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Psychological stress, cardiovascular disease and somatic pain in asylum seekers: a retrospective cross-sectional study

Nature Mental Health volume 2, pages 1442–1450 (2024)Cite this article

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Abstract

The refugee experience is a known risk factor for psychological stress, cardiovascular disease (CVD) and somatic pain. However, the prevalence and comorbidity of these health outcomes in asylum seekers is not elucidated. Here we performed a retrospective, cross-sectional study in which the forensic medical evaluations of 453 globally representative US asylum seekers were analyzed. Outcomes included the prevalence of symptoms of psychological stress, CVD, somatic pain and their comorbidity. Symptoms of psychological stress, CVD and somatic pain were documented in 94%, 47% and 50% of participants, respectively; 46% reported both CVD and stress symptoms, and 31% reported all three. Palpitations, presyncope/syncope, stroke symptoms and chest pain were reported in 33%, 25%, 20% and 16% of individuals with CVD symptoms, respectively. Furthermore, both stress symptoms and pain symptoms were each strongly predictive of comorbid CVD symptoms. These findings indicate that asylum seekers experience a high burden of comorbid and interrelated psychological stress, CVD and somatic pain.

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Fig. 1: Demographics of the research participants from the WCCHR from 2010 to 2020.
Fig. 2: Prevalence of stress, CVD and pain symptoms.
Fig. 3: ROC curve for multivariate logistic regression model of CVD symptom status.

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Data availability

Given the vulnerability of the study population, all of the individual participant data collected during this study, which form the minimum dataset necessary to interpret, verify and extend the research, after deidentification, will be made available by contacting the corresponding author. Statistical analysis plan and analytic code will be made available immediately following publication with no end date for anyone who wishes to access the data for any purposes.

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GraphPad PRISM 10.2.3 can be downloaded from https://www.graphpad.com/updates. ChartExpo 1.0.0.7 can be downloaded from https://chartexpo.com/. R 4.2.1 can be downloaded from https://www.r-project.org/about.html.

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Acknowledgements

Research reported in this publication was supported by the National Institute Of Neurological Disorders And Stroke of the National Institutes of Health (award number K23NS116114; G.K.). This study was also supported by grants from the National Institute of General Medical Sciences (T32GM007739 to the Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD program; H.L.P.) and a Predoctoral Fellowship from the National Cancer Institute (F30CA257282; H.L.P.). The content of this study is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The study sponsors had no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.

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  1. These authors contributed equally: Jacob Michael Lurie, Harlan Linver Pietz.

Authors and Affiliations

  1. Weill Cornell Medicine, New York, NY, USA

    Jacob Michael Lurie, Harlan Linver Pietz, Claudia Hatef, Faten Taki, Annabel Lee, Sargun Virk, Tanzilya Oren, Catherine Gbekie, Andrew R. Milewski, Richard Boyer & Gunisha Kaur

  2. Jacobs Technion-Cornell Institute, New York, NY, USA

    Richard Boyer

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Contributions

J.M.L.: data curation, methodology, writing—original draft, and writing—review and editing; H.L.P.: data curation, methodology, visualization, writing—original draft, and writing—review and editing; C.H.: conceptualization, methodology, data curation and project administration; R.B.: conceptualization, data curation, formal analysis, methodology, software, validation, visualization, writing—original draft, and writing—review and editing; F.T.: conceptualization, data curation, formal analysis, methodology, software, validation, visualization, writing—original draft, and writing—review and editing; A.L.: conceptualization, methodology, data curation and project administration; S.V.: methodology and formal analysis; C.G.: data curation, methodology and project administration; T.O.: methodology and formal analysis; A.R.M.: methodology, formal analysis, and writing—review and editing; G.K.: conceptualization, data curation, methodology, validation, writing—original draft, writing—review and editing, project administration, funding acquisition, resources and supervision.

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Correspondence to Gunisha Kaur.

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Lurie, J.M., Pietz, H.L., Hatef, C. et al. Psychological stress, cardiovascular disease and somatic pain in asylum seekers: a retrospective cross-sectional study. Nat. Mental Health 2, 1442–1450 (2024). https://doi.org/10.1038/s44220-024-00312-3

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