Trajectories of psychosocial symptoms and wellbeing in asylum seekers and refugees exposed to traumatic events and resettled in Western Europe, Turkey, and Uganda

Figures & data

Table 1. Socio-demographic and clinical characteristics at baseline.

Europe (n = 229)			Turkey (n = 320)		Uganda (n = 363)
	Frequence	Percent	Frequence	Percent	Frequence	Percent
Age group
18–24	50	22.83	72	23.61	100	29.07
25–29	57	26.03	59	19.34	92	26.74
30–44	88	40.18	142	46.56	107	31.10
45+	24	10.96	32	10.49	45	13.08
Working status
Unemployed	108	47.16	103	32.39	134	37.22
Employed	121	52.84	216	67.71	226	62.78
Educational level
No schooling/Illiterate	26	11.50	8	2.56	107	29.89
Primary school/Junior high school	92	40.71	195	62.30	206	57.54
Secondary and higher education	108	47.79	110	35.14	45	12.57
Marital status
Married or cohabitant	113	49.78	260	81.25	220	61.11
Not married or cohabitant	114	50.22	60	18.75	140	38.89
Length of stay
Length of stay up to 2 years	72	32.00	50	32.26	239	96.37
More than 2 years	153	68.00	105	67.74	9	3.63
Clinical scale scores	Mean	SD	Mean	SD	Mean	SD
PCL at baseline	8.24	5.48	6.67	4.94	15.87	4.76
PHQ-9 at baseline	8.39	5.54	6.30	4.73	15.09	4.73
WHODAS at baseline	0.15	0.14	0.12	0.15	0.50	0.17
WHO-5 at baseline	11.84	6.25	10.90	5.94	7.93	5.30

Figure 1. Trajectories of psychological symptoms and wellbeing over time.

Table 2. Psychological symptoms. Logistic regression to predict class membership and linear regression to predict slope.

Europe and Turkey	Logistic regression to predict class 1			Regression to predict slope
	OR	CI	p-value	Coeff.	CI	p-value
HTQ score	1.119	(1.014; 1.235)	.025	0.117	(0.064; 0.171)	<.001
Age	1.019	(0.988; 1.051)	.227	0.015	(−0.004; 0.033)	.119
Being married	0.794	(0.383; 1.644)	.534	0.116	(−0.297; 0.528)	.582
Primary education	0.880	(0.247; 3.137)	.003	−0.437	(−1.129; 0.255)	.005
Secondary education	2.981	(0.929; 9.567)		−0.915	(−1.592; −0.237)
Length of stay >2 yrs	1.321	(0.625; 2.794)	.466	0.012	(−0.472; 0.496)	.961
Unemployed	1.167	(0.555; 2.456)	.684	0.109	(−0.279; 0.498)	.580
Turkey	0.213	(0.085; 0.536)	.001	0.583	(0.115; 1.050)	.015
Uganda
HTQ score	0.623	(0.530; 0.733)	<.001	−0.058	(−0.169; 0.053)	.308
Age	0.981	(0.939; 1.026)	.403	−0.002	(−0.036; 0.033)	.932
Being married	0.625	(0.241; 1.622)	.334	−0.379	(−1.127; 0.368)	.320
Primary education	0.868	(0.356; 2.118)	.465	−0.418	(−1.145; 0.308)	.527
Secondary education	1.629	(0.588; 4.515)		−0.245	(−1.119; 0.628)
Length of stay >2 yrs	0.609	(0.131; 2.829)	.466	0.434	(−0.792; 1.661)	.488
Unemployed	0.766	(0.325; 1.809)	.543	0.424	(−0.252; 1.100)	.219

Table 3. WHO-5. Logistic regression to predict class membership and linear regression to predict slope.

Europe and Turkey	Logistic regression to predict class 1			Regression to predict slope
	OR	CI	p-value	Coeff.	CI	p-value
HTQ score	1.128	(0.984; 1.292)	.084	−0.144	(−0.267; −0.021)	.021
Age	1.015	(0.952; 1.081)	.651	0.009	(−0.045; 0.062)	.754
Being married	2.468	(0.790; 7.716)	.120	0.536	(−0.649; 1.722)	.375
Primary education	2.260	(0.571; 8.951)	.498	1.403	(0.352: 2.453)	.030
Secondary education	2.742	(0.439; 17.138)		1.302	(−0.216; 2.820)
Length of stay >2 yrs	7.309	(1.808; 29.551)	.005	0.951	(0.126; 1.776)	.024
Unemployed	2.651	(0.644; 10.908)	.177	0.543	(−0.925; 2.010)	.469
Turkey	0.753	(0.174; 3.260)	.704	−1.253	(−2.596; 0.090)	.067
Uganda
HTQ score	1.129	(0.991; 1.287)	.069	0.068	(−0.065; 0.201)	.317
Age	0.940	(0.914; 0.967)	<.001	−0.074	(−0.108; −0.040)	<.001
Being married	1.417	(0.689; 2.916)	.343	−0.126	(−0.892; 0.641)	.748
Primary education	2.520	(1.097; 5.793)	.076	1.238	(0.254; 2.221)	.047
Secondary education	1.264	(0.434; 3.678)		0.808	(−0.414; 2.030)
Length of stay >2 yrs	0.512	(0.079; 3.301)	.481	0.658	(−1.032; 2.349)	.445
Unemployed	1.351	(0.608; 3.002)	.460	−0.024	(−0.822; 0.774)	.952

Table 4. Predictors of WHO-5 and psychological symptoms (latent variable) at T1 and T2.

	WHO-5 at T1	WHO-5 at T2	Symptoms at T1	Symptoms at T2
Western Europe and Turkey	ß Coefficient (Confidence Interval)
Domestic violence	–	–	1.363 (0.167; 2.559)	–
Turkish trial	–	−1.525 (−2.883; −0.167)	–	–
Murder of family or friend	–	−1.692 (−3.060; −0.324)	–	1.235 (0.274; 2.192)
Kidnapped	–	−1.672 (−3.190; −0.154)	–	–
Close to death	–	−1.379 (−2.698; −0.059)	–	–
Length of stay > 2 yrs	–	−1.596 (−3.054; −0.137)	–	–
Uganda
Age	−0.078 (−0.132; −0.024)	−0.078 (−0.133; −0.023)	–	–
Lack of shelter	−2.509 (−4.435; −0.583)	–	–	–
Kidnapped	–	–	2.114 (0.581; 3.648)	–
Domestic violence	−1.361 (−2.667; −0.055)	–	–	–

Data availability statement

This study was conducted using data from three RCTs with a similar design involving asylum seekers and refugees resettled in Western European countries, Turkey, and Uganda (Acarturk et al., 2022; Purgato et al., 2021; Tol et al., 2020). The present manuscript uniquely examine the individual-participant data from the control groups of these three large RCTs.