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Mental Disorder among Refugees and the Impact of Persecution and Exile: Some Findings from an Out-Patient Population

Published online by Cambridge University Press:  02 January 2018

Nils Johan Lavik*
Psychosocial Centre for Refugees, University of Oslo
Edvard Hauff
Psychosocial Centre for Refugees, University of Oslo
Anders Skrondal
Psychosocial Centre for Refugees, University of Oslo
Øivind Solberg
Section of Medical Statistics, University of Oslo, Norway
Professor Nils Johan Lavik, Director, Psychosocial Centre for Refugees, University of Oslo, PO Box 45 Kringsjå, 0807 Oslo, Norway



Refugees have long been considered at risk for mental disorder. We sought to characterise this risk in an out-patient refugee sample by analysing the relationship between psychiatric symptoms and dysfunction, and between symptoms and the socio-demographic background and stressors specific to this refugee sample.


A consecutive sample of 231 refugee patients referred to the psychiatric out-patient unit at the Psychosocial Centre for Refugees, University of Oslo, was examined with a semi-structured interview guide, Brief Psychiatric Rating Scale (BPRS), Hopkins Symptom Check-List (HSCL-25) and a check-list for post-traumatic symptoms (PTSS-10). Global Assessment of Function (GAF) scores were obtained; and the data were analysed using nine predictor variables.


It was found that 46.6% of the patients had a post-traumatic stress disorder according to the criteria for DSM–III–R as the main diagnosis, while the mean GAF score for the patients was 57.3. Analysis of the GAF and BPRS data did not reveal any predictor of psychotic behaviour. However, torture emerged as an important predictor of emotional withdrawal/retardation. Also, age, gender and no employment or education predicted for anxiety/depression, while refugee status and no employment or school predicted for hostility/aggression.


The results confirm earlier findings that refugees constitute a population at risk for mental disorder. Past traumatic stressors and current existence in exile constitute independent risk factors. However, stressors other than those discussed here appear to be important also, particularly with regard to psychotic symptoms.

Copyright © 1996 The Royal College of Psychiatrists 

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