Emotional and behavioral problems and quality of life in unaccompanied adolescent male refugees residing in institutional care.


Unaccompanied refugee minors in Europe are at high risk of developing mental health problems and experiencing poor quality of life. However, there have been few studies on psychiatric disorders, behavioral problems, and quality of life among these adolescents. Furthermore, previously conducted studies in different European countries have reported inconsistent findings. This study investigated the frequency of emotional and behavioral problems in unaccompanied refugee minors residing in youth welfare institutions in Germany, using data from both self-reports and caregiver reports. Additionally, health-related quality of life was investigated, using caregiver reports only. Data on 191 male refugees, between the ages of 12 and 20 from 24 different countries of origin, living in 16 youth welfare institutions in Germany were included in the analysis. Residents completed the self-report version of the Strengths and Difficulties Questionnaire (SDQ) for the detection of emotional and behavioral problems, while caregivers completed the teacher version. Caregivers additionally completed a questionnaire on health-related quality of life domains, and provided general sociodemographic information. The results of the SDQ and the questionnaires on health-related quality of life were compared with age-matched norms, using t tests and chi2 tests. According to both self-reports and caregiver reports, the rates of internalizing problems (emotional problems and peer relationship problems) in this sample were significantly higher than in norms, with frequencies ranging from 35 to 61%. By contrast, externalizing problems were rated as significantly lower than for norms, particularly hyperactivity with frequencies ranging from only 4 to 7%. Both sets of informants reported high levels of prosocial behavior. Caregivers and residents gave similar ratings on most measures but differed for conduct problems, with the ratings by the former corresponding to norms while those by the latter being significantly lower. Health-related quality of life was rated by caregivers as being poorer than in the normative sample; the only exception was found in the domain of peer relationships, where participants showed average results. The findings of this study confirm that unaccompanied refugee minors are a highly vulnerable group, and suggest that mental health screenings should be done regularly in the youth welfare institutions that care for them. It is important to use culturally sensitive instruments and multi-informant methods to detect problems despite possible differences between caregiver and self-reports. Appropriate support systems should be developed and implemented, including access to mental health care as well as psychosocial and educational interventions within schools and youth welfare institutions. Thus, the health and quality of life of these young people can be improved as they adjust to life in the resettlement countries and develop a future perspective. Abstract (Germanan) Unbegleitete minderjahrige Fluchtlinge (UMF) gelten als Hochrisikogruppe fur die Entwicklung psychischer Erkrankungen. Hinsichtlich Haufigkeit und Art psychischer Storungen sowie gesundheitsbezogener. Lebensqualitat (LQ) fehlen fur Deutschland bislang Originalarbeiten. Anhand der Daten von 191 mannlichen UMF, erhoben in Jugendhilfeeinrichtungen in Deutschland, wurden emotionale und Verhaltensauffalligkeiten (SDQ) sowie gesundheitsbezogene LQ (ILK) untersucht und Vergleiche zur Normstichprobe durchgefuhrt. Internalisierende Verhaltensauffalligkeiten zeigten sich laut Selbst- und Fremdbeurteilung bei 35 bis 61% der Jugendlichen signifikant haufiger als in der Normstichprobe (20%). Hyperaktivitatssymptome waren dagegen sehr selten (4 bis 7%). Externalisierende Verhaltensprobleme wurden von Betreuungspersonen haufiger (20%) berichtet als von den Jugendlichen (8%). Gesundheitsbezogene LQ wurde niedrig eingeschatzt, als Ressource konnte prosoziales Verhalten identifiziert werden.