Systematic review of mental health problems and migration stressors among Kurdish migrants in western host countries

Abstract

Objectives

This systematic review aimed to evaluate the mental health outcomes of Kurdish migrants, with particular attention to the prevalence of psychological disorders and the impact of pre- and post-migration stressors.

Methods

A systematic search was conducted in PubMed, Scopus, and Google Scholar according to the PRISMA guidelines. The strategy combined medical subject headings (MeSH) and relevant keywords on Kurdish migrants, refugees, asylum seekers, and mental health. The search yielded 132 records, of which 15 studies met the eligibility criteria, representing a total of 5,319 participants. The methodological quality and risk of bias of the included studies were assessed using the Newcastle–Ottawa Scale.

Results

Following migration and resettlement in host countries, Kurdish migrants were found to experience high rates of PTSD (36.9%), depression (36.3%), and anxiety (27.7%), together with additional difficulties such as insomnia, fatigue, and suicidal ideation. Pre-migration was most often driven by war and political oppression (81.1%), violence and persecution (60.7%), and economic hardship (59.1%). Post-migration stressors included family separation (47%), discrimination and violence (51.4%), isolation and loneliness (51.7%), economic difficulties (40%), fear of deportation (21%), and other problems (30%).

Conclusion

As one of the largest stateless and historically persecuted populations, Kurds experience distinctive challenges in their migration journeys. Their significant burden of mental health problems underscores the need for culturally tailored and trauma-informed interventions that address both displacement experiences and barriers to integration in host societies, as well as during deportation and reintegration into their home countries.

Introduction

Migration is a long-standing phenomenon in human history, but in modern times, it increasingly reflects not voluntary movement, but forced displacement due to war, persecution, and political oppression. According to the International Organisation for Migration (IOM), an estimated 281 million people were international migrants in 2020, comprising 3.6% of the world’s population, a figure that has more than tripled since 1970. The most common destinations include the United States and Western Europe [39]. Forced migrants, as opposed to voluntary migrants, face particularly high risks to health and well-being because they are compelled to leave under conditions of instability, violence, and persecution [4].

A substantial body of evidence links migration to adverse mental health outcomes. Traumatic events before migration, the migration journey itself, and post-migration stressors collectively contribute to an increased prevalence of psychiatric disorders [7, 18, 30]. Global meta-analyses confirm consistently high prevalence rates of PTSD, depression, and anxiety among refugees and asylum seekers. For example, Steel et al. [32] reported pooled prevalence estimates of 30.6% for PTSD and 30.8% for depression, Fazel et al. [13] found lower but significant rates (9% PTSD, 5% depression) among resettled refugees,and Blackmore et al. [6] demonstrated a pooled prevalence of 31% PTSD and 32% depression across displaced populations. More recent evidence suggests even a higher prevalence in migrants living in uncertain or ‘limbo’ legal status, with rates of anxiety at 43%, depression at 49.5% and PTSD at 40.8% [12]. These findings highlight the cumulative effect of pre- and post-migration stressors on mental health and the importance of contextual factors such as host country policies, discrimination, and access to care.

The Kurdish population represents a particularly under-researched group in this field. Kurds, the largest stateless ethnic group worldwide, inhabit regions of Iraq (8–8.5 million), Syria (3–3.6 million), Turkey (15–20 million), and Iran (10–12 million), with additional diaspora communities in western countries, bringing the total to an estimated 36–45 million globally [19]. Kurds have experienced recurrent displacement due to decades of war, ethnic persecution, and political oppression [7, 16, 25]. Multiple migration waves have occurred, beginning in the 1970s, continuing through the 1990s, and intensifying after 2014 during the Syrian conflict and the rise of ISIS still ongoing [23, 25].

Study objectives, research questions, and hypotheses

Migration remains a persistent global challenge, and Kurds being notably active participants. Despite Kurds migrating since the mid-twentieth century, there is a lack of comprehensive data on the trauma, reasons for migration, and psychological effects of Kurdish immigration, with no systematic review study to fully understand it. Thus, our objective is to explore the mental health challenges experienced by Kurdish migrants, including pre-migration experiences (reasons for migration) and post-migration experiences (such as traumatic life events), and to gain an understanding of migration and mental health problems within the Kurdish community. To achieve this, the review is guided by the following research questions:

1. What are the primary pre-migration and post-migration stressors experienced by Kurdish migrants in western host countries?

