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Systematic review and meta-analysis : the prevalence of mental illness in child and adolescent refugees and asylum seekers

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Blackmore, Rebecca, Gray, Kylie M., Boyle, Jacqueline A., Fazel, Mina, Ranasinha, Sanjeeva, Fitzgerald, Grace, Misso, Marie and Gibson-Helm, Melanie (2020) Systematic review and meta-analysis : the prevalence of mental illness in child and adolescent refugees and asylum seekers. Journal of the American Academy of Child & Adolescent Psychiatry, 59 (6). pp. 705-714. doi:10.1016/j.jaac.2019.11.011

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Official URL: http://dx.doi.org/10.1016/j.jaac.2019.11.011

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Abstract

Objective
Over half of the world’s refugee population are under the age of 18 years. This systematic review aims to summarise the current body of evidence for the prevalence of mental illness in child and adolescent refugee populations.

Method
Eight electronic databases, grey literature, and Google Scholar were searched for articles from 1 January 2003 to 5 February 2018. Strict inclusion criteria regarding the diagnosis of mental illness were imposed. Study quality was assessed using a template according to study design, and study heterogeneity using I2 statistic. Random effects meta-analyses results were presented given heterogeneity among studies. The protocol for this systematic review was registered with PROSPERO (CRD42016046349).

Results
Eight studies were eligible, involving 779 child and adolescent refugees and asylum seekers, with studies conducted in five countries. The overall prevalence of post-traumatic stress disorder (PTSD) was 22.71% (95% CI 12.79-32.64), depression 13.81% (95% CI 5.96-21.67), and anxiety disorders 15.77% (95% CI 8.04-23.50). Attention-deficit/hyperactivity disorder (ADHD) was 8.6% (1.08-16.12) and oppositional defiant disorder (ODD) was 1.69% (95% CI -0.78 – 4.16). Due to high heterogeneity, further subgroup analyses were conducted.

Conclusion
Refugee and asylum seeker children have high rates of PTSD, depression, and anxiety. Without the serious commitment by health and resettlement services to provide early support to promote mental health, these findings suggest a high proportion of refugee children are at risk of educational disadvantage and poor social integration in host communities, potentially affecting their life course.

Item Type: Journal Article
Subjects: R Medicine > RJ Pediatrics
Divisions: Faculty of Social Sciences > Centre for Educational Development, Appraisal and Research (CEDAR)
Library of Congress Subject Headings (LCSH): Mentally ill children -- Refugees, Refugee children -- Psychological aspects, Political refugees -- Children, Child psychopathology -- Research
Journal or Publication Title: Journal of the American Academy of Child & Adolescent Psychiatry
Publisher: Elsevier BV
ISSN: 0890-8567
Official Date: 1 June 2020
Dates:
DateEvent
1 June 2020Published
25 November 2019Available
18 November 2019Accepted
Volume: 59
Number: 6
Page Range: pp. 705-714
DOI: 10.1016/j.jaac.2019.11.011
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

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