2026 ECNP Congress

PS02-2068

Evolution of clinical and treatment patterns among Syrian refugees: a comparative study from 2019 to 2025

Omer Fatih Yilmaz — E.E. Kılıcaslan · Izmir Katip Celebi University Atatürk Training and Research Hospital, Department of Psychiatry, Izmir, Türkiye

2026 ECNP Congress

Evolution of clinical and treatment patterns among Syrian refugees remains insufficiently characterised despite the protracted nature of displacement [1,2]. Early studies have primarily described acute and severe psychiatric presentations; however, less is known about how these profiles change over time with social and linguistic integration [3,4]. In a previous study conducted at our clinic, Syrian patients were more likely to receive antipsychotic treatment compared to Turkish patients [5]. This study aimed to compare the sociodemographic characteristics, clinical presentations and initial treatment patterns of all Syrian patients attending a tertiary psychiatric outpatient clinic in Türkiye in 2019 and 2025.

This retrospective, cross-sectional comparative study included all Syrian patients presenting in 2019 (n=50) and 2025 (n=81). Data were extracted from electronic health records and included sociodemographic variables (age, gender, marital status and employment status), clinical characteristics (admission unit, interview method, number of admissions, substance use history and preliminary diagnosis) and initial pharmacological treatments. Missing data were handled using pairwise deletion to preserve sample size. Categorical variables were analysed using Pearson’s chi-square test or Fisher’s exact test, and continuous variables using the Mann–Whitney U test following assessment of normality with the Shapiro–Wilk test. A binary logistic regression model was constructed to explore predictors of substance use history, including age, marital status and employment status as covariates.

The groups were comparable in age (median 27.5 vs 29.0 years, p=.661), gender (p=.383) and marital status (p=.443). The median number of admissions remained stable across the two periods (1.0 vs 1.0, p=.807). Employment rates increased significantly from 15.0% in 2019 to 42.2% in 2025 (p=.004). The proportion of patients able to conduct clinical interviews independently rose from 26.1% to 65.4%, while interpreter use decreased from 73.9% to 34.6% (p<.001). Admissions to specialised substance treatment services increased from 8.0% to 24.7% (p=.018), and the prevalence of substance use history rose from 8.2% to 25.9% (p=.013). Although differences in diagnostic distribution did not reach statistical significance (p=.191), descriptive trends suggested a relative decrease in psychotic disorders and an increase in anxiety and substance-related disorders over time. Pharmacological treatment patterns shifted significantly: antidepressant initiation increased from 44.2% to 67.6%, whereas antipsychotic initiation decreased from 55.8% to 26.8% (p=.004). Logistic regression did not identify independent predictors of substance use (all p>.05).

These findings suggest a temporal shift in psychiatric presentations among Syrian refugees, potentially reflecting the effects of increased social and linguistic integration and improved access to healthcare services. The observed increase in substance use may indicate emerging risk behaviours in a more settled population, while changes in treatment patterns appear to parallel evolving clinical needs. While causal inferences cannot be drawn from this cross-sectional design, the results highlight the importance of adapting psychiatric services to the changing clinical profiles of long-term refugee populations and underscore the need for further longitudinal studies.

References

  1. World Health Organization, 2022. World mental health report: transforming mental health for all. World Health Organization, Geneva.
  2. United Nations High Commissioner for Refugees, 2019. Global trends: forced displacement in 2019. UNHCR, Geneva.
  3. Satinsky, E., Fuhr, D.C., Woodward, A., Sondorp, E., Roberts, B., 2019. Mental health care utilisation and access among refugees and asylum seekers in Europe: a systematic review. Health Policy 123 (9), 851–863.
  4. Kirmayer, L.J., Narasiah, L., Munoz, M., Rashid, M., Ryder, A.G., Guzder, J., Hassan, G., Rousseau, C., Pottie, K., 2011. Common mental health problems in immigrants and refugees: general approach in primary care. CMAJ 183 (12), E959–E967.
  5. Kılıçaslan EE, Tamer Ş. Comparison of Syrian and Turkish Patients Presenting to a University Hospital Psychiatry Outpatient Clinic. Ege Klin Tıp Derg 2026;64 (1):63-68