2. What is the prevalence of major psychological disorders (e.g., PTSD, depression, anxiety) among Kurdish migrants?

3. How do these mental health outcomes compare to the broader findings of refugee and migrant populations reported in recent meta-analyses?

Based on prior research and global evidence, we formulated the following expectations: (a) Kurdish migrants will show high prevalence rates of PTSD, depression, and anxiety, comparable to or exceeding pooled prevalence estimates from recent meta-analyses; (b) pre-migration factors such as political oppression, war, and persecution will emerge as major drivers of migration, while post-migration factors such as discrimination, unemployment, and family separation will significantly contribute to ongoing psychological distress; and (c) gender and host-country context may moderate mental health outcomes, with women and migrants in restrictive asylum environments being particularly vulnerable. These objectives, research questions, and hypotheses provide a clear framework to synthesise the available evidence and situate the experiences of Kurdish migrants in broader theoretical and empirical contexts.

Method

Study design

The systematic review followed the guidelines set out by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) (Page et al. [26]). The current systematic review examines and synthesises studies on migration-related mental health issues among Kurdish migrants, with a focus on western countries. This emphasis reflects both the available evidence base and the fact that most Kurdish migration has historically been directed toward western nations rather than other regions.

Search strategies

The search was carried out across multiple disciplines, including social sciences, public health, medicine, and psychology, using PubMed, Scopus, and Google Scholar. These sources were chosen to ensure broad coverage: PubMed for biomedical and psychiatric literature, Scopus for multidisciplinary research, and Google Scholar as a meta-search engine to capture additional grey and cross-disciplinary studies not always indexed in traditional databases. A two-phase literature search was conducted between January 2022 and December 2023. The strategy combined medical subject headings (MeSH) and free-text keywords, including: ‘Kurdish migrants’ OR ‘Kurdish immigration’ OR ‘Kurdish refugees’ OR ‘Kurdish asylum seekers’ AND ‘mental health’ OR ‘psychological disorders’ OR ‘posttraumatic stress disorder’ OR ‘depression’ OR ‘anxiety’ OR ‘suicide’ OR ‘self-harm’. Boolean operators were applied to refine the searches. All identified titles and abstracts were independently screened for relevance by two reviewers. Potentially eligible articles underwent full text review, with disagreements resolved through discussion until consensus was reached. No restrictions were applied with respect to the publication date or language in order to capture the largest possible body of evidence.

Eligibility criteria

Studies were considered eligible if they met the following criteria: (1) focused on psychological and mental health problems among Kurdish migrants, (2) included Kurdish people from Iraq, Iran, Syria, or Turkey, and (3) were conducted outside their home country. Records were excluded if (1) focused on physical health, (2) case studies, narratives or non-peer-reviewed articles, and (3) Syrian Kurds who migrated to the Iraqi Kurdistan region.

Data extraction

Data extraction involved the use of a standardised extraction form to systematically retrieve information from the included studies. The data extracted included details on the authors and publication year, study design, study country, sample size, gender distribution, age range, and measures used. This precise approach ensured that the relevant baseline characteristics of the included studies were captured accurately and effectively synthesised. Characteristics of the included studies presented in Table 1.

Table 1.

