Background: Refugees in western countries often face long juridical procedures before their requests for a resident permit is granted. The, still scanty, literature shows high prevalence rates of psychopathology among asylum seekers, but there has been little interest for other impaired dimensions of health. The present study is part of a community-based mental health survey among Iraqi asylum seekers in the Netherlands, conducted between November 2000 and September 2001, on the risks of a long asylum procedure. Objectives: The objectives of this study were to explore quality of life (QoL), disability and physical health and their relationships with psychopathology and pre- and post-migration variables. Method: Two groups of pre-stratified (length of asylum procedure), randomly selected Iraqi asylum seekers (N = 43 and N = 51), were interviewed with fully structured, culturally validated questionnaires. Quality of life was examined with QoLWHO-Bref, functional disability with the Brief Disability Questionnaire and physical health with a newly developed questionnaire. Psychiatric (DSM IV) disorders were measured with the WHO Composite International Diagnostic Interview 2.1. Multivariate logistic regression analyses were used to estimate the relationships between the outcome measures and socio-demographics, adverse life events in Iraq, post-migration living problems (PMLP) and psychopathology. Results: Respondents with a long asylum procedure reported significantly lower QoL, higher functional disability and more physical complaints. Multivariate regression shows that length of stay is the strongest predictor for a low overall QoL. In addition, lower QoL was predicted by psychopathology, higher age, adverse life events in the Netherlands and the PMLP-clusters: family issues, socio-economic living conditions and socio-religious aspects. Disability was predicted by psychopathology, higher age and the PMLP clusters: family issues and socio-religious aspects. Physical complaints were predicted by length of asylum procedure, psychopathology, female sex, adverse life events in Iraq and PMLP-family issues. Conclusion: A long asylum procedure has a negative impact on the overall health situation and the QoL of asylum seekers. The situation is not only harming the affected, but also interferes with the integration process in the Netherlands or elsewhere. The findings are important for health professionals, governments and human right specialists. © Springer-Verlag 2008.

Disability Asylum seekers psychopathology Iraq Physical health Quality of life

Netherlands refugee demography Sampling Studies Disabled Persons mental health human Life Change Events Refugees sex difference middle aged Ethnic Groups economic aspect controlled study life event Iraq health status Time Factors Aged Logistic Models length of stay diagnostic and statistical manual of mental disorders religion Mental Disorders mental disease quality of life Humans Adolescent male Acculturation female Psychiatric Status Rating Scales Article help seeking behavior Questionnaires adult major clinical study migration Age Factors mental hospital physical disability health hazard Social Adjustment health survey