Author(s)(Year) | Country | Study population / Year(s) of data collection | Study design | Risk and protective factors of the PMLS | Symptoms | Size of association | Outcome measure | Co-/Variables | Study quality (MMAT) | ||
---|---|---|---|---|---|---|---|---|---|---|---|
Depression | Anxiety | PTSD | |||||||||
Barbieri et al. (2021) [21] | Italy | African refugees and Asylum Seekers (n = 122) 2016–2019 | Cross-sectional study | Legal status (asylum seeker vs. visa [Ref]) | - | - | PCL-5 | Sociodemographic factors (age, gender, education); Post-migration factors (legal status, duration of residence, employment, accommodation); Trauma-related factors (number of trauma types) | High | ||
- | - | ||||||||||
⇅ | OR3vs1 = 1.24 [CI 0.12, 13.02] OR3vs2 = 9.44 [CI 0.66, 134.93] OR2vs1 = 0.13 [CI 0.01, 2.16] | ||||||||||
Duration of residence (months since residing in host country) | - | - | |||||||||
- | - | ||||||||||
⇅ | OR3vs1 = 0.97 [CI 0.91, 1.04] OR3vs2 = 0.95 [CI 0.90, 1.00] OR2vs1 = 1.03 [CI 0.97, 1.08] | ||||||||||
Employment (unemployed vs. employed [Ref]) | - | - | |||||||||
- | - | ||||||||||
⇅ | OR3vs1 = 1.59 [CI 0.48, 5.21] OR3vs2 = 2.19 [CI 0.77, 6.24] OR2vs1 = 0.73 [CI 0.23, 2.26] | ||||||||||
Accommodation (large-reception centers with > 1000 people vs. small-medium reception centers with < 1000 people [Ref]) | - | - | |||||||||
- | - | ||||||||||
↑ | OR3vs1 = 12.77 [CI 1.49, 109.44] OR3vs2 = 6.68 [CI 1.81, 24.61] OR2vs1 = 1.91 [CI 0.19, 18.81] | ||||||||||
Böge et al. (2020) [22] | Germany / Jordan | Syrian refugees and asylum seekers (n = 89) 2017–2018 | Cross-sectional study | Social support (MSPSS) | ↓ | β = -0.240 [CI NA] | PHQ-9 GAD-7 HTQ | - | Moderate | ||
↓ | β = -0.042 [CI NA] | ||||||||||
↓ | β = -0.230 [CI NA] | ||||||||||
Borho et al. (2020) [23] | Germany | Syrian refugees (T1: n = 200, T2: n = 108) T1: 2017; T2: 2019 | Two-wave longitudinal study | Perceived discrimination | ↑ | βT1 = 0.235 [CI 0.219, 3.552] βT2 = 0.271 [CI 0.383, 2.769] | PHQ-9 GAD-7 ETI | Sociodemographic factors (age, gender, education); Trauma-related factors (number of traumatic events); Post-migration factors (accommodation, employment, duration of residence, future validity of permit, discrimination) | High | ||
↑ | βT1 = 0.263 [CI 0.359, 2.988] βT2 = 0.335 [CI 0.700, 2.738] | ||||||||||
↑ | N.A | ||||||||||
Future validity of permit (in months) | - | N.A | |||||||||
- | N.A | ||||||||||
↓ | N.A βT2 = -0.184 [CI -0.388, -0.035] | ||||||||||
Duration of residence (months since residing in host country) | - | N.A | |||||||||
- | N.A | ||||||||||
- | N.A | ||||||||||
Accommodation (Collective accommodation center, Own apartment alone or with family, Shared flat) | - | N.A | |||||||||
- | N.A | ||||||||||
- | N.A | ||||||||||
