High prevalence of anxiety disorders among adolescent Tibetan refugees

IntroductionPsychiatric disturbance has been shown to result from stress associated with events related to being a refugee. Children of refugees also experience significant stress but little is known about the prevalence of psychiatric disorders in this group. This survey explores the prevalence of psychiatric disorders in a Tibetan refugee enclave in rural North India.MethodsA prevalence survey was conducted using the Beck Anxiety Inventory (BAI) to determine the prevalence of anxiety amongst the Tibetan community. Three hundred fifty forms were distributed amongst the students; 335 were completed of which 300 were considered suitable to be collated and analysed.ResultsThe results revealed that 21% of the study population had significant levels of anxiety classed as moderate or severe using the BAI. Late adolescents had higher levels of significant moderate and severe anxiety than early and middle adolescents x2 = 92.95 (P < 0.0001). Female participants had higher levels of moderate and severe anxiety but this was not statistically significant (x2 = 1.286, P = 0.2568).ConclusionThere were high rates of anxiety in this study of Tibetan school aged children. School based anxiety prevention programmes and other interventions should be considered in such vulnerable populations especially amongst females and late adolescents who are disproportionately affected. These findings indicate a need for further evaluation of young Tibetan refugees for definitive diagnosis of anxiety disorders, specific phobias, social anxiety, post traumatic stress disorders and other anxiety disorders.

► The survey assessed anxiety levels among adolescent Tibetan refugees in Mussoorie, India using the Beck Anxiety Inventory.
► Late adolescents and in particular female adolescents had high levels of anxiety.
► The study indicates that there is a need for further psychiatric evaluation among this population.
► There is need for mental health services to be provided to young Tibetan refugees such as these in Uttarakhand.