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Parental PTSD increases psychiatric morbidity risk in offspring of refugees

Researchers identified parental PTSD as a predictor of psychiatric morbidity among the offspring of refugees, according to a study published in Lancet Public Health.

“Results from one study published in 2018 showed that PTSD in refugees was associated with adverse outcomes in their children, in part mediated through harsh parenting,” Maj Back Nielsen, MS, of Copenhagen University Hospital Hvidovre, Denmark, and colleagues wrote. “However, overall, the complexities and the effect of intergenerational factors in families coping with adverse traumatic experiences, social disadvantage and mental illness are not sufficiently investigated in this group.”

In their two-generation, Danish nationwide cohort study, researchers examined whether parental PTSD was linked to psychiatric morbidity among children younger than 18 years with at least one refugee parent using the Danish Immigration Services database and the Danish Psychiatric Central Research Register. They compared the risk of psychiatric contact among children of refugees with PTSD and children of refugees without a psychiatric diagnosis.

Of 51,793 children of refugees who arrived in Denmark over a 21-year period (Jan. 1, 1995, to Dec. 31, 2015), 1,307 had a psychiatric contact and 7,486 were exposed to parental PTSD.

Analysis indicated that parental PTSD significantly increased the risk of psychiatric contact in offspring (HR = 1.49 [95% CI, 1.17-1.89] for paternal PTSD; HR = 1.55 [95% CI, 1.2-2.01] for maternal PTSD; HR = 1.75 [95% CI, 1.22-2.52] for both parents with PTSD) after adjusting for sociodemographic variables.

Furthermore, Nielsen and colleagues reported that children of parents with PTSD were at greater risk of psychiatric morbidity than children of parents without a psychiatric diagnosis regardless of the child's own refugee status.

“We found that even children who were born in Denmark (descendants) had a non-negligible increased risk of psychopathology as a consequence of parental PTSD,” the researchers wrote. “This result points at a major public health challenge in the countries in which refugees seek asylum for decades to come, because the numbers of children of refugee parents will probably rise as a result of the displacement of millions of refugees, particularly to western Europe, since 2014.”

Compared with children with no parental psychiatric diagnosis (n = 1,126), those with parental PTSD (n = 181) were more likely to have nervous disorders (22.8% vs. 13.6%) and behavioral and emotional disorders (26.4% vs. 27.5%), the data revealed.

“Our study has identified a particularly psychologically vulnerable group of children within an already vulnerable refugee population,” Nielsen and colleagues wrote. “Public health interventions should, therefore, focus on the mental health of children of traumatized refugees, not only in the recipient country but also in places processing refugees, by use of appropriate assessment tools to identify children in need and by ensuring the consequent availability of relevant mental health services.” – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.