Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-08T16:06:11.720Z Has data issue: false hasContentIssue false

Variations in prevalence and risk profiles for Common Mental Disorders amongst Rohingya, Chin and Kachin refugees from Myanmar

Published online by Cambridge University Press:  11 September 2020

Alvin Kuowei Tay*
Affiliation:
Faculty of Medicine, School of Psychiatry, University of New South Wales, Australia Perdana University-Centre for Global Health and Social Change (PU-GHSC), Kuala Lumpur, Malaysia
Mohammed Mohsin
Affiliation:
Faculty of Medicine, School of Psychiatry, University of New South Wales, Australia Mental Health Academic Unit, Liverpool Hospital, Sydney, New South Wales, Australia
Hau Khat Mung
Affiliation:
Faculty of Medicine, School of Psychiatry, University of New South Wales, Australia
Mohammad Badrudduza
Affiliation:
Faculty of Medicine, School of Psychiatry, University of New South Wales, Australia
Susheela Balasundaram
Affiliation:
Health Unit, United Nations High Commissioner for Refugees, Kuala Lumpur, Malaysia
Karen Morgan
Affiliation:
Perdana University-Centre for Global Health and Social Change (PU-GHSC), Kuala Lumpur, Malaysia Perdana University-Royal College of Surgeons in Ireland (PU-RCSI) School of Medicine, Selangor, Malaysia
Nirmalatiban Parthiban
Affiliation:
Perdana University-Royal College of Surgeons in Ireland (PU-RCSI) School of Medicine, Selangor, Malaysia
Derrick Silove
Affiliation:
Faculty of Medicine, School of Psychiatry, University of New South Wales, Australia
*
Author for correspondence: Alvin Kuowei Tay, E-mail: alvin.tay@unsw.edu.au

Abstract

Background

Large variations in prevalence rates of common mental disorder (CMD) amongst refugees and forcibly displaced populations have raised questions about the accuracy and value of epidemiological surveys in these cross-cultural settings. We examined the associations of sociodemographic indices, premigration traumatic events (TEs), postmigration living difficulties (PMLDs), and psychosocial disruptions based on the Adaptive Stress Index (ASI) in relation to CMD prevalence amongst the Rohingya, Chin and Kachin refugees originating from Myanmar and relocated to Malaysia.

Methods

Parallel epidemiological studies were conducted in areas where the three groups were concentrated in and around Malaysia (response rates: 80–83%).

Results

TE exposure, PMLDs and ASI were significantly associated with CMD prevalence in each group but the Rohingya recorded the highest exposure to all three of these former indices relative to Chin and Kachin (TE: mean = 11.1 v. 8.2 v. 11; PMLD: mean = 13.5 v. 7.4 v. 8.7; ASI: mean = 128.9 v. 32.1 v. 35.5). Multiple logistic regression analyses based on the pooled sample (n = 2058) controlling for gender and age, found that ethnic group membership, premigration TEs (16 or more TEs: OR, 2.00; 95% CI, 1.39–2.88; p < 0.001), PMLDs (10–15 PMLDs: OR, 4.19; 95% CI, 3.17–5.54; 16 or more PMLDs: OR, 7.23; 95% CI, 5.24–9.98; p < 0.001) and ASI score (ASI score 100 or greater: OR, 2.19; 95% CI, 1.46–3.30; p < 0.001) contributed to CMD.

Conclusions

Factors specific to each ethnic group and differences in the quantum of exposure to TEs, PMLDs and psychosocial disruptions appeared to account in large part for differences in prevalence rates of CMDs observed across these three groups.

