Lindert, J U

Introduction: During the last decade, the number of children whose lives have been disrupted by war, organised violence, oppression, terror, and other forms of conflict has grown tremendously. Although the experiences of refugee children and adolescents vary considerably, many have witnessed violence. Research with this kind of population is a relatively new area of investigation, but there is emerging evidence that many of the refugee children experience long-term physical and mental health problems.

Objective: To describe the mental health status of refugee children in Germany and analyse the relationship between experienced events and mental health status.

Method: A cross-sectional study of refugee children included structured and unstructured interviews. Mental health was defined by assessing posttraumatic stress disorder, depression, anxiety and sleeping problems. Mental health was also defined by the participants. The methods were triangulated, that is an informal, unstructured interview was augmented by structured health and demographic questions.

Principal Findings: The refugee children and their families have been exposed to high levels of adversity. Compared with German children, refugee children are more likely to exhibit an accumulation of specific mental health problems. These are mostly unrelated to sociodemographic variables. Childrens mental health is found to be influenced by several interacting risk and protective factors.

Conclusions: The refugee children show different mental health outcomes than German children. There is still a great risk to misdiagnose the disorders because of the cultural pattern. Cultural sensitive understanding and cultural sensitive measures have to be improved. There is a real need for health research and health services to diagnose mental health needs of refugee children. Empirical evidence is emerging that the widespread emphasis on posttraumatic stress disorder (PTSD) concerning refugee children has to be discussed critically.

(C) 2003 Lippincott Williams & Wilkins, Inc.