Associations between post-migration stressors and symptoms of depression and anxiety among migrants, refugees, and asylum seekers: A systematic review

Background Post-migration difficulties may be associated with adverse mental health outcomes among migrants, refugees, and asylum seekers. However, differences in the measurement of these difficulties and mental health outcomes complicate comparisons across studies. Objective To synthesize evidence on the association between post-migration stressors and symptoms of depression and anxiety among migrants, refugees and asylum seekers. Methods A systematic review of studies examining post-migration stressors and symptoms of depression and/or anxiety was conducted. Data on study characteristics, stressor measures, mental health outcomes, and key findings were extracted and synthesized narratively. Results Ten studies involving 5063 participants were included. Most focused on refugees and relied on cross-sectional analyses. The post-migration stressors examined included financial hardship, discrimination, social difficulties, legal and administrative challenges and barriers to essential services. Reported associations involved depressive symptoms, anxiety symptoms, combined anxiety/depression scores, or broader psychological distress measures. Differences in exposure definitions, outcome assessments and statistical methods limited comparisons and prevented conclusions that individual stressors were consistently associated with both depression and anxiety. Conclusion The findings suggest associations between selected post-migration stressors and mental health symptoms in the populations studied. However, the heterogeneity of the evidence and predominance of cross-sectional analyses limit causal inference and comparisons across studies. Further research using comparable, outcome-specific measures and longitudinal designs is needed to clarify relationships between specific stressors and depressive and anxiety symptoms.