Characteristics of included studies

References	Study design	Country	Sample size	Sex	Age (range)	Measures
Salama et al. [29]	Cross-sectional	Finland	N = 500	♂ = 500 ♀ = 0	18–64	AUDITC & HSCL-25
Castaneda et al. [9]	Cross sectional	Finland	N = 1948	♂ = 1129 ♀ = 819	18–64	HSCL-25
Hollifield et al. [18]	Cross-sectional	USA	N = 117	♂ = 63 ♀ = 54	19–77	THQ 24-item, CTI-104, PMLP- 23, HSCL-25, & PSS-SR 17
Rask et al. [28]	Cross-sectional	Finland	N = 515	♂ = 277 ♀ = 238	18–64	HSCl-25
Sulaiman-Hill and Thompson [34]	Cross-sectional	Australia	N = 51	♂ = 28 ♀ = 23	30 +	K10 & PWI
Cummings et al. [11]	Cross-sectional	USA	N = 70	♂ = 35 ♀ = 35	50–79	GDS, MGLQ, IADL, SEC, LSNS & MCC
Gülsen et al. [16]	Cross-sectional	Multicounty: Turkey: 558 Germany: 333 France: 82 Netherlands: 51 Sweden: 51 United Kingdom: 51	N = 1127	♂ = 0 ♀ = 1127	16–86	GHQ–28 & PTSD (SI-PTSD)
Knipscheer et al. [20]	Cross-sectional	Netherland	N = 130	♂ = 85 ♀ = 45	36.9 (SD = 9)	GHQ-28, IES & LAS
Taloyan et al. [36]	Cross-sectional	Sweden	N = 111	♂ = 86 ♀ = 25	27–60	SRH
Taloyan et al. [37]	Cross-sectional	Sweden	N = 197	♂ = 111 ♀ = 86	27–60	GHQ-12
Taloyan et al. [35]	Cross-sectional	Sweden	N = 111	♂ = 111 ♀ = 0	27–60	SRH
Bradley and Tawfiq [7]	Cross-sectional	United Kingdom	N = 97	♂ = 83 ♀ = 14	16–64	DSM (IV)
Gilgen et al. [14]	Cross-sectional	Switzerland	N = 62	♂ = 23 ♀ = 39	17–67	EMIC
Söndergaard et al. [27]	Cross-sectional	Sweden	N = 86	♂ = 54 ♀ = 32	18–48	GHQ-28, HTQ, IES & HRLE
Bayard-Burfield et al. [1]	Cross-sectional	Sweden	N = 197	Not provided	20–44	Swedish national survey of immigrants

Risk of Bias Assessment

Quality assessment of the included studies was conducted using the Newcastle–Ottawa Scale (NOS) (Wells et al. [38]), this is a widely recognised tool for assessing the quality of non-randomized studies in meta-analyses and systematic reviews. NOS evaluates studies based on three main components: selection of study groups, comparability of groups, and determination of results. Each component is further subdivided into specific criteria, allowing for a detailed evaluation of study quality. Studies are awarded points up to nine based on their adherence to these criteria, with higher scores indicating better methodological quality. Using NOS, this systematic review ensured a rigorous evaluation of the included studies, allowing the identification of high-quality evidence and improving the reliability of the synthesised findings.

Data synthesis

A narrative synthesis approach was used to summarise and integrate the findings of the included studies. This method was chosen because the studies demonstrated considerable heterogeneity in terms of design, sample size, diagnostic instruments, and outcome measures, as well as the context of the host country. Policies on asylum, welfare support, access to healthcare and integration differ across host nations, shaping both the stressors faced by Kurdish migrants and the prevalence of mental health disorders. Such variability made it inappropriate to conduct a formal meta-analysis, as pooling prevalence rates across incomparable contexts would risk obscuring meaningful differences and producing misleading estimates. Instead, the synthesis focused on identifying recurring themes and patterns related to pre-migration factors, post-migration stressors, and the prevalence of psychological disorders among Kurdish migrants. This approach allowed for a comprehensive and structured overview of the available evidence while acknowledging methodological diversity in all studies.

Results

Study selection

The search yielded a total of 132 articles (PubMed = 43, Scopus = 8, Google Scholar = 81). Following the elimination of 19 duplicates, 113 records were subjected to an initial screening based on their titles and abstracts, resulting in the exclusion of 3 records due to lack of relevance. Eventually, 110 papers were selected for an in-depth full-text review. Of these, 95 were excluded for the following reasons: 88 did not meet eligibility criteria (e.g., wrong study population, inappropriate study design such as case reports or narrative reviews, indirect or insufficient data, non-English language, or lack of focus on mental health), 4 had participants not adequately verified, 2 evaluated only physical health outcomes, and 1 was published in a predatory journal. Consequently, 15 studies met the eligibility requirements and were included in the review. The Rayyan AI platform [24] was used for screening and selecting studies. The detailed selection process is presented in the PRISMA flowchart Fig. 1.

