Multimorbidity and Mental Health Burden Among Immigrant Adolescents Seeking Care: Implications for Comprehensive Assessment.

Purpose

Immigrant adolescents are exposed to multiple health risk factors. This study aimed to compare the burden of multimorbidity and psychological distress, along with associated exposure factors, among accompanied and unaccompanied immigrant adolescents seeking care in a hospital-based unit for vulnerable populations.

Methods

This monocentric observational cohort was undertaken in Marseille, France (2019-2024), and included 384 adolescents aged 10-17 years who had arrived within the previous 5 years. The Cumulative Illness Rating Scale assessed the multimorbidity, and the Protect questionnaire assessed the risk of psychological trauma as a major component of psychological distress.

Results

The mean Cumulative Illness Rating Scale was 3.98 (standard deviation: 2.64). Multimorbidity was common, with 35.4% of participants having impairment of ≥ 3 organ systems. The most frequent impairments involved the eye, ear, nose, throat or teeth (48.7%), musculoskeletal and integumentary systems (46.4%), and mental health conditions (25.3%). Multimorbidity was independently associated with chronic medical history before migration (adjusted OR = 1.40, p < .0005) and during migration (adjusted OR = 1.94, p = .005). The risk of psychological trauma was independently associated with unaccompanied immigrant adolescent status (adjusted OR = 4.27, p < .05) and physical morbidity burden (adjusted OR = 1.18, p < .05). Patients had less emergency department visits during and after care in this hospital-based unit.

Discussion

Immigrant adolescents seeking care experience a high burden of multimorbidity and psychological distress. This risk requires particular attention, especially for unaccompanied adolescents, despite the lack of a convenient screening tool. A comprehensive care pathway is needed to reduce health inequalities in this extremely vulnerable population.