Prevalence and predictors of depression, anxiety, and stress among refugees in Egypt

Background Many Refugees show multiple distressing psychological and mental health problems associated with stressful and adverse conditions in host countries. Even though Egypt is one of the top five destination countries hosting refugees and asylum-seekers in the MENA region, there is a lack of studies investigating mental health problems among refugees in Egypt. This study aimed to assess the prevalence and predictors of depression, anxiety, and stress symptoms among refugees living in Egypt. Methods A total of 398 refugees aged 18 and above were interviewed from migrants'/refugees' community centers in Giza, Alexandria, Dakahlia, and Damietta governorates. A predesigned structured interview questionnaire was used to collect socio-demographic and migration-related variables. The Arabic Version of Depression Anxiety Stress Scales (DASS-21) was used to assess the presence and severity of the three negative emotional states. Results Nearly two-thirds of the participants were Syrian (66.4%). The majority resided in Alexandria and Giza governorates (75.9%), were females (73.4%), and were married (71.1%). The most reported migration difficulty was housing (41.5%). Anxiety symptoms were reported among 63.3% (95% CI: 58.59%- 68.05%) of sampled refugees, followed by depression (61.3%, 95% CI: 56.52%-66.10%), and stress symptoms (51.5%, 95% CI: 46.56%-56.36%). Results of regression analysis showed that; female gender predicted anxiety (aOR 2.419, 95% CI: 1.485-3.941, p < 0.001) and stress (aOR 2.053, 95% CI: 1.197-3.519, p = 0.009), while younger age groups (18-25 yr. and 26-50 yr.) compared to the older age group (51 yr. and older) predicted depression (aOR 4.529, 95% CI: 1.696-12.097, p = 0.003 and aOR 2.177, 95% CI: 1.270- 3.733, p = 0.005, respectively) and stress (aOR 4.334, 95% CI: 1.556-12.074, p = 0.005 and aOR 1.808, 95% CI: 1.023-3.193, p = 0.041, respectively). Residence in Alexandria, housing, and employment difficulties predicted anxiety (aOR 2.354, 95% CI: 1.420-3.902, p < 0.001, aOR 1.726, 95% CI: 1.073-2.778, p = 0.025, and aOR 3.044, 95% CI: 1.248-7.425, p = 0.014, respectively), depression (aOR 1.949, 95% CI: 1.163-3.266, p = 0.011, aOR 1.666, 95% CI: 1.036-2.681, p = 0.035, and aOR 3.216, 95% CI: 1.321-7.828, p = 0.010, respectively), and stress (aOR 2.450, 95% CI: 1.431-4.195, p < 0.001, aOR 1.911, 95% CI: 1.187-3.078, p = 0.008, and aOR 4.482, 95% CI: 1.867-10.760, p < 0.001, respectively). Conclusion Mental health problems are prevalent among the refugee population in Egypt that are compounded by the difficult post-migration socio-economic situation. Multisectoral attention towards refugees' mental health is urgently needed.