Impact of a long asylum procedure on the prevalence of psychiatric disorders in Iraqi asylum seekers in the Netherlands

Clinically, a long asylum procedure seems to be associated with psychiatric disorders. However, data on this issue are lacking. In a national community-based study, using random sampling, we compared two groups of Iraqi asylum seekers, who had resided less than 6 months (N = 143) and more than 2 years (N = 151), respectively, in The Netherlands. Respondents were interviewed with fully structured, culturally validated, translated questionnaires. Psychiatric (DSM-IV) disorders were measured with the Composite International Diagnostic Interview 2.1 and evaluated in relation with premigration and postmigration adverse life events. Overall prevalence of psychiatric disorders was 42% in the first group and 66.2% in the second. The prevalence rates of anxiety, depressive, and somatoform disorders were significantly higher in the second group. Posttraumatic stress disorder was high in both groups but did not differ (p > .05). On logistic regression of all relevant risk factors, a long asylum procedure showed an odds ratio of 2.16 (confidence interval = 1.15-4.08) for psychopathology. The conclusion is that, indeed, the duration of the asylum procedure is an important risk factor for psychiatric problems. Both politicians and mental health workers should take note of this finding.