Fig. 1.

PRISMA flowchart of the study selection

Study characteristics

All included studies were cross-sectional in design. These studies were published between 2001 and 2022 and were conducted in different countries. Specifically, 11 articles were from Europe and the United Kingdom, five from Sweden, three from Finland, and one each from Netherlands, Switzerland, and United Kingdom. Additionally, two articles were from the United States of America and the one from Australia, and last one was multi-country study included participants from Turkey, Germany, France, the Netherlands, Sweden, and the United Kingdom.

Participants

The studies included Kurds from Turkey, Syria, Iran and Iraq, with the majority coming from Iraqi Kurdistan. In total, 5,319 participants were involved, with the smallest study sample having 51 participants and the largest 1,948. Among them, there were 2,585 males (48.6%) and 2,537 females (47.7%). The percentages do not total 100% because one study [1] did not report gender distribution. The age of the participants ranged from 16 to 86 years. More details of the participants are presented in Table 1.

Diagnostic instruments

In all included studies, a wide range of validated diagnostic instruments were used to assess mental health outcomes. These covered domains such as general mental health (e.g., GHQ-12, HSCL-25, K10), trauma and PTSD (e.g., HTQ, IES, CTI-104), stress and depression (e.g., SEC, PMLP, GDS), and other related constructs including medical conditions, acculturation, grief, and social functioning. The use of validated instruments strengthened the reliability of the findings; however, the diversity of tools introduced heterogeneity, limiting comparability between studies. Among these, the Harvard Trauma Questionnaire (HTQ) and the Hopkins Symptom Checklist-25 (HSCL-25) were the most frequently applied and thus provided the most reliable sources for pooled prevalence estimates. Summaries of instruments by category presented in Table 2.

Table 2.

Diagnostic instruments used in included studies

Focus	Diagnostic/measurements
General mental health assessment	General health questionnaire (GHQ-12 & 28)
	Hopkins symptom checklist-25 (HSCL-25)
	Kessler psychological distress scale (K10)
	Personal well-being index (PWI)
	Explanatory model interview catalogue (EMIC)
	Swedish national survey of immigrants
Trauma assessment	Impact of event scale (IES)
	Harvard trauma questionnaire (HTQ)
	Comprehensive trauma inventory-104 (CTI-104)
	Trauma history questionnaire (THQ) 24-item
	PTSD symptom scale-self report (PSS-SR) 17 items
	Structured interview for PTSD (SI-PTSD)
	PTSD DSM (IV) criteria
Stress and depression assessment	Holmes-rahe life event questionnaire 19 items (HRLE)
	Stressful events checklist (SEC) 12 items
	Post-migration living problems (PMLP) 23 items
	Geriatric depression scale (GDS)
Medical conditions assessment	Medical conditions checklist (MCC) 12 items
	Self-reported health
	open-ended health open-ended interview questions
Acculturation assessment	Lowlands acculturation scale (LAS)
Grief and loss assessment	Migratory grief and loss questionnaire (MGLQ)
Functional assessment	Lawton instrumental activities of daily living (IADL) scale
Social network assessment	Lubben social network scale (LSNS)
Alcohol use assessment	The alcohol use disorders identification test-concise (AUDIT-C)

Outcome of the quality assessment

We evaluated the methodological quality of the included studies using the Newcastle–Ottawa Scale (NOS), which assesses the adherence to predefined criteria. The scores ranged from three to five, reflecting variability in methodological rigour. Five studies including Hollifield et al. [18], Knipscheer et al. [20], Taloyan et al. [35], Peter Söndergaard et al. [27], Bayard-Burfield et al. [1] were classified as moderate quality, while the remaining ten studies by Salama et al. [29], Castaneda et al. [9], Rask et al. [28], Sulaiman-Hill and Thompson [34], Cummings et al. [11], Gülsen et al. [16], Taloyan et al. [36], Taloyan et al. [37], Bradley and Tawfiq [7], Gilgen et al. [14] were classified as high quality. All studies scored equally for comparability with a value of one, while no study exceeded one point in the evaluation of the results. These assessments highlight the general robustness of the evidence base and were considered when interpreting the findings, as detailed in Table 3.

