SAN FRANCISCO (FRONTLINE MEDICAL NEWS) – Nearly one-third of adult Syrian civil war refugees who have resettled in the Detroit area meet diagnostic criteria for posttraumatic stress disorder, according to preliminary results of an ongoing study presented by Arash Javanbakht, MD, at the annual conference of the Anxiety and Depression Association of America.

That’s comparable to PTSD rates documented in Vietnam War combat veterans.

Moreover, 90% of the Syrian war refugees who met criteria for PTSD also screened positive for clinically important levels of anxiety, and 85% had clinically significant depressive symptoms, added Dr. Javanbakht , a psychiatrist who directs the stress, trauma, and anxiety research and clinical program at Wayne State University in Detroit.

“Based on these data, mental health care for Syrian refugees resettling in the U.S. is highly needed,” he observed.

Michigan has a large population of Syrian war refugees. All who settle in southeastern Michigan undergo an initial health examination at Arab American and Chaldean Council primary care clinics staffed by bilingual teams. More than 90% of eligible adult refugees who have been invited to join Dr. Javanbakht’s mental health screening study have opted to participate. This extraordinarily high recruitment rate suggests that the findings are generalizable to the broader Syrian refugee community throughout the United States in his view.

The screening tools employed in the study are the PTSD Checklist, DSM-IV version ( PCL ), and the Hopkins Symptom Checklist ( HSCL-25 ), which contains 10 anxiety questions and 15 depression questions.

Of the first 82 adult Syrian refugees evaluated, 26 (31.5%) were diagnosed as having PTSD on the basis of a PCL total score of 40 or more plus fulfillment of the DSM-IV diagnostic criteria for the disorder. In fact, this subgroup had a mean PCL score of 62.3. The prevalence of PTSD was twice as great in women, compared with men (see graphic).

Clinically impactful anxiety symptoms as defined by an HSCL-25 anxiety score greater than 1.79 was present in 38 refugees (47%), and clinically meaningful depressive symptoms were present in 47 (58%).

Anxiety, depression, and PTSD all were tightly correlated, complicating the clinical challenges, the psychiatrist noted.

Enrollment in the study is ongoing, but a first pass examination of a participant population that’s now twice the size of that in his presentation at the conference continues to show similar results, according to Dr. Javanbakht.

Dr. Javanbakht reported having no financial conflicts of interest regarding the study, which was funded by the state of Michigan and the Detroit Wayne Mental Health Authority.


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