Screening and routine diagnosis of mental disorders among migrants in primary care: A cross-sectional study
Background: Migrants in host countries are at risk for the development of mental health conditions. The two aims of the study were to describe routine diagnoses of mental disorders among migrant patients at primary healthcare level and the associated risk factors, and to test the utility of an innov...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Journal of Migration and Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666623523000557 |
| _version_ | 1797454601069264896 |
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| author | Stella Evangelidou Angeline Cruz Yolanda Osorio Ethel Sequeira-Aymar Alessandra Queiroga Gonçalves Laura Camps-Vila Marta M. Monclús-González Alba Cuxart-Graell Elisa M. Revuelta-Muñoz Núria Busquet-Solé Susana Sarriegui-Domínguez Aina Casellas M. Rosa Dalmau Llorca Carina Aguilar Martín Ana Requena-Mendez |
| author_facet | Stella Evangelidou Angeline Cruz Yolanda Osorio Ethel Sequeira-Aymar Alessandra Queiroga Gonçalves Laura Camps-Vila Marta M. Monclús-González Alba Cuxart-Graell Elisa M. Revuelta-Muñoz Núria Busquet-Solé Susana Sarriegui-Domínguez Aina Casellas M. Rosa Dalmau Llorca Carina Aguilar Martín Ana Requena-Mendez |
| author_sort | Stella Evangelidou |
| collection | DOAJ |
| description | Background: Migrants in host countries are at risk for the development of mental health conditions. The two aims of the study were to describe routine diagnoses of mental disorders among migrant patients at primary healthcare level and the associated risk factors, and to test the utility of an innovative migrant mental health assessment by evaluating whether the health professionals followed the recommendations proposed by the clinical decision support system (CDSS) tool. Methods: A cross-sectional study was carried out in eight primary care centres (PCCs) in four non-randomly selected health regions of Catalonia, Spain from March to December 2018. Routine health data and mental health diagnoses based on the International Classification of Diseases (10th edition), including mental, behavioural and neuro developmental disorders (F01-F99), symptoms and signs involving emotional state (R45), and sleep disorders (G47), were extracted from the electronic health records. The proportion of mental health conditions was estimated and logistic regression models were used to assess any possible association with mental health disorders. The utility of the mental health assessment was assessed with the proportion of questionnaires performed by health professionals for migrants fulfilling the mental health screening criterion (country of origin with an active conflict in 2017) and the diagnoses given to the screened patients. Results: Of 14,130 migrants that visited any of the PCCs during the study period, 7,358 (52.1 %) were women with a median age of 38.0 years-old. There were 520/14,130 (3.7 %) migrant patients diagnosed with a mental disorder, being more frequent among women (342/7,358; 4.7 %, p-value < 0.001), migrants from Latin-America (177/3,483; 5.1 %, p < 0.001) and those who recently arrived in Spain (170/3,672; 4.6 %, p < 0.001). A lower proportion of mental disorders were reported in migrants coming from conflicted countries in 2017 (116/3,669, 3.2 %, p = 0.053).Out of the 547 mental health diagnoses reported in 520 patients, 69/14,130 (0.5 %) were mood disorders, 346/14,130 (2.5 %) anxiety disorders and 127/14,130 (0.9 %) sleeping disorders. Mood disorders were more common in migrants from Eastern Europe (25/2,971; 0.8 %, p < 0.001) and anxiety disorders in migrants from Latin-America (126/3,483; 3.6 %, p < 0.001), while both type of disorders were more often reported in women (p < 0.001).In the adjusted model, women (aOR: 1.5, [95 % CI 1.2–1.8, p < 0.001]), migrants with more than one visit to the health center during the study period (aOR: 4.4, [95 %CI 2.8–6.8, p < 0.001]) and who presented an infectious disease (aOR: 2.1, [95 %CI 1.5–3.1, p < 0.001]) had higher odds of having a mental disorder.Lastly, out of the 1,840 migrants coming from a conflicted country in 2017 who were attended in centres where the CDSS tool was implemented, 29 (1.6 %) had a mental health assessment performed and the tool correctly identified one individual. Conclusions: Mental health is a condition that may be overlooked in migrants at primary healthcare. Interventions at this level of care must be reinforced and adapted to the needs and circumstances of migrants to ensure equity in health services. |