Costa et al. (2020) [24] | Germany | Diverse refugee sample (n = 560) 2018 | Cross-sectional study | Subjective social status (3 or more steps down vs. no change [Ref]) | ↑ | B = 1.048 [CI NA] | PHQ-2 GAD-2 | Sociodemographic factors (sex, age, education); Post-migration factors (SSS mobility, SSS in country of origin, duration of residence) | Moderate | ||
↑ | B = 1.006 [CI NA] | ||||||||||
- | - | ||||||||||
Subjective social status (1 or 2 steps down vs. no change [Ref]) | ↓ | B = -0.176 [CI NA] | |||||||||
↑ | B = 0.114 [CI NA] | ||||||||||
- | - | ||||||||||
Subjective social status (1 or 2 steps up vs. no change [Ref]) | ↓ | B = -0.499 [CI NA] | |||||||||
↓ | B = -0.985 [CI NA] | ||||||||||
- | - | ||||||||||
Subjective social status (3 or more steps up vs. no change [Ref]) | ↑ | B = 0.19 [CI NA] | |||||||||
↑ | B = 0.269 [CI NA] | ||||||||||
- | - | ||||||||||
Georgiadou et al. (2018) [25] | Germany | Syrian refugees (n = 200) 2017 | Cross-sectional study | Future validity of permit (in months) | ↑ | β = 0.12 [CI -0.04, 0.24] | PHQ-9 GAD-7 ETI | Sociodemographic factors (sex, age, education, illiterate, marital status); Post-migration factors (accommodation, duration of residence, duration of residence permit, future validity of permit); Pre-/Peri-migration factors (escape journey, escape duration); Trauma-related factors (number of traumatic events); Health-related factors (PHQ-9 score, GAD score, ETI score, mental health treatment) | Moderate | ||
↑ | β = 0.05 [CI -0.07, 0.13] | ||||||||||
↓ | β = -0.20 [CI -0.58, -0.01] | ||||||||||
Duration of residence permit (in months) | ↓ | β = -0.15 [CI -0.22, 0.03] | |||||||||
↓ | β = -0.08 [CI -0.13, 0.05] | ||||||||||
↑ | β = 0.19 [CI -0.04, 0.46] | ||||||||||
Duration of residence (in months) | ↓ | β = -0.03 [CI -0.16, 0.11] | |||||||||
↑ | β = 0.08 [CI -0.04, 0.15] | ||||||||||
↓ | β = -0.09 [CI -0.43, 0.11] | ||||||||||
Accommodation (own apartment / with family vs. collective accommodation center / with others [Ref]) | ↑ | β = 0.03 [CI -0.95, 1.70] | |||||||||
↓ | β = -0.01 [CI -1.04, 0.82] | ||||||||||
↑ | β = 0.01 [CI -2.40, 2.89] | ||||||||||
Groen et al. (2019) [26] | Netherlands | Afghan and Iraqi refugees and asylum seekers (n = 57) 2012–2015 | Mixed-methods study | Legal status (asylum vs. refugee [Ref]) | ↑ | β = 0.193 [CI -0.143, 0.560] | HSCL-25 HTQ | Sociodemographic factors (age, sex); Post-migration factors (PMLD, acculturation, legal status); Trauma-related factors (number of experienced traumas) | High | ||
↑ | |||||||||||
↑ | β = 0.241 [CI -0.096, 0.628] | ||||||||||
Acculturation (CRM-BS) | ↓ | β = -0.113 [CI -0.625, 0.239] | |||||||||
↓ | |||||||||||
↓ | β = -0.112 [CI -0.642, 0.247] | ||||||||||
PMLD (PMLP-CL) | ↑ | β = 0.428 [CI 0.170, 0.710] | |||||||||
↑ | |||||||||||
↑ | β = 0.396 [CI 0.140, 0.713] | ||||||||||
Gühne et al. (2021) [27] | Germany | Syrian refugees (n = 133) 2018–2019 | Cross-sectional study | Social support (ESSI) | ↓ | N.A | PHQ-9 PDS-5 | Sociodemographic factors (age, sex, number of household members); Post-migration factors (employment, social support, duration of residence) | High | ||
