Risk of psychosis in refugees: a literature review

Abstract

Conflicts and precarious living conditions resulted in the arrival of large numbers of refugees in Europe and especially in Germany. Evidence suggests that immigrant populations are at elevated risk of psychotic disorders. Considering the traumatic pre- and post-migratory adversities refugees may have encountered, people granted refugee status may even be more susceptible to psychosis than non-refugee migrants. The aim of this literature review is to summarise and interpret recent research on the incidence or prevalence of psychotic disorders in refugees, additionally focusing on the aspects of gender and Middle Eastern provenance. A systematic search in PubMed was performed in the time from 20 to 28 May 2016. Relevant literature was limited to articles describing cohort studies conducted in Western industrialised countries. Articles published between 1 June 2006 and 28 May 2016 were analysed. Content relating to psychotic disorders in refugees was reviewed and summarised. The selected studies showed an increased risk of psychotic disorders in refugees compared with both the indigenous population and non-refugee. migrants. The elevated risk was more pronounced in refugee men. A particularly high risk in refugees of Middle Eastern origin could not be inferred. The higher susceptibility to psychotic disorders in refugees emphasises the need for the development and implementation of adequate prevention strategies. Clinicians and people working in a refugee setting should be aware of early signs and symptoms of psychosis. Further research is required to evaluate post-migratory experiences and investigate the population of refugees affected by the current humanitarian crisis.

Figure 1

Schematic representation of study selection.