Type
Original Article
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Carlsson, J. M., Mortensen, E. L., & Kastrup, M. (2005). A follow-up study of mental health and health-related quality of life in tortured refugees in multidisciplinary treatment. Journal of Nervous and Mental Disease, 193, 651657.10.1097/01.nmd.0000180739.79884.10CrossRefGoogle ScholarPubMed
Charlson, F. J., Flaxman, A., Ferrari, A. J., Vos, T., Steel, Z., & Whiteford, H. A. (2016). Post-traumatic stress disorder and major depression in conflict-affected populations: An epidemiological model and predictor analysis. Global Mental Health (Camb), 3, e4.CrossRefGoogle ScholarPubMed
Charlson, F., van Ommeren, M., Flaxman, A., Cornett, J., Whiteford, H., & Saxena, S. (2019). New WHO prevalence estimates of mental disorders in conflict settings: A systematic review and meta-analysis. The Lancet, 394, 240248.CrossRefGoogle ScholarPubMed
De Jong, J., Komproe, I. H., & Van Ommeren, M. (2003). Common mental disorders in postconflict settings. The Lancet, 361, 21282130.CrossRefGoogle ScholarPubMed
De Jong, J. T. V. M., Komproe, I. H., Van Ommeren, M. E. L., Masri, M., Araya, M., Khaled, N., … Somasundaram, D. (2001). Lifetime events and posttraumatic stress disorder in 4 postconflict settings. Journal of the American Medical Association, 286, 555562.CrossRefGoogle ScholarPubMed
De Jong, J. T. V. M., & Van Ommeren, M. (2002). Toward a culture-informed epidemiology: Combining qualitative and quantitative research in transcultural contexts. Transcultural Psychiatry, 39, 422433.10.1177/136346150203900402CrossRefGoogle Scholar
Human Rights Watch (2018). Burma: Ensure unfettered Aid in Kachin state: Military obliged to protect civilians in operations. New York: Human Rights Watch (HRW).Google Scholar
Mollica, R. F., Brooks, R., Tor, S., Lopes-Cardozo, B., & Silove, D. (2014). The enduring mental health impact of mass violence: A community comparison study of Cambodian civilians living in Cambodia and Thailand. International Journal of Social Psychiatry, 60, 620.CrossRefGoogle ScholarPubMed
Mollica, R. F., McInnes, K., Poole, C., & Tor, S. (1998). Dose-effect relationships of trauma to symptoms of depression and post- traumatic stress disorder among Cambodian survivors of mass violence. British Journal of Psychiatry, 173, 482488.CrossRefGoogle ScholarPubMed
Porter, M., & Haslam, N. (2005). Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: A meta-analysis. Journal of the American Medical Association, 294, 602612.CrossRefGoogle ScholarPubMed
Semrau, M., van Ommeren, M., Blagescu, M., Griekspoor, A., Howard, L. M., Jordans, M., … Thornicroft, G. (2012). The development and psychometric properties of the Humanitarian Emergency Settings Perceived Needs (HESPER) scale. American Journal of Public Health, 102, e55e63.CrossRefGoogle ScholarPubMed
Silove, D. (2013). The ADAPT model: A conceptual framework for mental health and psychosocial programming in post conflict settings. Intervention, 11(3), 237–248.CrossRefGoogle Scholar
Silove, D., Rees, S., Mohsin, M., Tam, N., Kareth, M., & Tay, A. K. (2018). Differentiating ICD-11 complex post-traumatic stress disorder from other common mental disorders based on levels of exposure to childhood adversities, the traumas of persecution and postmigration living difficulties among refugees from West Papua. British Journal of Psychiatry Open, 4, 361367.CrossRefGoogle Scholar
Silove, D., Ventevogel, P., & Rees, S. (2017). The contemporary refugee crisis: An overview of mental health challenges. World Psychiatry, 16, 130139.10.1002/wps.20438CrossRefGoogle ScholarPubMed
