Migrant adolescents' experience of depression as they, their parents, and their health-care professionals describe it: a systematic review and qualitative meta-synthesis

Migrant youth are vulnerable and face a risk of internalised disorders such as depression. This qualitative meta-synthesis explores migrant adolescents' experience of depression. 14 studies (7 qualitative studies and 7 case reports) were selected after a systematic search of PubMed, Embase, Scopus and PsycInfo. Their quality was assessed with the Critical Appraisal Tool (CASP) for qualitative studies and the Joanna Briggs Institute (JBI) checklist for case reports. The analysis identified six themes describing the experience of depression among migrant adolescents: (1) the vulnerability factors underlying depressive distress, before, during and after migration; (2) the subjective experience of depression, combining symptoms associated with a form of depression common in the West with symptoms more common in other cultures; (3) two types of aetiological hypotheses to make sense of their distress; (4) attitudes adopted in response to distress; (5) experience of care, especially reasons discouraging investment in care; and (6) impairment of identity construction by breaks in cultural transmission and intergenerational conflicts. The threat of losing their connections both at the interpersonal (connection to family, peers and community) and intrapsychic levels (construction of identity) is inherently linked to migrant adolescents' experience of depression. We propose to adapt Brandenberger's 3C model (communication, continuity of care, and confidence) for the care of young migrants to promote a therapeutic alliance, foster construction of a coherent bicultural identity, and support the family.