Global prevalence and influencing factors, protective factors, and outcomes of anxiety, depression, and post-traumatic stress disorder among refugee children and adolescents: a systematic review and meta-analysis.

BACKGROUND

Refugee status, as a forced situation in which people, including children and adolescents, migrate to other countries due to fleeing violence, war, persecution, or life-threatening conditions, is one of the global crises of this century. The aim of this study is to investigate the global prevalence, protective factors, and outcomes of anxiety, depression, and post-traumatic stress disorder among refugee children and adolescents.

METHODS

This study systematically reviewed and meta-analyzed data from studies conducted to determine the global prevalence of risk/influencing factors, protective factors, and outcomes of "anxiety, depression, and post-traumatic stress disorder" among refugee children and adolescents using the keywords "Prevalence", "Anxiety", "Depression", "PTSD", "Children", "Adolescents", "Refugee", and "Asylum Seeker". They were extracted from the databases of Science Direct, PubMed, Scopus, Web of Science, and Google Scholar search engine without a time limit until October 2025 and transferred to the information management software (EndNote) version 8.

RESULTS

Analysis of 44 observational and cross-sectional studies conducted between 1999 and 2025 showed that the global prevalence of PTSD, anxiety, and depression among refugee children and adolescents was 35%, 34.1%, and 32%, respectively. The sample sizes for these three disorders were 14,250, 4543, and 9547, respectively. Risk factors included trauma, family separation, and discrimination; protective factors included social support and resilience. Outcomes included emotional distress, social isolation, and reduced quality of life.

CONCLUSION

The high prevalence of post-traumatic stress disorder, anxiety, and depression in refugee children and adolescents requires immediate and targeted interventions, and strengthening social support and access to mental health services in this area are essential. The information in this article provides the basis for accurate diagnosis of psychiatric disorders in refugee children and adolescents by psychiatric nurses, as well as for providing accurate diagnostic and therapeutic measures by them.