- | - | ||||||||||
↓ | N.A | ||||||||||
Duration of residence (months since residing in host country) | ↑ | β = 0.016 [CI NA] | |||||||||
- | - | ||||||||||
↑ | β = 0.050 [CI NA] | ||||||||||
Employment (employed vs. unemployed [Ref]) | ↓ | β = -2.506 [CI NA] | |||||||||
- | - | ||||||||||
↓ | β = -4.871 [CI NA] | ||||||||||
Hecker et al. (2018) [28] | Switzerland | Diverse refugee sample (n = 94) 2015–2016 | Cross-sectional study | Social support (SPS) | - | - | ITQ | Sociodemographic factors (gender); Trauma-related factors (trauma exposure); Post-migration factors (social support, PMLD) | Moderate | ||
- | - | ||||||||||
↑ | β = 0.13 [CI NA] β = 0.22 [CI NA] (for DSO) | ||||||||||
PMLD (PMLD-CL) | - | - | |||||||||
- | - | ||||||||||
↑ | β = 0.17 [CI NA] β = 0.42 [CI NA] (for DSO) | ||||||||||
Kaltenbach et al. (2018) [29] | Germany | Diverse refugee sample (n = 57) 2015–2017 | Longitudinal study | Legal status | - | N.A | PHQ-9 PSS-I PCL-5 | - | High | ||
- | - | ||||||||||
- | N.A | ||||||||||
Duration of residence | - | N.A | |||||||||
- | - | ||||||||||
- | N.A | ||||||||||
PMLD (PMLD-CL) | - | N.A | |||||||||
- | - | ||||||||||
↑ | N.A | ||||||||||
Leiler et al. (2019) [30] | Sweden | Diverse refugee sample (n = 577) 2016–2017) | Cross-sectional study | Legal status (asylum seekers vs. individuals with residence permit) | - | N.A | PHQ-9 GAD-7 PC-PTSD | - | Moderate | ||
- | N.A | ||||||||||
- | - | ||||||||||
Nissen et al. (2021) [31] | Norway | Syrian refugees (n = 902) 2018 -2019 | Cross-sectional study | Legal status (quota refugee vs. asylum seeker [Ref]) | ↑ | OR = 1.35 [CI 0.69, 2.65] | HSCL-25 HTQ | Sociodemographic factors (gender, age, education, marital status); Post-migration factors (legal status, duration of residence); Migration-related factors (arrived with friends/alone, length of flight, family members resettled in host country); Trauma-related factors (potentially traumatic experience) | Moderate | ||
↑ | OR = 1.78 [CI 0.91, 3.49] | ||||||||||
↑ | OR = 1.20 [CI 0.60, 2.39] | ||||||||||
Legal status (family reunion vs. asylum seeker [Ref]) | ↓ | OR = 0.95 [CI 0.46, 1.98] | |||||||||
↑ | OR = 1.28 [CI 0.62, 2.65] | ||||||||||
↑ | OR = 1.32 [CI 0.63, 2.79] | ||||||||||
Duration of residence (years since residing in host country) | ↑ | OR = 1.52 [CI 1.13, 2.05] | |||||||||
↑ | OR = 1.52 [CI 1.14, 2.04] | ||||||||||
↑ | OR = 1.30 [CI 0.96, 1.75] | ||||||||||
Nutsch & Bozorgmehr (2020) [32] | Germany | Diverse refugee sample (n = 4,136) 2016 | Cross-sectional study | Language skills (moderate vs. good [Ref]) | ↑ | OR = 1.144 [CI 0.841, 1.557] | PHQ-2 | Sociodemographic factors (age, sex, marital status, education, nationality); Post-migration factors (legal status, asylum interview, employment, satisfaction with accommodation, language skills, loneliness); Psychosocial factors (self-esteem, resilient coping behavior, life satisfaction, anxiety) | High | ||
