Abstract
Zusammenfassung.Theoretischer Hintergrund: Während Untersuchungen in Krisenregionen gezeigt haben, dass Flüchtlingskinder häufig unter psychischen Erkrankungen leiden und behandlungsbedürftig sind, liegen bis zum jetzigen Zeitpunkt noch kaum Kenntnisse über die Situation in Deutschland bei Kindern von Asylbewerbern vor. Fragestellung: Wie hoch ist die Prävalenz von psychischen Erkrankungen und damit der Behandlungsbedarf bei Flüchtlingskindern in Deutschland? Methode: 104 Kinder von Asylbewerbern wurden in staatlichen Gemeinschaftsunterkünften im Rahmen von standardisierten psychodiagnostischen Interviews im Hinblick auf psychische Erkrankungen untersucht. Ergebnisse: 19% der Kinder litten unter einer Posttraumatischen Belastungsstörung, weitere Störungen traten eher selten auf. In psychotherapeutischer Behandlung befanden sich nur 4,8% der Kinder. Schlussfolgerungen: Flüchtlingskinder besitzen ein hohes Risiko für chronische Traumafolgeerkrankungen, wodurch eine normale und gesunde Entwicklung in sozialen, schulischen und beruflichen Bereichen behindert wird. Entsprechende psychotherapeutische Hilfe sollte daher weiter entwickelt und breiter angeboten werden.
Abstract.Background: Studies in post-conflict regions have repeatedly demonstrated that displaced children are at high risk for mental disorders. In contrast, little is known about mental ill-health in refugee children living in Germany. Objective: Determine the prevalence of mental disorders among refugee children in Germany. Methods: 104 structured psychodiagnostic interviews were completed with children of asylum seekers in representative refugee homes. Results: The PTSD prevalence rate was 19%. Other mental health problems were rarely observed. Only 4.8% of the children had received any form of therapy. Conclusions: One in five children of asylum seekers in Germany suffer from chronic PTSD and thus are deprived of a normal and healthy social, school, and occupational development. Existing evidence-based treatments need to be offered and additional routes to healing need to be developed.
Literatur
(1997). Refugee children in Sweden: Post-traumatic stress disorder in Iranian preschool children exposed to organized violence. Child Abuse Negl, 21 (4), 351–366.
. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington DC: Author.
(2007). Narrative exposure therapy for political imprisonment-related chronic posttraumatic stress disorder and depression. Behav Res Ther, 45 (9), 2212–2220.
(2009). Treating children traumatized by war and tsunami: A comparison between exposure therapy and meditation-relaxation in north-east Sri Lanka. BMC Psychiatry, 9 (1), 22.
(2004). A multisite, randomized controlled trial for children with sexual abuse-related PTSD symptoms. J Am Acad Child Adolesc Psychiatry, 43 (4), 393–402.
(2002). Children exposed to warfare: A longitudinal study. J Trauma Stress, 15 (1), 59–68.
(2005). School-based cognitive-behavioural therapy group intervention for refugee children who have experienced war-related trauma. Clinical Child Psychology and Psychiatry, 10 (2), 235–250.
(2009). Trauma-related impairment in children – a survey in Sri Lankan provinces affected by armed conflict. Journal of Child Abuse & Neglect, 33, 238–246.
(1999). Häufigkeit der Posttraumatischen Belastungsstörung bei Jugendlichen: Ergebnisse der Bremer Jugendstudie. Z Kinder Jugendpsychiatr Psychother, 27 (1), 37–45.
(2005). Prevalence of serious mental disorder in 7000 refugees resettled in western countries: A systematic review. Lancet, 365 (9467), 1309–1314.
(2008). Traumatische Erfahrungen, aktuelle Lebensbedingungen im Exil und psychische Belastung junger Flüchtlinge. Kindheit und Entwicklung, 17 (4), 224–231.
(2006). Prävalenz der Posttraumatischen Belastungsstörung (PTSD) und Möglichkeiten der Ermittlung in der Asylverfahrenspraxis. Zeitschrift für Klinische Psychologie und Psychotherapie, 35 (1), 12–20.