| first_indexed | 2024-03-09T15:39:30Z |
| format | Article |
| id | doaj.art-f77e27a578434554a7ed783c75626818 |
| institution | Directory Open Access Journal |
| issn | 2666-6235 |
| language | English |
| last_indexed | 2024-03-09T15:39:30Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Migration and Health |
| spelling | doaj.art-f77e27a578434554a7ed783c756268182023-11-25T04:50:25ZengElsevierJournal of Migration and Health2666-62352023-01-018100205Screening and routine diagnosis of mental disorders among migrants in primary care: A cross-sectional studyStella Evangelidou0Angeline Cruz1Yolanda Osorio2Ethel Sequeira-Aymar3Alessandra Queiroga Gonçalves4Laura Camps-Vila5Marta M. Monclús-González6Alba Cuxart-Graell7Elisa M. Revuelta-Muñoz8Núria Busquet-Solé9Susana Sarriegui-Domínguez10Aina Casellas11M. Rosa Dalmau Llorca12Carina Aguilar Martín13Ana Requena-Mendez14Barcelona Institute for Global Health (ISGlobal, Hospital Clínic-Universitat de Barcelona). Carrer Roselló 132, 40, 08036 Barcelona, SpainBarcelona Institute for Global Health (ISGlobal, Hospital Clínic-Universitat de Barcelona). Carrer Roselló 132, 40, 08036 Barcelona, SpainParc Sanitari Sant Joan de Deu, Programa Atenció a la Salut Mental de les persones Immigrades i Programa per Persones Sense Llar, Carrer Dr. Antoni Pujadas, 42, 08830 Barcelona, SpainBarcelona Institute for Global Health (ISGlobal, Hospital Clínic-Universitat de Barcelona). Carrer Roselló 132, 40, 08036 Barcelona, Spain; Consorci d'Atenció Primària de Salut Barcelona Esquerra (CAPSBE) Casanova, Carrer Rosselló 161, 08036 Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Carrer Rosselló, 149, Barcelona, SpainUnitat de Suport a la Recerca Terres de l'Ebre, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 43500 Tortosa, Tarragona, Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), SpainUnitat Docent Multiprofessional d'Atenció Familiar i Comunitària Catalunya Central, Institut Català de la Salut, Carrer Pica d'Estats, 13-15, 08272 Sant Fruitós de Bages, Barcelona, SpainCentre d'Atencio Primaria Sagrada Família, Consorci Sanitari Integral (CSI), Carrer Còrsega 643, 08025 Barcelona, SpainBarcelona Institute for Global Health (ISGlobal, Hospital Clínic-Universitat de Barcelona). Carrer Roselló 132, 40, 08036 Barcelona, SpainCentre d'Atencio Primaria Rambla Ferran, Institut Català de la Salut (ICS), Carrer Rambla Ferran 44, 25007, Lleida, SpainCentre d'Atencio Primaria Sagrada Família, Institut Català de la Salut, Carrer St. Cristòfol, 34, 08243 Manresa, Barcelona, SpainCentre d'Atencio Primaria 1 Maig, Institut Català de la Salut (ICS), Carrer De la Mercè, 5, 25003, Lleida, SpainBarcelona Institute for Global Health (ISGlobal, Hospital Clínic-Universitat de Barcelona). Carrer Roselló 132, 40, 08036 Barcelona, SpainUnitat de Suport a la Recerca Terres de l'Ebre, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 43500 Tortosa, Tarragona, Spain; Equip d'Atenció Primària Tortosa Oest, Institut Català de la Salut, 43500, Tortosa, Tarragona, SpainUnitat de Suport a la Recerca Terres de l'Ebre, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 43500 Tortosa, Tarragona, Spain; Unitat d'Avaluació, Direcció d'Atenció Primària Terres de l'Ebre, Institut Català de la Salut, Tortosa, 43500 Tarragona, SpainBarcelona Institute for Global Health (ISGlobal, Hospital Clínic-Universitat de Barcelona). Carrer Roselló 132, 40, 08036 Barcelona, Spain; Department of Medicine Solna, Karolinska Institutet, Solnavägen 17177, Solna, Stockholm, Sweden; CIBERINFEC, ISCIII-CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain; Corresponding author at: Department of Medicine Solna, Karolinska Institute, Barcelona Institute for Global Health, Sten Bergmans Väg 1, 12146, Stockholm, Sweden.Background: Migrants in host countries are at risk for the development of mental health conditions. The two aims of the study were to describe routine diagnoses of mental disorders among migrant patients at primary healthcare level and the associated risk factors, and to test the utility of an innovative migrant mental health assessment by evaluating whether the health professionals followed the recommendations proposed by the clinical decision support system (CDSS) tool. Methods: A cross-sectional study was carried out in eight primary care centres (PCCs) in four non-randomly selected health regions of Catalonia, Spain from March to December 2018. Routine health data and mental health diagnoses based on the International Classification of Diseases (10th edition), including mental, behavioural and neuro developmental disorders (F01-F99), symptoms and signs involving emotional state (R45), and sleep disorders (G47), were extracted from the electronic health records. The proportion of mental health conditions was estimated and logistic regression models were used to assess any possible association with mental health disorders. The utility of the mental health assessment was assessed with the proportion of questionnaires performed by health professionals for migrants fulfilling the mental health screening criterion (country of origin with an active conflict in 2017) and the diagnoses given to the screened patients. Results: Of 14,130 migrants that visited any of the PCCs during the study period, 7,358 (52.1 %) were women with a median age of 38.0 years-old. There were 520/14,130 (3.7 %) migrant patients diagnosed with a mental disorder, being more frequent among women (342/7,358; 4.7 %, p-value < 0.001), migrants from Latin-America (177/3,483; 5.1 %, p < 0.001) and those who recently arrived in Spain (170/3,672; 4.6 %, p < 0.001). A lower proportion of mental disorders were reported in migrants coming from conflicted countries in 2017 (116/3,669, 3.2 %, p = 0.053).Out of the 547 mental health diagnoses reported in 520 patients, 69/14,130 (0.5 %) were mood disorders, 346/14,130 (2.5 %) anxiety disorders and 127/14,130 (0.9 %) sleeping disorders. Mood disorders were more common in migrants from Eastern Europe (25/2,971; 0.8 %, p < 0.001) and anxiety disorders in migrants from Latin-America (126/3,483; 3.6 %, p < 0.001), while both type of disorders were more often reported in women (p < 0.001).In the adjusted model, women (aOR: 1.5, [95 % CI 1.2–1.8, p < 0.001]), migrants with more than one visit to the health center during the study period (aOR: 4.4, [95 %CI 2.8–6.8, p < 0.001]) and who presented an infectious disease (aOR: 2.1, [95 %CI 1.5–3.1, p < 0.001]) had higher odds of having a mental disorder.Lastly, out of the 1,840 migrants coming from a conflicted country in 2017 who were attended in centres where the CDSS tool was implemented, 29 (1.6 %) had a mental health assessment performed and the tool correctly identified one individual. Conclusions: Mental health is a condition that may be overlooked in migrants at primary healthcare. Interventions at this level of care must be reinforced and adapted to the needs and circumstances of migrants to ensure equity in health services.http://www.sciencedirect.com/science/article/pii/S2666623523000557Mental healthMigrantScreeningDisordersPrimary careElectronic health records |
| spellingShingle | Stella Evangelidou Angeline Cruz Yolanda Osorio Ethel Sequeira-Aymar Alessandra Queiroga Gonçalves Laura Camps-Vila Marta M. Monclús-González Alba Cuxart-Graell Elisa M. Revuelta-Muñoz Núria Busquet-Solé Susana Sarriegui-Domínguez Aina Casellas M. Rosa Dalmau Llorca Carina Aguilar Martín Ana Requena-Mendez Screening and routine diagnosis of mental disorders among migrants in primary care: A cross-sectional study Journal of Migration and Health Mental health Migrant Screening Disorders Primary care Electronic health records |
| title | Screening and routine diagnosis of mental disorders among migrants in primary care: A cross-sectional study |
| title_full | Screening and routine diagnosis of mental disorders among migrants in primary care: A cross-sectional study |
| title_fullStr | Screening and routine diagnosis of mental disorders among migrants in primary care: A cross-sectional study |
| title_full_unstemmed | Screening and routine diagnosis of mental disorders among migrants in primary care: A cross-sectional study |
| title_short | Screening and routine diagnosis of mental disorders among migrants in primary care: A cross-sectional study |
| title_sort | screening and routine diagnosis of mental disorders among migrants in primary care a cross sectional study |
| topic | Mental health Migrant Screening Disorders Primary care Electronic health records |
| url | http://www.sciencedirect.com/science/article/pii/S2666623523000557 |
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