Risk of non-affective psychotic disorder and post-traumatic stress disorder by refugee status in Sweden

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Refugees have different experiences of obtaining a refugee status, however it remains unclear if this affects their risk of psychiatric disorders. The aim of this study was to investigate whether risk for non-affective psychotic disorder (NAPD) and post-traumatic stress disorder (PTSD) differs between quota refugees (resettled from refugee camps) and non-quota refugees (former asylum seekers).

Method

A register-based cohort with a sample size of 52 561 refugees in Sweden starting 1 January 1997 ending 31 December 2011. Exposure: refugee status (quota or non-quota refugees). Cox regression models estimated adjusted HRs with 95% CIs for NAPD (International Classification of Diseases, Tenth Revision (ICD-10), F20–29) and PTSD (ICD-10, F43.1) by refugee status.

Results

There were more non-quota refugees (77.0%) than quota refugees (23.0%). In total we identified 401 cases of NAPD, 1.0% among quota refugees and 0.7% among non-quota refugees, and 1070 cases of PTSD, 1.9% among quota refugees and 2.1% among non-quota refugees. Male quota refugees were at increased risk for NAPD compared with male non-quota refugees (HR _male=1.41, 95% CI 1.09 to 1.82 and HR _female=0.65, 95% CI 0.42 to 1.00). All quota refugees were at a reduced risk of PTSD compared with non-quota refugees (HR=0.74, 95% CI 0.64 to 0.87).

Conclusions

This study suggests that risk of NAPD and PTSD varies for quota and non-quota refugees, highlighting the possibility that different experiences of the migration process differentiate the risk of psychiatric disorders among refugees.

Related collections

Most cited references 25

Record: found
Abstract: found
Article: found

Is Open Access

External review and validation of the Swedish national inpatient register

Jonas F. Ludvigsson, Eva Andersson, Anders Ekbom … (2011)

Background The Swedish National Inpatient Register (IPR), also called the Hospital Discharge Register, is a principal source of data for numerous research projects. The IPR is part of the National Patient Register. The Swedish IPR was launched in 1964 (psychiatric diagnoses from 1973) but complete coverage did not begin until 1987. Currently, more than 99% of all somatic (including surgery) and psychiatric hospital discharges are registered in the IPR. A previous validation of the IPR by the National Board of Health and Welfare showed that 85-95% of all diagnoses in the IPR are valid. The current paper describes the history, structure, coverage and quality of the Swedish IPR. Methods and results In January 2010, we searched the medical databases, Medline and HighWire, using the search algorithm "validat* (inpatient or hospital discharge) Sweden". We also contacted 218 members of the Swedish Society of Epidemiology and an additional 201 medical researchers to identify papers that had validated the IPR. In total, 132 papers were reviewed. The positive predictive value (PPV) was found to differ between diagnoses in the IPR, but is generally 85-95%. Conclusions In conclusion, the validity of the Swedish IPR is high for many but not all diagnoses. The long follow-up makes the register particularly suitable for large-scale population-based research, but for certain research areas the use of other health registers, such as the Swedish Cancer Register, may be more suitable.

0 comments Cited 1166 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria.

Dean G. Kilpatrick, Heidi S Resnick, Melissa E Milanak … (2013)

Prevalence of posttraumatic stress disorder (PTSD) defined according to the American Psychiatric Association's Diagnostic and Statistical Manual fifth edition (DSM-5; 2013) and fourth edition (DSM-IV; 1994) was compared in a national sample of U.S. adults (N = 2,953) recruited from an online panel. Exposure to traumatic events, PTSD symptoms, and functional impairment were assessed online using a highly structured, self-administered survey. Traumatic event exposure using DSM-5 criteria was high (89.7%), and exposure to multiple traumatic event types was the norm. PTSD caseness was determined using Same Event (i.e., all symptom criteria met to the same event type) and Composite Event (i.e., symptom criteria met to a combination of event types) definitions. Lifetime, past-12-month, and past 6-month PTSD prevalence using the Same Event definition for DSM-5 was 8.3%, 4.7%, and 3.8% respectively. All 6 DSM-5 prevalence estimates were slightly lower than their DSM-IV counterparts, although only 2 of these differences were statistically significant. DSM-5 PTSD prevalence was higher among women than among men, and prevalence increased with greater traumatic event exposure. Major reasons individuals met DSM-IV criteria, but not DSM-5 criteria were the exclusion of nonaccidental, nonviolent deaths from Criterion A, and the new requirement of at least 1 active avoidance symptom.

