Post-displacement mental health among Syrian refugees: A systematic review and meta-analysis comparing Middle Eastern and European host contexts across time.

This systematic review and meta-analysis examines PTSD, depression, and anxiety among adult Syrian refugees living in neighboring Middle Eastern countries and European contexts, comparing prevalence across regions and different phases of displacement. Evidence was synthesized from 23 quantitative studies conducted between 2014 and 2025. A random-effects meta-analysis using generalized linear mixed-effects models (GLMM) yielded a pooled PTSD prevalence of 32.4% based on 19 studies. Temporal subgroup analyses showed no significant difference between early (2014-2017: 32.2%) and later periods (2018-2025: 32.7%). Similarly, PTSD prevalence was nearly identical across regions, with estimates of 30.5% in Middle Eastern countries and 34.6% in European settings. No interaction was found between time and region. Depression and anxiety were consistently elevated across studies. Depression tended to be higher in Middle Eastern samples, whereas anxiety showed greater variability in European contexts. A key conceptual contribution of this review is the observation that PTSD burden among Syrian refugees did not show detectable variation across macro-level contextual differences under the present analytic conditions, suggesting that pre-migration trauma may represent a potentially strong and relatively context-independent influence of posttraumatic psychopathology, at least in the absence of targeted therapeutic intervention. Overall, these findings suggest a persistently elevated mental health burden among Syrian refugees. However, the absence of significant differences across time and region should be interpreted cautiously, as the limited number of studies likely precluded adequate statistical power to detect moderation effects. Proposed theoretical explanations should be regarded as hypotheses warranting future empirical investigation rather than conclusions supported by the current data.