 0.50 (0.42-0.61) and 0.36 (0.30-0.41) respectively. After 7–10 years of residence, the ORs in these refugee groups approached the Swedish comparison population. Refugees from Afghanistan presented ORs similar to the Swedish-born, with no consistent trend by duration of residence. Women from the Horn of Africa and Iraq/Iran consumed less psychotropic drugs compared with men from these regions of origin, relative to the Swedish-born (p < 0.01). The ORs for dispensed neuroleptics were similar between the different refugee study groups, while the ORs for dispensed antidepressants differed fourfold between the group with the lowest (Horn of Africa) and the highest (Afghanistan).

Conclusion

The rates of dispensed psychotropic drugs in the newly settled refugee populations in this study were low, with an increase with longer duration of residence. This pattern suggests barriers to access mental health care. Interventions that can lower these barriers are needed to enable newly settled refugees to access mental health care on equal terms with the native population.

【 授权许可】

   
2014 Brendler Lindqvist et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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