{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T19:00:21Z","timestamp":1793386821740,"version":"4.5.0"},"reference-count":84,"publisher":"Royal College of Psychiatrists","issue":"3","license":[{"start":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T00:00:00Z","timestamp":1620000000000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec id=\"S2056472421000545_sec_a1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In total numbers, Germany has faced the largest number of refugees and asylum seekers (RAS) in Europe in the past decade. Although a considerable proportion have experienced traumatic and stressful life events, there is no systematic review to date examining the prevalence of depressive symptoms and post-traumatic stress disorder (PTSD) symptoms in RAS in Germany.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472421000545_sec_a2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To calculate the prevalence of depressive symptoms and PTSD symptoms in the general population of RAS living in Germany after the year 2000 and explore the impact of study- and participant-related characteristics on prevalence estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472421000545_sec_a3\" sec-type=\"methods\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We systematically searched PubMed, CINAHL, PsycINFO, PSYNDEX, Academic Search Complete, Science Direct and Web of Science from January 2000 to May 2020 to identify articles reporting prevalence of depressive symptoms and PTSD in RAS in Germany (PROSPERO registration number: CRD42020182796).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472421000545_sec_a4\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 31 different surveys met inclusion criteria with 20 surveys reporting prevalence estimates of depressive symptoms and 25 surveys symptoms of PTSD. Based on screening tools, the pooled prevalence estimate of PTSD symptoms was 29.9% (95% CI 20.8\u201338.7%) and of depressive symptoms 39.8% (95% CI 29.8\u201350.1%). Heterogeneity was large within and between subgroups. In multivariate meta-regressions on depressive symptoms, heterogeneity was largely explained by survey period, length of field period and study quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472421000545_sec_a5\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prevalence rates of depressive symptoms and PTSD symptoms in RAS are notably large. They exceed the prevalence in the general German population. As a result of high heterogeneity, however, pooled prevalence rates should be interpreted with caution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjo.2021.54","type":"journal-article","created":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T05:07:56Z","timestamp":1620018476000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":82,"title":["Prevalence of depressive symptoms and symptoms of post-traumatic stress disorder among newly arrived refugees and asylum seekers in Germany: systematic review and meta-analysis"],"prefix":"10.1192","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2725-046X","authenticated-orcid":false,"given":"Andreas","family":"Hoell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eirini","family":"Kourmpeli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans Joachim","family":"Salize","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Heinz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Padberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ute","family":"Habel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inge","family":"Kamp-Becker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar","family":"H\u00f6hne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8263-4936","authenticated-orcid":false,"given":"Kerem","family":"B\u00f6ge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malek","family":"Bajbouj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2021,5,3]]},"reference":[{"key":"S2056472421000545_ref50","unstructured":"50 Ruf, M . [Traumatised refugee children in Germany epidemiology, treatment and neurocognitive as well as neurophysiological changes]. Dissertation Institute of Psychology, University of Konstanz, 2008 [in German]."},{"key":"S2056472421000545_ref48","doi-asserted-by":"publisher","DOI":"10.1017\/S2045796019000325"},{"key":"S2056472421000545_ref34","unstructured":"34. Butollo, W , Maragkos, M . [Final Report of the Expert Panel on Asylum Seekers: Detection of Mental Disorders in Asylum Seekers]. 100. Lehrstuhl Klinische Psychologie und Psychotherapie der Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, 2012 [in German]."},{"key":"S2056472421000545_ref1","unstructured":"1 United Nations High Commissioner for Refugees (UNHCR). Global Trends. Forced Displacement in 2019. United Nations High Commissioner for Refuge, 2020."