Visions from the past: Reflecting on the history of epidemiological research in the refugee and post-conflict mental health field.

Derrick Silove
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Abstract

Epidemiological research has made a major contribution to the knowledge-base in the field of refugee and post-conflict mental health in the last 30 years. There is a tendency however to question the cultural validity of study findings, or, alternatively, to argue that we have sufficient data to predict the mental health and psychosocial (MHPSS) needs of future populations exposed to mass conflict. This paper attempts to address both issues. Specifically, it is argued that, rather than an indicator of cultural inaccuracy in measure-ment, the large variation in symptom preva-lence rates observed across studies may reflect a genuine difference given the unique profile of risk and protective factors that characterize refugee populations based on their individual histories of conflict and current conditions of resettlement. There are compelling reasons therefore, where feasible, to include epide-miological studies in the comprehensive ap-proach of data gathering in assessing MHPSS needs - and to monitor changes over time - in current and future populations exposed to mass conflict.

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过去的愿景:反思难民和冲突后精神卫生领域流行病学研究的历史。
在过去30年中,流行病学研究对难民和冲突后心理健康领域的知识库作出了重大贡献。然而,有一种趋势是质疑研究结果的文化有效性,或者认为我们有足够的数据来预测未来面临大规模冲突的人群的心理健康和社会心理(MHPSS)需求。本文试图解决这两个问题。具体而言,有人认为,各研究中观察到的症状患病率的巨大差异可能反映了真正的差异,而不是衡量文化不准确的指标,因为难民人口的独特风险和保护因素特征是基于他们的个人冲突历史和目前的重新安置条件。因此,在可行的情况下,有令人信服的理由将流行病学研究纳入评估MHPSS需求的综合数据收集方法,并监测当前和未来面临大规模冲突的人群的长期变化。
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