# Frequency and correlates of suicidality in a sample of traumatized treatment-seeking refugees

## TL;DR

This study finds that 15% of treatment-seeking refugees show suicidal behavior, linked to trauma, mental disorders, and postmigration stressors.

## Contribution

The study identifies Disturbances in Self-Organization and insecure asylum status as significant correlates of suicidality in traumatized refugees.

## Key findings

- 14.66% of the sample met criteria for Suicidal Behavior Disorder.
- Disturbances in Self-Organization were associated with both presence and severity of suicidality.
- Insecure asylum status was linked to suicidality in multivariate analyses.

## Abstract

Refugees are at heightened risk for suicidality due to trauma exposure, elevated prevalence of mental disorders, and postmigration stressors. Therefore, it is important to study Suicidal Behavior Disorder (SBD), included in DSM-5 for research purposes, as well as correlates of suicidality in this population.

In a sample of N = 103 treatment-seeking refugees, SBD frequency was assessed using a clinical interview. Associations between suicidality (presence and severity) and potential correlates - gender, age, Posttraumatic Stress Disorder (PTSD), Disturbances in Self-Organization (DSO), depression, insecure asylum status, flight duration, postmigration living difficulties (PMLD) and religiosity - were examined via univariate and multivariate analyses.

Fifteen patients (14.66%) met criteria for SBD. DSO were associated with the presence of suicidality in univariate and multivariate analyses and with the severity of suicidality in multivariate analyses. Sexual trauma frequency was associated with the presence of suicidality, while PTSD severity and lower religiosity were linked to greater suicidality severity. Depressive symptoms were associated with suicidality only in univariate analyses while an insecure asylum status was associated with suicidality in multivariate analyses only.

Suicidality should be systematically assessed in treatment-seeking refugees, particularly those with DSO or an insecure asylum status. Brief suicide prevention interventions may be warranted when treatment duration is uncertain, and targeted PTSD treatments should be offered when indicated.

The RCT was pre-registered at the German Clinical Trials Register (DRKS 00019876) on 28th of April 2020. The specific research question and analyses of this investigation were not pre-registered separately.