0 comments Cited 421 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

The longitudinal integrated database for health insurance and labour market studies (LISA) and its use in medical research

Jonas F. Ludvigsson, Pia Svedberg, Ola Olén … (2019)

Education, income, and occupation are factors known to affect health and disease. In this review we describe the Swedish Longitudinal Integrated Database for Health Insurance and Labour Market Studies (LISA, Longitudinell Integrationsdatabas för Sjukförsäkrings- och Arbetsmarknadsstudier). LISA covers the adult Swedish population aged ≥ 16 years registered on December 31 each year since 1990 (since 2010 individuals aged ≥ 15 years). The database was launched in response to rising levels of sick leave in the country. Participation in Swedish government-administered registers such as LISA is compulsory, and hence selection bias is minimized. The LISA database allows researchers to identify individuals who do not work because of injury, disease, or rehabilitation. It contains data on sick leave and disability pension based on calendar year. LISA also includes information on unemployment benefits, disposable income, social welfare payments, civil status, and migration. During 2000–2017, an average of 97,000 individuals immigrated to Sweden each year. This corresponds to about 1% of the Swedish population (10 million people in 2017). Data on occupation have a completeness of 95%. Income data consist primarily of income from employment, capital, and allowances, including parental allowance. In Sweden, work force participation is around 80% (2017: overall: 79.1%; men 80.3% and women 77.9%). Education data are available in > 98% of all individuals aged 25–64 years, with an estimated accuracy for highest attained level of education of 85%. Some information on civil status, income, education, and employment before 1990 can be obtained through the Population and Housing Census data (FoB, Folk- och bostadsräkningen).

0 comments Cited 365 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): J Epidemiol Community Health

Journal ID (iso-abbrev): J Epidemiol Community Health

Journal ID (hwp): jech

Journal ID (publisher-id): jech

Title: Journal of Epidemiology and Community Health

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Print): 0143-005X

ISSN (Electronic): 1470-2738

Publication date (Print): March 2020

Publication date (Electronic): 25 November 2019

Volume: 74

Issue: 3

Pages: 276-282

Affiliations

[1 ] departmentDepartment of Public Health Sciences , Karolinska Institute , Stockholm, Sweden

[2 ] departmentDivision of Psychiatry , UCL , London, UK

[3 ] departmentDivision of Public Health Epidemiology, Department of Public Health Sciences , Karolinska Institutet , Stockholm, Sweden

[4 ] departmentPsykisk Hälsa , Centrum för epidemiologi och samhällsmedicin , Stockholm, Sweden

Author notes

[Correspondence to ] Dr Anna-Clara Hollander, Public Health Sciences, Karolinska Institutet, Stockholm 171 77, Sweden; anna-clara.hollander@ 123456ki.se

Author information

James B Kirkbride http://orcid.org/0000-0003-3401-0824

Anna-Clara Hollander http://orcid.org/0000-0002-1246-5804

Article

Publisher ID: jech-2019-212798

DOI: 10.1136/jech-2019-212798

PMC ID: 7035697

PubMed ID: 31767729

SO-VID: f030a093-1b64-4ce3-a0a5-d60059a8b210

License:

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

History

Date received : 12 June 2019

Date revision received : 06 November 2019

Date accepted : 12 November 2019

Funding

Funded by: Sir Henry Dale fellowship jointly funded by the Wellcome Trust and the Royal Society;

Award ID: 101272/Z/13/Z

Funded by: FundRef http://dx.doi.org/10.13039/501100004359, Vetenskapsrådet;

Award ID: 5232010-1052

Funded by: FundRef http://dx.doi.org/10.13039/501100006636, Forskningsrådet om Hälsa, Arbetsliv och Välfärd;

Award ID: 2014-1430

Award ID: 2014-2678

Custom metadata

special-feature unlocked

ScienceOpen disciplines: Public health

Keywords: cohort studies,migration,psychiatry,public health,record linkage

Data availability:

ScienceOpen disciplines: Public health

Keywords: cohort studies, migration, psychiatry, public health, record linkage

Comments

Comment on this article

scite_

Cited by 1

Prevalence of mental disorders in refugees and asylum seekers: a systematic review and meta-analysis
Authors: Martina Patanè, Samrad Ghane, Eirini Karyotaki …

See all cited by

Most referenced authors 512

See all reference authors

Risk of non-affective psychotic disorder and post-traumatic stress disorder by refugee status in Sweden

Read this article at

Abstract

Background

Method

Results

Conclusions

Related collections

UCL: UN SDG 03 Good Health and Well-Being

Most cited references 25

External review and validation of the Swedish national inpatient register

National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria.

The longitudinal integrated database for health insurance and labour market studies (LISA) and its use in medical research

Author and article information

Journal

Affiliations

Author notes

Author information

Article

History

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 397

Cited by 1

Most referenced authors 512