Steel, Z., Chey, T., Silove, D., Marnane, C., Bryant, R. A., & Van Ommeren, M. (2009a). Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: A systematic review and meta-analysis. Journal of the American Medical Association, 302, 537549.10.1001/jama.2009.1132CrossRefGoogle Scholar
Steel, Z., Silove, D., Giao, N. M., Phan, T. T., Chey, T., Whelan, A., … Bryant, R. A. (2009b). International and indigenous diagnoses of mental disorder among Vietnamese living in Vietnam and Australia. British Journal of Psychiatry, 194, 326333.10.1192/bjp.bp.108.050906CrossRefGoogle Scholar
Tay, A. K., Islam, R., Riley, A., Welton-Mitchell, C., Duchesne, B., Waters, V., … Ventevogel, P. (2018). Culture, context, and mental health of Rohingya refugees. A review for staff in mental health and psychosocial support programmes for Rohingya refugees (pp. 161). Geneva: United Nations Commissioner for Refugees.Google Scholar
Tay, A. K., Rees, S., Chen, J., Kareth, M., Mohsin, M., & Silove, D. (2015). The Refugee-Mental Health Assessment Package (R-MHAP); rationale, development and first-stage testing amongst West Papuan refugees. International Journal of Mental Health Systems, 9, 113.10.1186/s13033-015-0018-6CrossRefGoogle Scholar
Tay, A. K., Rees, S., Miah, M. A. A., Khan, S., Badrudduza, M., Morgan, K., … Silove, D. (2019a). Functional impairment as a proxy measure indicating high rates of trauma exposure, post-migration living difficulties, common mental disorders, and poor health amongst Rohingya refugees in Malaysia. Translational Psychiatry, 9, 213.CrossRefGoogle Scholar
Tay, A. K., Rees, S., Tam, N., Kareth, M., & Silove, D. (2019b). Developing a measure of adaptive stress arising from the psychosocial disruptions experienced by refugees based on a sample of displaced persons from West Papua. The International Journal of Methods in Psychiatric Research, 28, e1770.CrossRefGoogle Scholar
Tay, A. K., Rees, S., Tam, N., Kareth, M., & Silove, D. (2019c). Developing a measure of adaptive stress arising from the psychosocial disruptions experienced by refugees based on a sample of displaced persons from West Papua. The International Journal of Methods in Psychiatric Research, 1770, 111.Google Scholar
Tay, A. K., Riley, A., Islam, R., Welton-Mitchell, C., Duchesne, B., Waters, V., … Ventevogel, P. (2019d). The culture, mental health and psychosocial wellbeing of Rohingya refugees: A systematic review. Epidemiology and Psychiatric Sciences, 28(5), 489494.CrossRefGoogle Scholar
Tay, A. K., & Silove, D. (2016). The ADAPT model: Bridging the gap between psychosocial and individual responses to mass violence and refugee trauma. Epidemiology and Psychiatric Sciences, 26, 14.Google ScholarPubMed
Tol, W. A., Barbui, C., Galappatti, A., Silove, D., Betancourt, T. S., Souza, R., … van Ommeren, M. (2011a). Mental health and psychosocial support in humanitarian settings: Linking practice and research. The Lancet, 378, 15811591.10.1016/S0140-6736(11)61094-5CrossRefGoogle Scholar
Tol, W. A., Patel, V., Tomlinson, M., Baingana, F., Galappatti, A., Panter-Brick, C., … van Ommeren, M. (2011b). Research priorities for mental health and psychosocial support in humanitarian settings. PLoS Medicine, 8, e1001096.CrossRefGoogle Scholar
Tol, W. A., Rees, S. J., & Silove, D. M. (2013). Broadening the scope of epidemiology in conflict-affected settings: Opportunities for mental health prevention and promotion. Epidemiology and Psychiatric Sciences, 22, 197203.10.1017/S2045796013000188CrossRefGoogle ScholarPubMed
Van Ommeren, M. (2003). Validity issues in transcultural epidemiology. British Journal of Psychiatry, 182, 376378.CrossRefGoogle ScholarPubMed
Supplementary material: File

Tay et al. supplementary material

Tay et al. supplementary material

Download Tay et al. supplementary material(File)
File 28.7 KB