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Original Articles
Introduction
Refugees, in addition to displacement from their homes, have been exposed to many horrifying traumatic events such as threat of death, torture, or serious injury and the injury, death, disappearance of family members, rape, lack of food and water, or lack of shelter (Mollica et al. 1992). Epidemiological studies indicate a high risk of mental health problems among refugees (Fazel et al. 2005; Porter & Haslam, 2005). A meta-analysis including studies conducted among refugees in Western countries indicated that one in every 10 adult refugees has post-traumatic stress disorder (PTSD) and one in every 20 has major depression (Fazel et al. 2005). If not treated, mental health problems among refugees may become chronic. A longitudinal study conducted in two different refugee camps for Bosnian refugees indicated that 24-30% had PTSD co-morbid with depression, 4-6% had only PTSD and 19% had only depression 3 years after the war (Vukovic et al. 2014). PTSD has a chronic course if not treated and those with PTSD have low quality of life (Kessler, 2000; Mollica et al. 2001).
Since the start of the war in Syria in 2011, 3.8 million Syrians have been forced to find a safer place. Almost half of them have fled to other countries as refugees (UNHCR, 2015). Turkey hosts the highest number of Syrian refugees who sought asylum (UNHCR, 2015), residing either in refugee camps or in cities. A study using a structured diagnostic interview in a sample of 352 Syrian refugees staying at refugee camps in Turkey (Alpak et al. 2014) showed that 33.5% had a diagnosis of PTSD. Female refugees who were exposed to two or more traumatic events and had a personal and family history of psychiatric disorder had higher risk for PTSD.
In humanitarian settings, such as refugee camps, specialized mental health interventions have been shown to reduce symptoms of mental disorders such as PTSD and depression (Tol et al. 2011). Two randomized controlled trials (RCTs) in Uganda show evidence for the efficacy of narrative exposure therapy (NET) in refugee camps (Neuner et al. 2008). In one of them, 43 Sudanese refugees living in a refugee settlement either received NET, supportive counselling, or psychoeducation. NET...