Children of refugees with PTSD have increased risk for psychiatric disorders

Researchers from the University of Copenhagen have studied what it means for children to have parents who are refugees and have PTSD. The study shows that these children have a significantly higher risk of contact with the psychiatric system. The researchers believe that there should be focus on the problem and that early measures and treatment options should be developed.

Post-traumatic stress syndrome (PTSD) is a delayed response to trauma and is often seen in refugees fleeing war and conflict. Now, in a large register study, researchers from the University of Copenhagen have studied the significance for children of having parents who are refugees and have been diagnosed with PTSD.

They have looked at whether children of refugees with PTSD are in more contact with the psychiatric system than children of refugees who do not have PTSD. The study shows that children with one or two parents who suffer from PTSD have a significantly higher risk of psychiatric contact. The new research results are published in the scientific journal Lancet Public Health.

'The results of the study indicate that there is a group of children and adolescents who are at increased risk of morbidity. You often focus on the traumatized parents, but it is also important to pay attention to the consequences which the parents' trauma may have for the whole family so that you do not disregard a group of children and young people who also need help'.

This does not just apply to children who have fled to Denmark and may themselves be traumatized by war. We also see an increased risk in children born in Denmark."
Maj Back Nielsen, co-author on the study and Master in Public Health

PTSD can cause insomnia, nightmares, flashbacks and memory and concentration difficulties. In the study, the researchers show that if both parents had PTSD, their children were 75 per cent more likely to be in contact with the psychiatric system before they turned 18.
If it was just the mother, they had a 55 per cent higher risk, while the number was 49 per cent if only the father had PTSD - irrespective of whether the children themselves had fled to Denmark or were born here.

'We know that PTSD has a big effect on the daily ability to function. And having a PTSD diagnosis affects the dynamics of the whole family. It is important to emphasize that these are not bad parents, but due to their disorder, they are stressed and have some other conditions for being a parent and be there for their children.'

'It is an already vulnerable group which may be further stressed by uncertainties about temporary residency and other socio-economic conditions, such as finances. We know from other research that social conditions are linked to diseases,' says Professor and co-author of the study Marie Louise Nørredam, the Department of Public Health Sciences.

Dark figures cannot be excluded

The researchers have analyzed data from refugees who came to Denmark in the period from January 1995 to December 2015 and have been granted a residence permit. In total, they have analyzed data from 51,793 children of refugees and their contact with the psychiatric system.

Contact with the psychiatric system means that the child has had contact with the system at hospital level, on an outpatient basis or as inpatient at a hospital. The researchers did not have access to information from general practitioners and e.g. practicing psychiatric therapists. Therefore, they cannot rule out that there are dark figures and that the number of children who have been in contact with the psychiatric system is higher.

The psychiatric disorders most commonly seen in children of parents with PTSD were behavioral and emotional disorders, nervous disorders and developmental disorders.

'If we want to ensure that these children have a proper future and opportunities in our community, we have to do something. Both the number of children and parents may be underestimated. Thus, there is a need for greater focus on the problem and on how we may take precautions and secure an earlier detection and develop early measures and treatment options for the children and their families,' says Marie Louise Nørredam.

University of Copenhagen The Faculty of Health and Medical Sciences

Journal reference:

Nielsen, M.B. et al. (2019) Risk of childhood psychiatric disorders in children of refugee parents with post-traumatic stress disorder: a nationwide, register-based, cohort study. The Lancet Public Health. doi.org/10.1016/S2468-2667(19)30077-5.