Psychiatry research · 2026
Comparison of specialized mental healthcare utilization among Syrian refugees and the general Norwegian population: A longitudinal, registry-based cohort study on PTSD, mood disorders, and anxiety and fear-related disorders.
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Ojha Sneha, Thapa Suraj B, Haag Katharina, Straiton Melanie L, Nickerson Angela, Nissen Alexander
Аннотация
BACKGROUND: Refugees face elevated mental health risks, yet large cohort studies suggest lower use of specialist mental health services. Most studies focus on younger groups and rarely examine changes in use over time. We compared specialist mental healthcare use between Syrian refugees and the general Norwegian population during the first three years after residency, an important early resettlement period.
METHODS: We linked Norwegian Patient Registry and Statistics Norway data for 10,165 Syrian refugees (≥18 years) and 8424 individuals from the general Norwegian population, followed for three years. Two-part hurdle models adjusted for sociodemographic factors estimated odds of specialist contact and among users, visit frequency. Mixed-effects models assessed temporal and sociodemographic patterns within refugees.
FINDINGS: Syrian refugees had lower adjusted odds of outpatient specialist contact than the comparison population (aOR 0.45, 95% CI 0.36-0.56), with larger differences for mood disorders (0.29, 0.21-0.41) and anxiety and fear-related disorders (AFRD) (0.50, 0.37-0.67). For PTSD, higher unadjusted odds (uOR 1.95, 1.40-2.72) became nonsignificant after adjustment (0.91, 0.55-1.51). Among service users, refugees had fewer visits (combined mental health: aIRR 0.51, 0.35-0.73; mood disorders: 0.40, 0.23-0.70). Within refugees, odds of any contact were three to four times higher in year three than year one. Being partnered was associated with lower service use for mood disorders and AFRD. Other sociodemographic factors showed no significant associations.
CONCLUSION: Syrian refugees showed lower specialist mental healthcare use than the comparison population despite known elevated mental health risks, which may indicate potential unmet needs during early resettlement.
METHODS: We linked Norwegian Patient Registry and Statistics Norway data for 10,165 Syrian refugees (≥18 years) and 8424 individuals from the general Norwegian population, followed for three years. Two-part hurdle models adjusted for sociodemographic factors estimated odds of specialist contact and among users, visit frequency. Mixed-effects models assessed temporal and sociodemographic patterns within refugees.
FINDINGS: Syrian refugees had lower adjusted odds of outpatient specialist contact than the comparison population (aOR 0.45, 95% CI 0.36-0.56), with larger differences for mood disorders (0.29, 0.21-0.41) and anxiety and fear-related disorders (AFRD) (0.50, 0.37-0.67). For PTSD, higher unadjusted odds (uOR 1.95, 1.40-2.72) became nonsignificant after adjustment (0.91, 0.55-1.51). Among service users, refugees had fewer visits (combined mental health: aIRR 0.51, 0.35-0.73; mood disorders: 0.40, 0.23-0.70). Within refugees, odds of any contact were three to four times higher in year three than year one. Being partnered was associated with lower service use for mood disorders and AFRD. Other sociodemographic factors showed no significant associations.
CONCLUSION: Syrian refugees showed lower specialist mental healthcare use than the comparison population despite known elevated mental health risks, which may indicate potential unmet needs during early resettlement.