},{"key":"S2056472421000545_ref69","volume-title":"[Scientific Findings on the Structure of Medical Care in Initial Reception Centres for Refugees: Preliminary Results of a Study to Develop and Evaluate Context-Specific Interventions to Improve Health Care for Asylum Seekers]","author":"Biddle","year":"2019"},{"key":"S2056472421000545_ref56","first-page":"191","article-title":"[The influence of residence status on psychiatric symptom load of asylum seekers in Germany]","volume":"46","author":"Winkler","year":"2019","journal-title":"Psychiat Prax"},{"key":"S2056472421000545_ref57","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22358"},{"key":"S2056472421000545_ref75","volume-title":"[On the Way to a \u201cNormal Life\u201d? An Analysis of the Health Situation of Asylum Seekers in the Region Osnabr\u00fcck]","author":"Behrensen","year":"2012"},{"key":"S2056472421000545_ref55","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2019.1686801"},{"key":"S2056472421000545_ref45","first-page":"377","article-title":"[Posttraumatic stress and depressive symptoms amongst asylum seekers. Screening in a state refugee reception center]","volume":"66","author":"Kr\u00f6ger","year":"2016","journal-title":"Psychother Psych Med"},{"key":"S2056472421000545_ref73","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-020-01678-2"},{"key":"S2056472421000545_ref21","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2013-203104"},{"key":"S2056472421000545_ref82","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-019-2110-y"},{"key":"S2056472421000545_ref8","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20438"},{"key":"S2056472421000545_ref15","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1132"},{"key":"S2056472421000545_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2019.11.011"},{"key":"S2056472421000545_ref80","doi-asserted-by":"publisher","DOI":"10.1002\/jcop.22338"},{"key":"S2056472421000545_ref58","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.090313"},{"key":"S2056472421000545_ref32","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2018.00212"},{"key":"S2056472421000545_ref37","doi-asserted-by":"publisher","DOI":"10.1007\/s10903-018-0692-y"},{"key":"S2056472421000545_ref62","first-page":"1","article-title":"Depressive symptoms among adults in Germany","volume":"2","author":"Bretschneider","year":"2017","journal-title":"J Health Monitor"},{"key":"S2056472421000545_ref66","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-020-02746-2"},{"key":"S2056472421000545_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.semcdb.2017.11.030"},{"key":"S2056472421000545_ref9","first-page":"353","article-title":"[The current state of intercultural opening in psychosocial services\u2013the results of an assessment in an Inner-City District of Berlin]","volume":"65","author":"Penka","year":"2015","journal-title":"Psychother Psychosom Med Psychol"},{"key":"S2056472421000545_ref17","volume-title":"Asylum and Migration Glossary 6.0. A Tool for Better Comparability Produced by the European Migration Network","year":"2018"},{"key":"S2056472421000545_ref35","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2019.1591330"},{"key":"S2056472421000545_ref74","doi-asserted-by":"publisher","DOI":"10.1007\/s00103-016-2336-5"},{"key":"S2056472421000545_ref16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"S2056472421000545_ref76","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2017.1388102"},{"key":"S2056472421000545_ref5","doi-asserted-by":"publisher","DOI":"10.3402\/ejpt.v7.28057"},{"key":"S2056472421000545_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2015.05.010"},{"key":"S2056472421000545_ref28","first-page":"356","article-title":"[Trauma and reconciliation: child refugees in Hamburg]","volume":"5","author":"Adam","year":"2011","journal-title":"Trauma and Gewalt"},{"key":"S2056472421000545_ref29","volume-title":"[Living Conditions and Mental Health of Residents in a Collective Accommodation Centre for Asylum Seekers in W\u00fcrzburg]. Medizinische Fakult\u00e4t: 116","author":"Albers","year":"2012"},{"key":"S2056472421000545_ref36","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2018.11.001"},{"key":"S2056472421000545_ref65","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-018-1973-7"},{"key":"S2056472421000545_ref6","first-page":"24","article-title":"[Health and healthcare provision to asylum seekers and refugees in Germany]","volume":"2","author":"Frank","year":"2017","journal-title":"J Health Monitor"},{"key":"S2056472421000545_ref70","volume-title":"Culture, Context and the Mental Health and Psychosocial Wellbeing of Syrians: A Review for Mental Health and Psychosocial Support staff working with Syrians Affected by Armed Conflict","author":"Hassan","year":"2015"},{"key":"S2056472421000545_ref78","volume-title":"mhGAP Intervention Guide for Mental, Neurological and Substance use Disorders in Non-Specialized Health Settings","year":"2010"},{"key":"S2056472421000545_ref12","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2012.301136"},{"key":"S2056472421000545_ref19","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.6504"},{"key":"S2056472421000545_ref24","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"S2056472421000545_ref31","volume-title":"[Language Skills and Employment Rate of Refugees in Germany Improving with Time] DIW Wochenbericht 4\/2019: 56\u201370","author":"Br\u00fccker","year":"2019"},{"key":"S2056472421000545_ref10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003337"},{"key":"S2056472421000545_ref46","doi-asserted-by":"publisher","DOI":"10.7146\/torture.v28i2.106884"},{"key":"S2056472421000545_ref2","unstructured":"2 Eurostat, . Asylum Seeker and First-Time Application of Asylum. Monthly Data. European Union, 2020. Eurostat, 2020 (https:\/\/ec.europa.eu\/eurostat\/databrowser\/view\/tps00189\/default\/table?lang=de) [in German]."