- | - | ||||||||||
- | - | ||||||||||
Language skills (bad vs. good [Ref]) | ↑ | OR = 1.239 [CI 0,907, 1.692] | |||||||||
- | - | ||||||||||
- | - | ||||||||||
Loneliness (LS-S) | ↑ | OR = 1.143 [CI 1.103, 1.184] | |||||||||
- | - | ||||||||||
- | - | ||||||||||
Legal status (rejected status vs. recognized status or asylum seekers [Ref]) | ↑ | OR = 1.344 [CI 1.062, 1.701] | |||||||||
- | - | ||||||||||
- | - | ||||||||||
Asylum interview (yes vs. no [Ref]) | ↓ | OR = 0.710 [CI 0.556, 0.908] | |||||||||
- | - | ||||||||||
- | - | ||||||||||
Employment (unemployed vs. employed [Ref]) | ↑ | OR = 1.483 [CI 1.037, 2.121] | |||||||||
- | - | ||||||||||
- | - | ||||||||||
Satisfaction with accommodation | ↓ | OR = 0.943 [CI 0.909, 0.978] | |||||||||
- | - | ||||||||||
- | - | ||||||||||
Renner et al. (2021) [33] | Germany | Syrian refugees (n = 133) 2018–2019 | Cross-sectional study | Social support (ESSI) | ↓ | B = -0.32 [CI NA] | PHQ-9 GAD-7 PDS-5 | Sociodemographic factors (age, sex, education, living alone); Post-migration factors (employment, financial hardship, social support, connection to country of origin); Trauma-related factors (variability of traumatic events,); Psychosocial factors (self-efficacy, stigma, life satisfaction); Other factors (Religiousness) | High | ||
↓ | B = -0.20 [CI -0.39, 0.01] | ||||||||||
↓ | B = -0.55 [CI -0.98, -0.05] | ||||||||||
Employment (employed vs. unemployed [Ref]) | ↓ | B = -1.51 [CI NA] | |||||||||
↓ | B = -1.70 [CI -3.59, 0.17] | ||||||||||
↓ | B = -1.37 [CI -5.40, 2.93] | ||||||||||
Financial hardship (income < 500€ vs. income > 500€ [Ref]) | ↑ | B = 0.64 [CI NA] | |||||||||
↑ | B = 0.88 [CI -1.34, 3.54] | ||||||||||
↑ | B = 7.04 [CI 0.79, 13.72] | ||||||||||
Schiess-Jokanovic et al. (2021) [34] | Austria | Afghan refugees (n = 93) 2019–2020 | Randomized Controlled Trail (RCT) | Language acquisition and barriers | - | - | ITQ | - | Moderate | ||
- | - | ||||||||||
- | N.A | ||||||||||
Family concerns | - | - | |||||||||
- | - | ||||||||||
- | N.A | ||||||||||
Perceived discrimination | - | - | |||||||||
- | - | ||||||||||
- | N.A | ||||||||||
Distress of asylum procedure | - | - | |||||||||
- | - | ||||||||||
- | N.A | ||||||||||
Socioeconomic living situation | - | - | |||||||||
- | - | ||||||||||
- | N.A | ||||||||||
Sengoelge et al. (2020) [35] | Sweden | Diverse refugee sample (n = 455) 2016–2018 | Cross-sectional study | Social and financial hardship (RPMS) | ↑ | B = 0.786 [CI 0.598, 1.021] | HSCL-25 | - | Moderate | ||
↑ | |||||||||||
- | - | ||||||||||
Social support (ESSI) | ↑ | B = -0.103 [CI NA] | |||||||||
↑ | |||||||||||
- | - | ||||||||||
