Background: While it is recognised that many refugee and migrant clients present at mental health services with non-specific psychological distress little is known about successful intervention strategies. Aims: The aim of this study was to systematically review clinical files to determine the degree of 'demoralisation' symptoms among a sample of refugee and migrant clients attending a community-based mental health service. Method: Sixty-four closed cases were reviewed using a specifically designed case review sheet as a checklist which included diagnostic criteria for a Demoralisation Syndrome. Results: The findings indicated that while many of the refugee and migrant clients had attracted a diagnosis of major depressive disorder, in the main they did not benefit from a normal course of treatment. Further analysis suggested that demoralisation may be a preferable concept for many of these clients rather than affective disorder. This finding suggests that demoralisation may be a different construct than low mood or depression. Conclusions: The findings add support to the concept that demoralisation could be a distinct diagnostic entity in its own right that may be useful to clinicians attending refugee and migrant clients. © 2006 Sage Publications.

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medical record review treatment response mood disorder refugee mental health service community care human immigration Refugees middle aged Ethnic Groups Data collection method checklist diagnostic and statistical manual of mental disorders Treatment Failure Humans Severity of Illness Index male female social psychiatry cultural factor Community Mental Health Services demoralization syndrome Article patient compliance major clinical study adult posttraumatic stress disorder distress syndrome Stress Disorders, Post-Traumatic ethnicity major depression antidepressant agent somatization concept formation