Posttraumatic growth, depressive symptoms, posttraumatic stress symptoms, post-migration stressors and quality of life in multi-traumatized psychiatric outpatients with a refugee background in Norway

Health and Quality of Life Outcomes

Research

Edvard Hauff¹  Dinu-Stefan Teodorescu²  Lars Lien³  Trond Heir⁴  Tore Wentzel-Larsen⁵  Johan Siqveland⁶ 

[1] Division of Mental Health and Addiction, Oslo University Hospital, Kirkeveien 166, N-0407, Oslo, Norway;Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway;Innlandet Hospital Trust, PO Box 104, N-2381, Brumunddal, Norway;Innlandet Hospital Trust, PO Box 104, N-2381, Brumunddal, Norway;Division of Mental Health and Addiction, Oslo University Hospital, Kirkeveien 166, N-0407, Oslo, Norway;Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway;Norwegian Centre for Violence and Traumatic Stress Studies, Kirkeveien 166, N-0407, Oslo, Norway;Norwegian Centre for Violence and Traumatic Stress Studies, Kirkeveien 166, N-0407, Oslo, Norway;Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Postboks 4623 Nydalen, N-0405, Oslo, Norway;Biostatistics and Epidemiology Unit, Oslo University Hospital, Postboks 4956 Nydalen, N-0424, Oslo, Norway;R & D Department, Mental Health Sevices, Akershus University Hospital, Lørenskog, Norway;

关键词: Depressive Symptom;    Traumatic Event;    Posttraumatic Stress;    Ptsd Symptom;    Acculturation Stress;   

DOI  :  10.1186/1477-7525-10-84

 received in 2012-01-31, accepted in 2012-06-26,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundPsychiatric outpatients with a refugee background have often been exposed to a variety of potentially traumatizing events, with numerous negative consequences for their mental health and quality of life. However, some patients also report positive personal changes, posttraumatic growth, related to these potentially traumatic events. This study describes posttraumatic growth, posttraumatic stress symptoms, depressive symptoms, post-migration stressors, and their association with quality of life in an outpatient psychiatric population with a refugee background in Norway.MethodsFifty five psychiatric outpatients with a refugee background participated in a cross-sectional study using clinical interviews to measure psychopathology (SCID-PTSD, MINI), and four self-report instruments measuring posttraumatic growth, posttraumatic stress symptoms, depressive symptoms, and quality of life (PTGI-SF, IES-R, HSCL-25-depression scale, and WHOQOL-Bref) as well as measures of social integration, social network and employment status.ResultsAll patients reported some degree of posttraumatic growth, while only 31% reported greater amounts of growth. Eighty percent of the patients had posttraumatic stress symptoms above the cut-off point, and 93% reported clinical levels of depressive symptoms. Quality of life in the four domains of the WHOQOL-Bref levels were low, well below the threshold for the’life satisfaction’ standard proposed by Cummins.A hierarchic regression model including depressive symptoms, posttraumatic stress symptoms, posttraumatic growth, and unemployment explained 56% of the total variance found in the psychological health domain of the WHOQOL-Bref scale. Posttraumatic growth made the strongest contribution to the model, greater than posttraumatic stress symptoms or depressive symptoms. Post-migration stressors like unemployment, weak social network and poor social integration were moderately negatively correlated with posttraumatic growth and quality of life, and positively correlated with psychopathological symptoms. Sixty percent of the outpatients were unemployed.ConclusionsMulti-traumatized refugees in outpatient clinics reported both symptoms of psychopathology and posttraumatic growth after exposure to multiple traumatic events. Symptoms of psychopathology were negatively related to the quality of life, and positively related to post-migration stressors such as unemployment, weak social network and poor social integration. Posttraumatic growth was positively associated with quality of life, and negatively associated with post-migration stressors. Hierarchical regression modeling showed that posttraumatic growth explained more of the variance in quality of life than did posttraumatic stress symptoms, depressive symptoms or unemployment. It may therefore be necessary to address both positive changes and psychopathological symptoms when assessing and treating multi-traumatized outpatients with a refugee background.

【 授权许可】

CC BY   
© Teodorescu et al.; licensee BioMed Central Ltd. 2012