Solberg et al. (2020) [36] | Sweden | Diverse asylum-seeker sample (n = 455) 2016–2018 | Cross-sectional study | Language difficulties (yes vs. no [Ref]) | ↑ | OR = 1.95 [CI 1.18, 3.23] | HSCL-25 HTQ | Sociodemographic factors (gender, age, education, marital status); Trauma-related factors (potentially traumatic pre-/peri-migratory events); Post-migration factors (discrimination, language difficulties, financial hardship, missing social life back home, sadness due to lack of family reunification, social isolation, family conflicts) | Moderate | ||
↑ | OR = 2.02 [CI 1.26, 3.26] | ||||||||||
↑ | OR = 5.43 [CI 1.87, 5.18] | ||||||||||
Missing social life back home (yes vs. no [Ref]) | ↑ | OR = 2.09 [CI 1.23, 3.57] | |||||||||
↑ | OR = 2.18 [CI 1.31, 3.62] | ||||||||||
↑ | OR = 1.23 [CI 0.74, 2.04] | ||||||||||
Sadness due to lack of family reunification (yes vs. no [Ref]) | ↑ | OR = 1.14 [CI 0.65, 2.01] | |||||||||
↑ | OR = 1.32 [CI 0.77, 2.27] | ||||||||||
↓ | OR = 0.76 [CI 0.43, 1.33] | ||||||||||
Family conflicts (yes vs. no [Ref]) | ↑ | OR = 9.44 [CI 2.81, 31.72] | |||||||||
↑ | OR = 4.72 [CI 2.09, 10.70] | ||||||||||
↑ | OR = 3.85 [CI 1.76, 8.42] | ||||||||||
Social isolation (yes vs. no [Ref]) | ↑ | OR = 3.10 [CI 1.76, 5.44] | |||||||||
↑ | OR = 3.97 [CI 2.34, 6.71] | ||||||||||
↑ | OR = 5.69 [CI 3.25, 9.96] | ||||||||||
Perceived discrimination (yes vs. no [Ref]) | ↑ | OR = 4.26 [CI 1.43, 12.70] | |||||||||
↑ | OR = 2.22 [CI 1.01, 4.90] | ||||||||||
↑ | OR = 5.43 [CI 2.00–14.75] | ||||||||||
Financial hardship (yes vs. no [Ref]) | ↑ | OR = 3.58 [CI 1.91, 6.72] | |||||||||
↑ | OR = 2.95 [CI 1.70, 5.13] | ||||||||||
↑ | OR = 5.85 [CI 3.14, 10.89] | ||||||||||
Strømme et al. (2021) [37] | Norway, Lebanon | Syrian refugees (n = 353) T0: 2017–2018 T1: 2018–2019 | Longitudinal study | Social support (poor vs. not poor [Ref]) | ↑ | RRT0 = 1.6 [CI 1.2, 2.1] RRT1 = 6.2 [CI 3.6, 10.8] | HSCL-10 | Sociodemographic factors (age, gender) Post-migration factors (social support, economy); | High | ||
↑ | |||||||||||
- | - | ||||||||||
Economy (Poor vs. not poor [Ref]) | ↑ | RRT0 = 1.1 [CI 0.7, 1.7] RRT1 = 4.5 [CI 2.6, 7.9] | |||||||||
↑ | |||||||||||
- | - | ||||||||||
Tinghög et al. (2017) [38] | Sweden | Syrian refugees (n = 1,215) 2016 | Cross-sectional study | Language difficulties (yes vs. no [Ref]) | ↑ | OR = 2.39 [CI 1.78, 3.19] | HSCL-25 HTQ | Sociodemographic factors (gender, age, education, marital status); Trauma-related factors (potentially traumatic pre-/peri-migratory events); Post-migration factors (discrimination, language difficulties, financial hardship, missing social life back home, sadness due to lack of family reunification, social isolation, family conflicts) | Moderate | ||
↑ | OR = 1.77 [CI 1.30, 2.40] | ||||||||||
↑ | OR = 2.77 [CI 2.00, 3.83] | ||||||||||
Missing social life back home (yes vs. no [Ref]) | ↑ | OR = 2.37 [CI 1.74, 3.23] | |||||||||
↑ | OR = 2.00 [CI 1.46, 2.81] | ||||||||||
↑ | OR = 2.90 [CI 1.97, 4.27] | ||||||||||
Sadness due to lack of family reunification (yes vs. no [Ref]) | ↑ | OR = 1.41 [CI 1.06, 1.86] | |||||||||
