Objective

Turkey is hosting three and a half million of refugee people from Syria and it is the leading refugee hosting country. Despite previous study findings indicating high rates of psychiatric morbidity among refugee children, little is known about the mental health service utilization patterns of refugee children in Turkey. We aimed to investigate psychiatric service utilization pattern and clinical profiles of refugee children and compare the findings with non-refugee children who applied to the same child psychiatry service in Istanbul.

Method

We determined sociodemographic characteristics, psychiatric diagnoses, and the number of visits among refugee children in comparison to non-refugees. Predictors of early dropout in refugees were analysed using logistic regression.

Results

Our sample comprised 91 refugee children (31.9% female, mean age=9.02 years) and 82 non-refugees (34.1% female, mean age=9.32 years). A broad range of war-related traumatic events was reported by the refugee children. The most prevalent traumatic events were hearing shootings or blasts (87.3%), witnessing clashes or bombardment (68.8%), and exposing to corpses or mutilated bodies (33.3%). Even though depression (28.6%) and posttraumatic stress disorder (PTSD) (22%) were more common among refugee children, ADHD (36.3% in refugee vs. 47.6% in non-refugee) was the most common disorder in both groups. Refugee children were attended fewer appointments for mental healthcare than non-refugee children (p<0.05). Logistic regression analysis revealed that the lower likelihood of early dropout from mental healthcare service were associated with having ADHD (OR 0.229, 95%C.I: 0.066-0.798) and PTSD (OR 0.125, 95%C.I:0.030-0.520) diagnoses in refugee group.

Conclusions

Our findings highlighted that clinicians and service providers should be aware of refugees' complex mental health needs and social difficulties. To provide effective mental health services for refugee children, it is crucial to develop policies facilitating the access to the services and increasing the treatment adherence.

中文翻译：

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土耳其难民儿童的心理健康需求和精神科服务使用方式的比较研究

客观的

土耳其正在收容来自叙利亚的三百五十万难民，它是主要的难民收容国。尽管先前的研究结果表明难民儿童中精神病的发病率很高，但对土耳其难民儿童的心理健康服务利用方式知之甚少。我们旨在调查难民儿童的精神科服务使用模式和临床概况，并将调查结果与在伊斯坦布尔使用相同儿童精神科服务的非难民儿童进行比较。

方法

我们确定了社会人口统计学特征，精神病学诊断以及与非难民相比难民儿童的探视次数。使用逻辑回归分析了难民中提前辍学的预测因素。

结果

我们的样本包括91名难民儿童（女性31.9％，平均年龄= 9.02岁）和82名非难民（34.1％女性，平均年龄= 9.32岁）。难民儿童报告了与战争有关的广泛创伤事件。最普遍的创伤事件是听到枪击或爆炸（87.3％），目睹冲突或轰炸（68.8％）以及暴露于尸体或肢体（33.3％）。尽管在难民儿童中抑郁症（28.6％）和创伤后应激障碍（PTSD）（22％）更为常见，但ADHD（难民中36.3％，非难民中47.6％）是两组中最常见的疾病。与非难民儿童相比，难民儿童接受心理保健的约会更少（p <0.05）。

结论

我们的研究结果强调，临床医生和服务提供者应注意难民的复杂心理健康需求和社会困难。为了向难民儿童提供有效的精神卫生服务，至关重要的是制定政策，以便利获得服务和增加对治疗的依从性。