},{"key":"S2056472421000545_ref7","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-033658"},{"key":"S2056472421000545_ref13","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-018-1215-z"},{"key":"S2056472421000545_ref59","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyp203"},{"key":"S2056472421000545_ref79","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-12-14"},{"key":"S2056472421000545_ref43","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2017.1389205"},{"key":"S2056472421000545_ref38","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-016-0148-4"},{"key":"S2056472421000545_ref40","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph14060612"},{"key":"S2056472421000545_ref42","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2018.00628"},{"key":"S2056472421000545_ref52","first-page":"135","article-title":"[Mental health problems of unaccompanied young refugees in youth welfare institutions]","volume":"46","author":"Sierau","year":"2019","journal-title":"Psychiat Prax"},{"key":"S2056472421000545_ref63","doi-asserted-by":"publisher","DOI":"10.1007\/s00103-007-0250-6"},{"key":"S2056472421000545_ref68","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0239211"},{"key":"S2056472421000545_ref54","doi-asserted-by":"publisher","DOI":"10.3402\/ejpt.v6.25863"},{"key":"S2056472421000545_ref61","doi-asserted-by":"publisher","DOI":"10.1007\/s00115-008-2467-5"},{"key":"S2056472421000545_ref18","unstructured":"18 K\u00fchne, S , Jacobsen, J , Kroh, M . Sampling in Times of High Immigration: The Survey Process of the IAB-BAMF-SOEP Survey of Refugees. Survey Methods: Insights from the field, 2019 (https:\/\/surveyinsights.org\/?p=11416)."},{"key":"S2056472421000545_ref26","doi-asserted-by":"publisher","DOI":"10.1097\/XEB.0000000000000141"},{"key":"S2056472421000545_ref67","unstructured":"67 G\u00f6pffarth, D , Bauhoff, S . [Provision of Healthcare for Asylum Seekers \u2013 Analysis of Claims Data from the BARMER Health Insurance Company]. Gesundheitswesen aktuell: 32\u201365. BARMER GEK, 2017."},{"key":"S2056472421000545_ref81","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2018.00663"},{"key":"S2056472421000545_ref51","first-page":"1","article-title":"[Health of refugees in Germany - A survey on refugees from Syria, Iraq and Afghanistan]","volume":"15","author":"Schr\u00f6der","year":"2018","journal-title":"WIdO Monitor"},{"key":"S2056472421000545_ref47","first-page":"9","article-title":"Mental health and associated stress factors in accompanied and unaccompanied refugee minors resettled in Germany: a cross-sectional study","volume":"13","author":"M\u00fcller","year":"2019","journal-title":"Child Adolesc Ment Health"},{"key":"S2056472421000545_ref39","doi-asserted-by":"publisher","DOI":"10.1026\/1616-3443.35.1.12"},{"key":"S2056472421000545_ref83","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2019.1937"},{"key":"S2056472421000545_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2009.04.032"},{"key":"S2056472421000545_ref4","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckw010"},{"key":"S2056472421000545_ref20","volume-title":"MetaXL User Guide Version 5.3","author":"Barendregt","year":"2016"},{"key":"S2056472421000545_ref30","doi-asserted-by":"publisher","DOI":"10.1186\/s12982-019-0085-2"},{"key":"S2056472421000545_ref23","doi-asserted-by":"publisher","DOI":"10.1214\/aoms\/1177729756"},{"key":"S2056472421000545_ref33","first-page":"538","volume-title":"Exploring Hair Steroid Concentrations in Asylum Seekers, Internally Displaced Refugees, and Immigrants. Stress","volume":"23","author":"Buchm\u00fcller","year":"2020;"},{"key":"S2056472421000545_ref53","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30595-0"},{"key":"S2056472421000545_ref64","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-017-1239-9"},{"key":"S2056472421000545_ref49","unstructured":"49 Niklewski, G , Richter, K , Lehfeld, H . [Report of the expert panel on asylum seekers: Detection of mental disorders in asylum seekers in Zirndorf]. Klinik f\u00fcr Psychiatrie und Psychotherapie, Klinikum N\u00fcrnberg, 2012 [in German]."},{"key":"S2056472421000545_ref71","doi-asserted-by":"publisher","DOI":"10.1186\/s12914-015-0064-9"},{"key":"S2056472421000545_ref72","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-019-01340-6"},{"key":"S2056472421000545_ref27","first-page":"9","article-title":"Practical issues in calculating the sample size for prevalence studies","volume":"1","author":"Naing","year":"2006","journal-title":"Arch Orofactial Sci"},{"key":"S2056472421000545_ref41","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2018.00393"},{"key":"S2056472421000545_ref60","doi-asserted-by":"crossref","first-page":"207","DOI":"10.4103\/INTV.INTV_60_18","article-title":"Mental disorder or emotional distress? How psychiatric surveys in Afghanistan ignore he role of gender, culture and context","volume":"16","author":"Ventevogel","year":"2018","journal-title":"Intervention"},{"key":"S2056472421000545_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(01)00377-8"},{"key":"S2056472421000545_ref44","first-page":"385","article-title":"[Psychometric evaluation of an Arabic version of the PHQ-4 based on a representative survey of Syrian refugees]","volume":"66","author":"Kliem","year":"2016","journal-title":"PPmP"},{"key":"S2056472421000545_ref77","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-019-00991-5"},{"key":"S2056472421000545_ref84","doi-asserted-by":"publisher","DOI":"10.1002\/j.2051-5545.2009.tb00233.x"}],"container-title":["BJPsych Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056472421000545","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T01:13:49Z","timestamp":1698974029000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056472421000545\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":84,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["S2056472421000545"],"URL":"https:\/\/doi.org\/10.1192\/bjo.2021.54","relation":{},"ISSN":["2056-4724"],"issn-type":[{"value":"2056-4724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e93"}}