Table 3.

Risk of bias assessment using the Newcastle–Ottawa scale

References	Selection	Comparability	Outcome	Total	Quality*
Salama et al. [29]	2	2	3	7	High
Castaneda et al. [9]	2	3	2	7	High
Hollifield et al. [18]	2	1	1	5	Moderate
Rask et al. [28]	3	3	2	8	High
Sulaiman-Hill and Thompson [34]	3	1	3	7	High
Cummings et al. [11]	3	2	3	8	High
Gülsen et al. [16]	3	1	3	7	High
Knipscheer et al. [20]	2	2	2	6	Moderate
Taloyan et al. [36]	2	3	2	7	High
Taloyan et al. [37]	2	3	2	7	High
Taloyan et al. [35]	2	1	3	6	Moderate
Bradley and Tawfiq [7]	2	3	3	8	High
Gilgen et al. [14]	3	3	3	9	High
Peter Söndergaard et al. [27]	1	1	3	5	Moderate
Bayard-Burfield et al. [1]	2	1	3	6	Moderate

^*Low quality (0–3 stars), moderate quality (4–6 stars), or high quality (7–9 stars) based on their overall score

Main findings

Based on the objectives of our systematic review, the findings were classified into three areas corresponding to the study research questions. First, we examined pre-migration factors, including the primary reasons for migration such as war, political oppression, persecution, and economic hardship. Second, we analysed post-migration experiences, with particular focus on traumatic life events and ongoing stressors encountered by Kurdish migrants in host countries, including discrimination, unemployment, family separation, and social isolation. Third, we evaluated the general prevalence of psychological disorders, notably PTSD, depression, and anxiety among Kurdish migrants, and considered how these estimates compare with prevalence patterns reported in recent meta-analyses of refugee and asylum-seeker populations. These results are summarised in Table 4, and detailed findings for each category are presented in the following subsections.

Table 4.

