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Psychiatric screening and interventions for minor refugees in Europe: an overview of approaches and tools

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Abstract

Currently hundreds of thousands of minor refugees entered Europe. This group has been exposed to traumatic events pre-, during, and post-migration and is at increased risk of developing psychiatric disorders. In this article, we describe the results of our literature search on screening and interventions for post-traumatic stress disorder (PTSD) in minor refugees, in order to make recommendations for clinical practice. Results show that studies on diagnostic accuracy of assessment instruments and efficacy of mental healthcare interventions in this population are lacking. Traumatic experiences pre-flight, during the flight and at resettlement, superimposed by parental PTSD, and other contextual factors, might lead to more than 25% of minor refugees developing PTSD.

Conclusion: To enhance the number of minor refugees recognized with PTSD, we recommend the use of a brief screening instrument. A public health approach, focusing on environmental supportive factors is the first step in treatment for this group, followed by short-term psychological group interventions focusing on psycho-education and stress reduction. Minor refugees with no improvement in PTSD symptoms by these interventions need referral to specialized mental health care services. Mental health providers should be culturally competent.

What is Known:

• Post-traumatic stress disorder, anxiety, sleeping problems, and depression are the most common psychiatric disorders in minor refugees.

• Evidence based methods on screening and interventions in minor refugees with psychiatric disorders are lacking.

What is New:

• In the absence of validated screening tools a best practice reliable, quick and child-friendly tool is presented.

• A layered system for mental health care and psychosocial support in minor refugees is explained.

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Abbreviations

CRIES:

Children’s Revised Impact of Event Scale

DSM-5:

diagnostic and statistical manual of mental disorders-5

EMDR:

eye movement desensitization and reprocessing

IASC:

Inter-agency Standing Committee

IES:

impact of event scale

KIDNET:

narrative exposure therapy for children

NICE:

National Institute for Health and Care Excellence

PTSD:

post-traumatic stress disorder

TF-CBT:

trauma focused-cognitive behavior therapy

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Funding

This study has not been funded.

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Authors and Affiliations

  1. Karakter, Postbus 40244 Dr. E. Schattenkerkweg 1, 8004, DE Zwolle, The Netherlands

    Annerieke Horlings

  2. De Bascule/Academic Medical Centre Amsterdam, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands

    Irma Hein

Authors
  1. Annerieke Horlings
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  2. Irma Hein
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Contributions

Study design: Horlings AH, Hein IM

Literature search: Horlings AH, Hein IM

Drafting the article: Horlings AH

Figures, tables: Horlings AH

Critical revision: Hein IM

Final approval of the version to be published: Horlings AH, Hein IM

Corresponding author

Correspondence to Annerieke Horlings.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Communicated by Nicole Ritz

This article refers to the Editiorial https://doi.org/10.1007/s00431-017-3019-4

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Horlings, A., Hein, I. Psychiatric screening and interventions for minor refugees in Europe: an overview of approaches and tools. Eur J Pediatr 177, 163–169 (2018). https://doi.org/10.1007/s00431-017-3027-4

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  • DOI: https://doi.org/10.1007/s00431-017-3027-4

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