(2004). PTSD and depression in refugee children: Associations with pre-migration trauma and post-migration stress. Eur Child Adolesc Psychiatry, 13 (6), 373–380.
(2000). Organized violence and mental health of refugee children in exile: A six-year follow-up. Acta Paediatr, 89 (6), 722–727.
(1998). Political violence, family stress and mental health of refugee children in exile. Scand J Soc Med, 26 (1), 18–25.
(2005). Judging psychiatric disorders in refugees. Lancet, 366 (9497), 1604–1605; author reply 1605.
(2005). Seeking asylum in Denmark: Refugee children’s mental health and exposure to violence. Eur J Public Health, 15 (3), 233–237.
(2005). Psychosocial support for war-traumatized child and adolescent refugees: Evaluation of a short-term program. Australian and New Zealand Journal of Psychiatry, 39, 81–87.
(1998). The effects of stress and trauma on brain and memory: A view from developmental cognitive neuroscience. Dev Psychopathol, 10 (4), 793–809.
(2010). Can asylum-seekers with posttraumatic stress disorder be successfully treated? A randomized controlled pilot study. Cogn Behav Ther, 39 (2), 81–91.
(2008). Treatment of posttraumatic stress disorder by trained lay counselors in an African refugee settlement: A randomized controlled trial. J Consult Clin Psychol, 76 (4), 686–694.
(2004). Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress disorder through previous trauma among west Nile refugees. BMC Psychiatry, 4, 34.
(2004). Treatment of traumatized refugee children with eye movement desensitization and reprocessing in a psychodynamic context. Nord J Psychiatry, 58 (3), 199–203.
(
im Druck ). Posttraumatische Belastungsstörung bei Kindern & Jugendlichen. In , Lehrbuch der Verhaltenstherapie (Band 4): Materialien für die Psychotherapie. Berlin – Heidelberg: Springer.(
im Druck ). UPID – UCLA PTSD Index for DSM-IV. In , Fragebögen zur Diagnostik psychischer Störungen des Kindes- und Jugendalters. Göttingen: Hogrefe.(
im Druck ). Narrative exposure therapy for 7–16 year olds – a randomized controlled trial with traumatised refugee children. J Trauma Stress.(2008). KIDNET – Narrative Expositionstherapie (NET) für Kinder. In , Traumatherapie bei Kindern und Jugendlichen (S. 84–110). Göttingen: Hogrefe.
(1999). Twelve-year follow-up study of Khmer youths who suffered massive war trauma as children. J Am Acad Child Adolesc Psychiatry, 38 (9), 1173–1179.
(2009). Narrative exposure therapy versus group interpersonal psychotherapy – a controlled clinical trial with orphaned survivors of the rwandan genocide. Psychotherapy and Psychosomatics, 78, 298–306.
(2006). Wiedererfahrung durch Psychotherapie modifiziert Geist und Gehirn. Verhaltenstherapie, 16, 96–103.
(2005). Narrative exposure therapy (NET). A short-term intervention for traumatic stress disorders after war, terror and torture. Göttingen: Hogrefe & Huber.
(2003). New findings on alternative criteria for PTSD in preschool children. J Am Acad Child Adolesc Psychiatry, 42 (5), 561–570.
(1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry, 59 Suppl 20, 22-33; quiz 34–57.
(2009). The Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID): Validity and Reliability. 49th Annual NCDEU Meeting June 29–July 2, 2009: Hollywood, Florida, Abstract, 101.
(2002). Mini International Neuropsychiatric Interview for Children and Adolescents – Englisch Version 2.0.
Unpublished manuscript, University of South Florida – Tampa .(1998). A compendium of neuropsychological tests – second edition. New York – Oxford: Oxford University Press.
(2004). The University of California at Los Angeles post-traumatic stress disorder reaction index. Curr Psychiatry Rep, 6 (2), 96–100.
(2005). Developmental trauma disorder: Towards a rational diagnosis for chronically traumatized children. Psychiatric Annals, 35 (5), 401–408.
(2009, 19/09/09). Proposal to include a developmental trauma disorder diagnosis for children and adolescents in DSM-IV. Retrieved 19/09/2009, from www.beforeyoutakethatpill.com/2009/5/DTD_ NCTSN.pdf.