↑ | OR = 1.26 [CI 0.93, 1.71] | ||||||||||
↑ | OR = 1.49 [CI 1.08, 2.05] | ||||||||||
Family conflicts (yes vs. no [Ref]) | ↑ | OR = 4.87 [CI 2.25, 10.53] | |||||||||
↑ | OR = 2.51 [CI 1.29, 4.92] | ||||||||||
↑ | OR = 5.16 [CI 2.56, 10.40] | ||||||||||
Social isolation (yes vs. no [Ref]) | ↑ | OR = 3.40 [CI 2.39, 4.83] | |||||||||
↑ | OR = 2.42 [CI 1.70, 3.46] | ||||||||||
↑ | OR = 3.29 [CI 2.27, 4.78] | ||||||||||
Perceived discrimination (yes vs. no [Ref]) | ↑ | OR = 5.68 [CI 2.83, 11.41] | |||||||||
↑ | OR = 5.49 [CI 2.79, 10.81] | ||||||||||
↑ | OR = 5.96 [CI 2.97, 11.94] | ||||||||||
Financial hardship (yes vs. no [Ref]) | ↑ | OR = 3.46 [CI 2.14, 5.60] | |||||||||
↑ | OR = 3.46 [CI 2.14, 5.60] | ||||||||||
↑ | OR = 4.31 [CI 2.49, 7.45] | ||||||||||
Walther et al. (2020) [39] | Germany | Diverse refugee sample (n = 4,325) 2016 | Cross-sectional study | Language skills | ↓ | β = ‐0.156 [CI -0.261, -0.052] | PHQ-4 | Geographical factors (federal states of Germany); Sociodemographic factors (sex, age, education, country of origin, marital status); Post-migration factors (duration of residence, legal status, seeking family reunification, accommodation, employment, number of (language) courses, social contacts, language skills); Pre-/Peri-migration-related factors (number of flight reasons, arrived in host country alone, negative flight experience); Other factors (Religiousness) | High | ||
↓ | |||||||||||
- | - | ||||||||||
Language and integration courses attended (number of courses) | ↓ | β = ‐0.013 [CI -0.105, 0.079] | |||||||||
↓ | |||||||||||
- | - | ||||||||||
Seeking family reunification (seeking vs. not seeking [Ref]) | ↑ | β = 1.111 [CI 0.805, 1.417] | |||||||||
↑ | |||||||||||
- | - | ||||||||||
Social contacts (time with people from host country) | ↓ | β = -0.176 [CI -0.270, -0.082] | |||||||||
↓ | |||||||||||
- | |||||||||||
Social contacts (time with people from country of origin) | ↓ | β = -0.079 [CI -0.172, 0.013] | |||||||||
↓ | |||||||||||
- | - | ||||||||||
Legal status (subsidiary protection vs. refugee status or asylum [Ref]) | ↑ | β = 0.493 [CI 0.021, 0.965] | |||||||||
↑ | |||||||||||
- | - | ||||||||||
Legal status (awaiting outcome vs. refugee status or asylum [Ref]) | ↑ | β = 0.495 [CI 0.288, 0.702] | |||||||||
↑ | |||||||||||
- | - | ||||||||||
Legal status (suspension of deportation vs. refugee status or asylum [Ref]) | ↑ | β = 0.749 [CI 0.137, 1.362] | |||||||||
↑ | |||||||||||
- | - | ||||||||||
Employment (currently working vs. currently not working [Ref]) | ↓ | β = -0.422 [CI -0.710, -0.134] | |||||||||
↓ | |||||||||||
- | - | ||||||||||
Employment (not seeking work vs. currently not working [Ref]) | ↑ | β = 0.312 [CI -0.016, 0.640] | |||||||||
↑ | |||||||||||
- | - | ||||||||||
Accommodation (private accommodation vs. refugee housing facility [Ref]) | ↓ | β = -0.446 [CI -0.658, -0.233] | |||||||||
↓ | |||||||||||
- | - |