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Gender differences in the mental health of unaccompanied refugee minors in Europe: a systematic review
  1. Lea-Marie Mohwinkel1,
  2. Anna Christina Nowak2,
  3. Anne Kasper3,
  4. Oliver Razum1
  1. 1 Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
  2. 2 Department of Environment and Health, School of Public Health, Bielefeld University, Bielefeld, Germany
  3. 3 Department of Prevention and Health Promotion, School of Public Health, Bielefeld University, Bielefeld, Germany
  1. Correspondence to Lea-Marie Mohwinkel; lea-marie.mohwinkel{at}


Objectives Our aim was to summarise the current evidence regarding gender differences in the mental health of unaccompanied refugee minors (URM) and to identify gaps in research.

Setting We focused on quantitative studies presenting primary data from Organisation for Economic Co-Operation and Development(OECD)countries. Language was restricted to English or German.

Participants To be eligible, a study had to involve (former) URM who immigrated to an OECD country.

Design We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The databases MEDLINE, CINAHL, LIVIVO, PSYNDEX and PsycINFO were searched from 1990 to 2017. Studies were judged for eligibility by two independent reviewers each. We narratively summarised our results.

Results 9 primary studies, all from Europe, examined gender differences in the mental health of URM. The majority of the included studies found female URM to be more often affected by post-traumatic or depressive symptoms than their male counterparts. There is only weak evidence regarding other mental health outcomes. Two studies each conducted gender-specific analyses on anxiety and externalising behaviour, but no statistically significant differences between female and male URM were detected.

Conclusions Female gender is associated with a higher vulnerability towards certain mental health problems among URM residing in Europe. However, the lack of representative studies using reliable diagnostic methods indicates that the findings so far should be treated with caution. Further research is needed to clarify the role of gender for mental health in URM and to examine underlying mechanisms.

  • public health
  • mental health
  • Ptsd
  • unaccompanied refugee minors

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Contributors L-MM and OR conceived the study. L-MM, ACN and AK conducted the systematic review and the critical appraisal of the included studies. L-MM led the literature review and prepared the manuscript. All authors contributed to the interpretation of data and have revised and approved the final manuscript.

  • Funding This work was supported by the Ministry for Culture and Science of the German State of North Rhine-Westphalia within the graduate school ’FlüGe – Opportunities and challenges of global refugee migration for health care in Germany'.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available following this study.

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