Depression and anxiety in labor migrants and refugees – A systematic review and meta-analysis
Section snippets
Background
The total number of migrants in 2006 was about 200 millions and is expected to rise until 2050 to 230 millions worldwide (Bhopal, 2007, Unites Nations, 2005, International Organization of Migration, 2008). The definition and range of persons defined as “migrants” are often unclear. A variety of persons may be considered ‘‘migrants'’, including those who migrated because of “pull” factors of the immigration country (i.e. labor migrants); as well as those who migrated because of “push” factors
Methods
Conflicting evidence exists on the reliability of self reported and of clinician administered questionnaires. We included studies conducted with both types of assessment methods. Reliability studies examining inter-rater reliability of self reported and of clinician administered questionnaires have shown good agreement between those methods (Ustun, Compton, Mager, et al., 1997). The included studies were evaluated for differences between the assessment methods in relation to the reported
Results
Fig. 1 presents a flow diagram outlining the systematic review process. A total of 37 publications including 35 migrant study populations addressing the prevalence of depression, anxiety and posttraumatic stress and/or respective disorders after migration were included in this review (Alegria et al., 2007, Allden et al., 1996, Bhui et al., 2003). Among these, 23 related to 20 refugee groups, 10 to labor migrants, and three to mixed groups. The studies included 24,051 migrants in total. Table 1
Discussion
Our assessment suggests that prevalence rates of depression are almost twofold higher in refugees than in labor migrants (Fig. 2, Fig. 3) (labor migrants 20 percent with 95 percent CI: 14, 26; refugees: 44 percent with 95 percent CI: 27, 62). The pooled prevalence rates of depression and anxiety among labor migrants are similar to the general US-population (22 percent for depression; 18 percent for anxiety) (Kessler, Chiu, Demler, & Walter, 2005). This review and meta-analysis is to our
Acknowledgements
This work was supported in part by the Intramural Research Program at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
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