Risk and protective factors for comorbidity of PTSD, depression, and anxiety among Somali refugees in Kenya

H Im, LET Swan, AH Warsame… - International journal of …, 2022 - journals.sagepub.com
H Im, LET Swan, AH Warsame, MM Isse
International journal of social psychiatry, 2022journals.sagepub.com
Background: Comorbid common mental disorders (CMDs) are pervasive in refugee
populations. However, limited research has explored psychosocial factors for mental
disorder comorbidity in Somali refugee samples. Aims: This study aims to explore potential
risk and protective factors for comorbid depression-anxiety and comorbid depression-PTSD
by examining associations between trauma exposure, psychosocial factors, and mental
health symptoms among a sample of Somali refugees displaced in urban Kenya. Methods …
Background
Comorbid common mental disorders (CMDs) are pervasive in refugee populations. However, limited research has explored psychosocial factors for mental disorder comorbidity in Somali refugee samples.
Aims
This study aims to explore potential risk and protective factors for comorbid depression-anxiety and comorbid depression-PTSD by examining associations between trauma exposure, psychosocial factors, and mental health symptoms among a sample of Somali refugees displaced in urban Kenya.
Methods
We used snowball sampling to recruit Somali youth aged 15 to 35years(N = 250,n = 143 female, n = 88 male, n = 19 unknown gender). We measured 16 common types of trauma exposure and three psychosocial factors (endorsing violence, willingness to share problems, and symptom awareness) and used the HSCL-25 and PCL-C to capture individual and comorbid CMD symptoms, using guided cutoff points and/or algorithms. We then ran a series of logistic regression analyses to examine relationships between trauma exposure, psychosocial factors, and individual and comorbid CMD symptoms.
Results
Findings showed that increased trauma exposure predicted symptoms of individual and comorbid CMDs. Increased symptom awareness and endorsement of violence predicted comorbid depression-PTSD and comorbid anxiety-depression symptoms, respectively. Willingness to share problems buffered depressive symptoms but did not predict comorbidity.
Conclusions
These findings revealed the high CMD comorbidity prevalence with differential effects of trauma and psychosocial factors on individual or comorbid mental disorders. This study suggests a need for transdiagnostic approaches that cut across Western diagnostic boundaries and consider culturally responsive and relevant items for mental health measures.
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