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Factors Associated with Symptoms of Depression Among Bhutanese Refugees in the United States

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Refugees are at risk for psychiatric morbidity, yet little is known about their mental health conditions. We identified factors associated with depression symptoms among Bhutanese refugees in the US. We randomly selected adult Bhutanese refugees (N = 386) to complete a cross-sectional survey concerning demographics, mental health symptoms, and associated risk factors. The case definition for depression symptoms was ≥1.75 mean depression score on the Hopkins Symptom Checklist-25. More women (26 %) than men (16 %) reported depression symptoms (p = 0.0097). Higher odds of depression symptoms were associated with being a family provider, self-reported poor health, and inability to read and write Nepali (OR 4.6, 39.7 and 4.3, respectively) among men; and self-reported poor health and inability to read and write Nepali (OR 7.6, and 2.6 respectively) among women. US-settled Bhutanese refugees are at risk for depression. Providers should be aware of these concerns. Culturally appropriate mental health services should be made more accessible at a local level.

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  1. Adapted from a standard protocol developed by the Injury and Prevention Branch, CDC.


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This study was partially supported in part by an appointment to the Applied Epidemiology Fellowship Program administered by the Council of State and Territorial Epidemiologists (CSTE) and funded by the Centers for Disease Control and Prevention (CDC) Cooperative Agreement U60/CCU007277. We want to express sincere appreciation to the Bhutanese refugee community, community leaders, interviewers and the resettlement agencies and refugee health programs in the cities of the investigation for their vital assistance with this project. Additionally, we would like to acknowledge the following individuals from the US Centers for Disease Control and Prevention for their assistance with this project: Dr. Eboni Taylor, Curtis Blanton and Teri Sivilli.

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Correspondence to Laura A. Vonnahme.

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Disclaimer: The findings and conclusions in this report are those of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.

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Vonnahme, L.A., Lankau, E.W., Ao, T. et al. Factors Associated with Symptoms of Depression Among Bhutanese Refugees in the United States. J Immigrant Minority Health 17, 1705–1714 (2015).

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