Pauline Anderson

May 05, 2014

NEW YORK ― Being female, being exposed to 2 or more traumatic events, and having a personal or family history of psychiatric disorders are risk factors linked to posttraumatic stress disorder (PTSD) in Syrian refugees, a new study shows.

The healthcare needs of refugees have become an increasingly important global issue, especially during the last few decades. The number of refugees worldwide has reached 45.2 million, according to the United Nations High Commission for Refugees.

Gökay Alpak, MD, assistant professor of psychiatry in Gaziantep University, Turkey, shared results of a new study of PTSD in Syrian refugees during a press briefing held here at the American Psychiatric Association's 2014 Annual Meeting.

Since the beginning of the Syrian Civil War in March 2011, refugees have been seeking asylum in Turkey, Jordan, Lebanon, Iraq, and Armenia. Turkey is a "key point" for Syrian refugees, especially those from the northern part of the country, said Dr. Alpak. "In 2014, the number of Syrian refugees in Turkey is expected to surpass 600,000."

These refugees need healthcare services in addition to housing, education, and other services, he said.

Along with depression, PTSD is the most common psychiatric disorder among war refugees, although the frequency of post-war PTSD varies widely in the literature, from 4.4% to 86%, according to Dr. Alpak.

Dr. Gökay Alpak

The current study was conducted between November 1 and November 20, 2013, in a tent city in Gaziantep, Turkey, where 4125 Syrian refugees aged 18 to 65 years are now living. The study included a random sample of 352 of these refugees who underwent a face-to-face interview with an experienced native Arabic-speaking psychiatrist.

The study evaluated the presence of PTSD and the association of PSTD with various factors, including sex and history of psychiatric disorders.

The study found that 33.5% of the sample had PTSD. The PTSD was acute in 9.3% of individuals, chronic in 89%, of late-onset in 1.7%, and spontaneously remitted in 11.6%, said Dr. Alpak.

The average number of traumatic events was 3.71. Most traumatic events (66.2%) were related to living in an area affected by war. In terms of the type of trauma, witnessing a close friend's or family member's (except spouse's and children's) death was present in 66.2% of individuals, whereas being abducted or taken hostage was evident in 48%, and being a subject of or witnessing torture in 42%.

Four factors ― female sex, being diagnosed in the past with psychiatric disorders, having a family history of psychiatric disorder, and experiencing 2 or more traumatic events ― significantly raised the risk of having a PSTD diagnosis.

"The results suggest that PTSD among refugees in Turkey might be an important mental health issue in refugee camps, especially among female refugees who were exposed to 2 or more trauma events and who have a personal and family history of psychiatric disorders," said Dr. Alpak.

The probability of being diagnosed with PTSD among refugees with these risk factors was 71%, he said.

A screening tool for PTSD that uses these relevant factors could help pick up cases of PTSD in the refugee population, he said.

Heroic Work

Briefing moderator Jeffrey Borenstein, MD, president and CEO, Brain and Behavior Research Foundation, New York City, described this work as "extraordinary" and "heroic."

"It means going into very difficult situations and helping people where there is probably nobody else available to help them," said Dr. Borenstein. "In addition to providing this treatment, you're also studying what's going on so that we have a better understanding and our profession can do a better job of helping people" who have lived through such traumatic situations.

"We will all be interested in seeing more information as you develop it," he added.

American Psychiatric Association's 2014 Annual Meeting. Abstract NR6-155. Presented May 4, 2014.

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