{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T03:14:02Z","timestamp":1791256442667,"version":"4.1.0"},"reference-count":32,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2020,9,11]],"date-time":"2020-09-11T00:00:00Z","timestamp":1599782400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0033291720003190_sec_a1\"><jats:title>Background<\/jats:title><jats:p>The study aimed to examine differences in, and characteristics of psychiatric care utilization in young refugees who came to Sweden as unaccompanied or accompanied minors, compared with that of their non-refugee immigrant and Swedish-born peers.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291720003190_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>This register-linkage cohort study included 746 688 individuals between 19 and 25 years of age in 2009, whereof 32 481 were refugees (2896 unaccompanied and 29 585 accompanied) and 32 151 non-refugee immigrants. Crude and multivariate Cox regression models yielding hazard ratios (HR) and 95% confidence intervals (CI) were conducted to investigate subsequent psychiatric care utilization for specific disorders, duration of residence and age at migration.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291720003190_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>The adjusted HRs for psychiatric care utilization due to any mental disorder was significantly lower in both non-refugee and refugee immigrants when compared to Swedish-born [aHR: 0.78 (95% CI 0.76\u20130.81) and 0.75 (95% CI 0.72\u20130.77, respectively)]. Within the refugee group, unaccompanied had slightly lower adjusted risk estimates than accompanied. This pattern was similar for all specific mental disorders except for higher rates in schizophrenia, reaction to severe stress\/adjustment disorders and post-traumatic stress disorder. Psychiatric health care utilization was also higher in immigrants with more than 10 years of residency in Sweden entering the country being younger than 6 years of age.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291720003190_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>For most mental disorders, psychiatric health care utilization in young refugees and non-refugee immigrants was lower than in their Swedish-born peers; exceptions are schizophrenia and stress-related disorders. Arrival in Sweden before the age of 6 years was associated with higher rates of overall psychiatric care utilization.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291720003190","type":"journal-article","created":{"date-parts":[[2020,9,11]],"date-time":"2020-09-11T09:18:45Z","timestamp":1599815925000},"page":"1365-1375","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":35,"title":["Differences in psychiatric care utilization between refugees, non-refugee migrants and Swedish-born youth"],"prefix":"10.1017","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3142-2137","authenticated-orcid":false,"given":"Emma","family":"Bj\u00f6rkenstam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Helgesson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Norredam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marit","family":"Sijbrandij","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher Jamil","family":"de Montgomery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellenor","family":"Mittendorfer-Rutz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2020,9,11]]},"reference":[{"key":"S0033291720003190_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2019.02.007"},{"key":"S0033291720003190_ref12","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckx034"},{"key":"S0033291720003190_ref23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-7379.2008.01153.x"},{"key":"S0033291720003190_ref8","first-page":"1","article-title":"Traumatized refugees: Morbidity, treatment and predictors of outcome","volume":"61","author":"Buhmann","year":"2014","journal-title":"Danish Medical Journal"},{"key":"S0033291720003190_ref24","doi-asserted-by":"publisher","DOI":"10.1002\/ajcp.12085"},{"key":"S0033291720003190_ref15","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0b013e31829dbd64"},{"key":"S0033291720003190_ref32","unstructured":"World Health Organization (2018). Health of refugee and migrant children. Retrieved from http:\/\/www.euro.who.int\/__data\/assets\/pdf_file\/0011\/388361\/tc-health-children-eng.pdf?ua=1."},{"key":"S0033291720003190_ref27","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-018-1122-3"},{"key":"S0033291720003190_ref31","unstructured":"United Nations, D. o. E. a. S. A., Population Division. (2017). International migration report 2017: Highlights (ST\/ESA\/SER.A\/404). New York. Retrieved from http:\/\/www.un.org\/en\/development\/desa\/population\/migration\/publications\/migrationreport\/docs\/MigrationReport2017_Highlights.pdf."},{"key":"S0033291720003190_ref4","doi-asserted-by":"publisher","DOI":"10.1097\/01.nmd.0000243751.49499.93"},{"key":"S0033291720003190_ref30","unstructured":"UNHCR (2019). Guidelines on policies and procedures in dealing with unaccompanied children seeking asylum. Retrieved from https:\/\/www.unhcr.org\/3d4f91cf4.pdf."},{"key":"S0033291720003190_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32114-7"},{"key":"S0033291720003190_ref18","doi-asserted-by":"publisher","DOI":"10.1007\/s10597-019-00481-x"},{"key":"S0033291720003190_ref20","first-page":"15","volume-title":"Migration and mental health","author":"Kirkbride","year":"2011"},{"key":"S0033291720003190_ref25","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2010.109595"},{"key":"S0033291720003190_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.02.015"},{"key":"S0033291720003190_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.01.013"},{"key":"S0033291720003190_ref2","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0000000000000576"},{"key":"S0033291720003190_ref19","first-page":"1295","article-title":"Prevalence of mental disorders in young refugees and asylum seekers in European Countries: A systematic review","volume":"10","author":"Kien","year":"2018","journal-title":"European Child and Adolescent Psychiatry"},{"key":"S0033291720003190_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60051-2"},{"key":"S0033291720003190_ref22","first-page":"1","article-title":"Trauma, exile and mental health in young refugees","volume":"146","author":"Montgomery","year":"2011","journal-title":"Acta Psychiatrica Scandinavia Supplementum"},{"key":"S0033291720003190_ref17","doi-asserted-by":"publisher","DOI":"10.1186\/1753-2000-3-13"},{"key":"S0033291720003190_ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-016-1260-1"},{"key":"S0033291720003190_ref14","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002944"},{"key":"S0033291720003190_ref21","doi-asserted-by":"publisher","DOI":"10.1017\/S2045796016000445"},{"key":"S0033291720003190_ref7","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-014-0122-2"},{"key":"S0033291720003190_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.semcdb.2017.11.030"},{"key":"S0033291720003190_ref29","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-014863"},{"key":"S0033291720003190_ref16","first-page":"1","article-title":"Refugee migration and risk of schizophrenia and other non-affective psychoses: Cohort study of 1.3 million people in Sweden","volume":"352","author":"Hollander","year":"2016","journal-title":"BMJ"},{"key":"S0033291720003190_ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s10488-006-0046-2"},{"key":"S0033291720003190_ref9","first-page":"1","article-title":"Psychiatric healthcare utilisation among refugee adolescents and their peers in Denmark","author":"de Montgomery","year":"2020","journal-title":"Social Psychiatry and Psychiatric Epidemiology"},{"key":"S0033291720003190_ref10","doi-asserted-by":"publisher","DOI":"10.1017\/S2045796017000695"}],"container-title":["Psychological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0033291720003190","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T05:14:11Z","timestamp":1654060451000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0033291720003190\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,11]]},"references-count":32,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["S0033291720003190"],"URL":"https:\/\/doi.org\/10.1017\/s0033291720003190","relation":{},"ISSN":["0033-2917","1469-8978"],"issn-type":[{"value":"0033-2917","type":"print"},{"value":"1469-8978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,11]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2020. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}