The migration experiences and mental health outcome of Kurds migrants

References	Country	Pre-migration experiences (reasons of migration)	Post migration experiences (traumatic life event)	Psychological disorders
Salama et al. [29]	Finland	Not reported	Not reported	31% of Suicidal thoughts and affective symptoms were linked to binge drinking and daily smoking
Castaneda et al. [9]	Finland	Not provided	Not provided	Affective symptoms 16.97%
Hollifield et al. [18]	USA	Not provided	Separation from family 47%, Fears of being sent home 21%, Discrimination 25%, Not being able to find work 28%, Bad job conditions 30%, Poverty 37%, Loneliness and boredom 38%, Isolation 48%	PTSD = 56% Depression = 41% Anxiety = 34%
Rask et al. [28]	Finland	Not provided	Unemployment and poor economic situation, poor language proficiency and short time since migration, discrimination	Depression & Anxiety: 36%, men: 23% and women: 49%
Sulaiman-Hill and Thompson [34]	Australia	Not provided	Social/family/isolation, Cultural/religious discrimination, Language difficulties, economic challenges, Status dissonance, unfulfilled Personal aspirations/achievements	High psychological distress and poor mental wellbeing
Cummings et al. [11]	USA	Not provided	migratory grief, Citizenship issues (understanding the application process, forms, and documents): 72.9%, Death of a friend: 52.9%, Children moving out: 50.0%	Depression 67.1%, Severe depression 25.7%
Gülsen et al. [16]	Multicountries: Turkey, Germany, France, Netherlands, Sweden, United Kingdom	War and political oppression	Death/life-threatening disease suffered by a loved one (child/husband): 49.7%, Political violence, detention, and torture: 27.4%, Military violence and destruction: 27.1%, Crime: 21.5%, Migration issues: 7.5%, racism and discrimination	PTSD 46.4%
Knipscheer et al. [20]	Netherland	Political and economic factors	Disaster/ life threatening accident 13%, trauma Death close one/life threatening illness 16.5%, Problems in relation/ divorce 6.1%, Migration 5.2%, Political violence (refuge)/torture/violence 59.1%	PTSD 31.1%
Taloyan et al. [36]	Sweden	Seeking political asylum in Sweden (female: 44.2%, male: 87.4%). Travelling alone to Sweden (female: 31.4%, male: 73.0%). Subjection to violence in the home country (female: 47.7%, male: 62.2%)	Discrimination, Low sense of control over own life, worried about, International situation (risk for war or political unrest in the home country): 90.2%, Children's future: 60.3%, Own health: 48.1%, Being exposed to violence or threats due to ethnic or religious affiliation: 48.1%, Own economic situation: 71.3%	Sleeping difficulties 37.5%: Women 41.7%, Men 33.3%, General fatigue 52.65%: Women 59.3%, Men 46.0%, Anxiety 27.3%: Women 38.4%, Men 16.2%
Taloyan et al. [37]	Sweden	Not provided	Not provided	Poor psychological well-being, 26% and Anxiety, 26%
Taloyan et al. [35]	Sweden	The majority of the Kurdish men (87.4%) had left their countries for political reasons, to escape a war or a war-like situation and a majority (62.2%) had experienced violence against self or a close relative	54.3% reported having worries about their economic situation or about their children's future or their own health. 91.0% reported worries about the political situation in the home country. 81.1% perceived themselves to be highly or moderately discriminated against in Sweden	Anxiety = 16.2, Sleeping difficulties = 32.4
Bradley and Tawfiq [7]	United Kingdom	Political oppression and torture	Physical injuries, pain, disability and psychopathology and unbale to work all due to torture	PTSD: 14%, Depression 7%, Anxiety: 7%
Gilgen et al. [14]	Switzerland	War-related experiences, being exiled, persecution	Racism, social problems, Legal restrictions/work permit, social isolation, financial problems, Language challenges, Cultural differences, Separation from family	Affective symptoms: 55%, Ideation of self-harm: 50%
Söndergaard et al. [27]	Sweden	Political situation and war	Housing problems, Too high demands, Progress regarding family reunification, Difficulties of orientation in new environment, Financial difficulties, Death of relative or friend, hostility towards refugees	Full PTSD: 37.2%, PTSD symptoms: 27.9%
Bayard-Burfield et al. [1]	Sweden	Political/religious instability or war in their native countries 68.5	Discrimination 23.9, living alone 19.3, poor knowledge of Swedish 50.3, and Unemployment 46.2	Increased risk of self-reported psychiatric illness

Pre-migration experiences (reasons for migration)

The results of our systematic review indicated that the reasons for migration among Kurdish populations were multifaceted, driven by political, social, and economic pressures. When aggregated across studies, the most common reasons were war and political oppression (81.1%), violence and persecution (60.7%), and economic hardship (59.1%) (Fig. 2).

Fig. 2.

Pre- and post-migration stressors reported by Kurdish migrants. Pre-migration was most commonly driven by war and political oppression (81.1%), violence and persecution (60.7%), and economic hardship (59.1%). Post-migration stressors included discrimination/violence (51.4%), isolation/loneliness (51.7%), family separation (47%), economic difficulties (40%), and fear of deportation (21%). These stressors compound throughout the migration process, increasing the risk of mental health problems

