Mental health trajectories among refugees: A systematic review

BACKGROUND: Forced displacement exposes refugees to a wide range of potentially traumatic experiences, increasing their vulnerability to mental health problems. However, longitudinal research indicates substantial heterogeneity in refugees' mental health trajectories. This systematic review aimed to synthesize existing evidence on these trajectories using growth mixture modeling and to identify predictors of differential outcomes. METHODS: A systematic search of peer-reviewed articles was conducted in PsycINFO, Medline, PTSDPubs, and Web of Science. Studies investigating refugees' mental health trajectories longitudinally using growth mixture modeling were included. Two independent reviewers systematically screened studies for eligibility and assessed methodological quality and risk of bias. RESULTS: A total of 1271 publications were initially identified, of which seven met the inclusion criteria, resulting in a total of 13 distinct trajectory analyses. All studies identified chronic trajectories, followed by resilient and recovery patterns, with delayed trajectories emerging as the least frequent pattern. Among those trajectories identified, the prevalence rates within studies were highest for the resilient trajectory (57.4 %), followed by recovery (29.4 %), chronic (14.4 %), and delayed (14.3 %). Across studies, older age was associated with increased risk for unfavorable trajectories, whereas greater social support was linked to more favorable trajectories. Findings regarding gender differences were mixed. CONCLUSIONS: This review suggests that refugees may follow similar mental health trajectories as other trauma-exposed populations, though notable differences in their distribution exist. Person-centered approaches such as growth mixture modeling offer valuable insights but remain underutilized. Longitudinal, theory-driven research is needed to inform tailored psychological interventions in displaced populations.