Several studies provided more nuanced insights. Gülsen et al. [16] found that war and political oppression, including political violence, detention, and torture, were the main reasons for migration, including countries such as Turkey, Germany, France, Netherlands, Sweden and United Kingdom. Similarly, Bradley and Tawfiq [7] identified political oppression and torture as significant factors leading to migration to the UK, while Knipscheer et al. [20] reported that political violence and economic factors drove many Kurds to flee to the Netherlands, with 59.1% experiencing political violence. Gilgen et al. [14] also demonsarted war-related experiences, exile, and persecution as significant reasons for migration to Switzerland. Taloyan et al. [35] highlighted that a majority of Kurdish men (87.4%) left to escape war-like situations, with 62.2% experiencing violence, focussing on migrants in Sweden. Taloyan et al. [36] reported that seeking political asylum in Sweden was a major reason, particularly among men (87.4%), with significant percentages travelling alone and experiencing violence. Bayard-Burfield et al. [1] emphasised political and religious instability or war in native countries, indicated by 68.5% of migrants to Sweden. Economic factors were also significant, as Knipscheer et al. [20] and Rask et al. [28] noted unemployment and poor economic situations as critical motivators, with the latter study focussing on Finland. Collectively, the desire to seek political asylum, better economic opportunities, and escape violence were the primary drivers of migration among the Kurdish population in various countries.

Post-migration experiences (traumatic life event)

Post-migration stressors were also widespread and had a profound impact on the well-being of Kurdish migrants. On average, family separation (47%), discrimination and violence (51.4%), isolation and loneliness (51.7%), economic hardship (40%), fear of deportation (21%) and other legal or social difficulties (30%) were reported (Fig. 2).

Several studies further contextualise these challenges. Hollifield et al. [18] reported that 47% of Kurdish migrants in the USA experienced family separation, while 21% lived with fear of deportation and 25% reported discrimination. In Sweden, up to 81.1% of migrants experienced discrimination or violence related to ethnic or religious identity [35, 36]. Social isolation was another recurring theme, with 38–48% of participants in the USA reporting loneliness and isolation [18], findings echoed in Australia [34] and the Netherlands [20]. Economic hardships such as unemployment and housing difficulties were prevalent across contexts, affecting nearly half of Kurdish migrants in Sweden [1]; Söndergaard et al. [27], and Switzerland (Gilgen et al. [14]), and similarly identified as major stressors in Finland [28]. Language barriers and legal uncertainties also contributed significantly to the distress. Sulaiman-Hill and Thompson [34] and Cummings et al. [11] found that nearly three-quarters of Kurdish migrants in Australia struggled with application processes, while Gilgen et al. [14] described widespread legal restrictions in Switzerland. Traumas from pre-migration continued to affect Kurdish migrants, with 49.7% reporting the death or life-threatening illness of a loved one and 27.4% reporting political violence, detention, or torture [16]. In the UK, migrants often reported lasting physical injuries and disability due to torture [7]. Generally, the main post-migration stressors included discrimination, economic difficulties, unemployment, language barriers, social isolation, family separation, unresolved trauma, and challenges related to legal procedures. These complex challenges significantly contributed to psychological distress and poor well-being, often exacerbating the initial reasons for migration.

Mental health disorders

In general, the synthesis of the findings in the studies indicated that Kurdish migrants experienced a substantial mental health burden, with consistently elevated prevalence rates across disorders. PTSD was reported in five studies, with rates ranging from 14 to 56% and an overall mean of 36.9%. Depression was examined in ten studies, ranging from 7 to 67% with an average prevalence of 36.3%, while anxiety ranged from 16 to 55% with an average of 27.7%. Beyond these common disorders, additional problems such as suicidal ideation (reported in up to 40% to 50% of participants), insomnia (32–48%), fatigue (over 50%), poor well-being (26–75%), and self-harm ideas (around 50% in some samples) were also documented. The detailed prevalence rates of each condition presented in (Fig. 3) and the breakdown of each condition is presented in the subsections.

Fig. 3.

Overall prevalence of common mental health disorders among Kurdish migrants. This bar graph shows the pooled prevalence in all studies, indicating high rates of PTSD (36.9%), depression (36.3%) and anxiety (27.7%). These findings highlight the substantial psychological burden facing Kurdish migrants

Posttraumatic stress disorder (PTSD) Five studies examined the prevalence of PTSD among Kurdish migrants, revealed an overall prevalence rate of 36.9%. The highest prevalence rates were observed in the USA (56%), Sweden (37.2%), and in the multi-country study (46.4%). Hollifield et al. [18] indicated a remarkably high prevalence of PTSD of 56% among Kurdish migrants in the USA. In Sweden, Söndergaard et al. [27] found that 37.2% suffered from full PTSD, while 27.9% exhibited only symptoms of PTSD. Gülsen et al. [16] conducted a multicountry study that included Turkey, Germany, France, Netherlands, Sweden, and United Kingdom, finding a prevalence of PTSD of around 46.4%. A comparatively lower prevalence of PTSD was reported in the United Kingdom (14%) and the Netherlands (31.1%). In the United Kingdom, Bradley and Tawfiq [7] reported a prevalence of 14%. Knipscheer et al. [20] conducted their study in Netherlands, revealed a prevalence of PTSD of 31.1%. Similarly, high prevalence rates were observed in the United States, where Hollifield et al. [18] indicated a remarkably high prevalence of PTSD of 56% among Kurdish migrants.

Depression and Anxiety Ten studies examined depression, anxiety, and affective symptoms. The overall prevalences were 36.3% for depression and 27.7% for anxiety. The prevalence was highest in the USA, with depression rates reaching up to 67.1% and anxiety up to 34%, in which Hollifield et al. [18] found that 41% of migrants experienced depression and 34% suffered from anxiety, while Cummings et al. [11] reported that 67.1% of migrants had depression, with 25.7% experiencing severe depression. In Scandinavian countries (Finland and Sweden), the prevalence of depression and anxiety was observed, particularly for affective symptoms and gender-specific variations in depression and anxiety in Finland. For example, Rask et al. [28] identified that 36% of Kurdish migrants in Finland experienced both depression and anxiety, with a gender-specific variation, where 23% of men and 49% of women were affected and 16.9% of suffered from affective symptoms (depression and anxiety) as reported by Castaneda et al. [9]. According to Salama et al. [29], in Finland, affective symptoms were present in 31% of Kurdish migrants and were related to daily smoking (OR: 1.6, 95% CI: 1.02–2.6) and lifetime cannabis use (OR: 6.1, 95% CI: 2.6–14.5). In Sweden, Taloyan et al. [36] reported an anxiety prevalence of 27.3%, with a greater impact on women (38.4%) compared to men (16.2%). Taloyan et al. [37] reported that 26% suffered from anxiety, while an earlier study by Taloyan et al. [35] found that 16.2% of Kurdish migrants experienced anxiety. This placed Scandinavian countries at intermediate prevalence rates for mood disorders. In Switzerland, Gilgen et al. [14] found that 55% of Kurdish migrants experienced affective symptoms, indicating a substantial mental health burden. The lowest prevalence rates were observed in the United Kingdom, where Bradley and Tawfiq [7] reported that depression and anxiety affected only 7% of the migrant population.

Other mental health problems Seven studies, five of which were conducted in Scandinavian countries (Finland and mainly Sweden), examined various mental health problems among Kurdish migrants, including suicidal thoughts and binge drinking, smoking and cannabis use, sleeping difficulties, fatigue, poor well being, and self-harm ideas. In Sweden, a series of studies by Taloyan et al. tracked the progression of these mental health problems over time. Bayard-Burfield et al. [1] highlighted an increased risk of self-reported psychiatric illnesses among Kurdish migrants in Sweden. In 2006, Taloyan et al. reported that 32.4% of Kurdish migrants suffered from sleeping difficulties [35], which increased to 37.5% by 2008 [36]. Furthermore, general fatigue affected 52.6% of the population in 2008, and women experienced higher rates (59.3%) compared to men (46%) [36]. Another 2008 study indicated that 26% of Kurdish migrants experienced poor psychological well-being [37]. In Finland, Salama et al. [29] found a significant association between suicidal thoughts and binge drinking, with an odds ratio of 2.4 (95% CI: 1.3–4.3). Affective symptoms were also related to daily smoking (OR: 1.6, 95% CI: 1.02–2.6) and lifetime cannabis use (OR: 6.1, 95% CI: 2.6–14.5), suggesting that these behaviours could serve as coping mechanisms or indicators of underlying psychological distress. In Switzerland, Gilgen et al. [14] revealed that 50% of Kurdish migrants had ideas of self-harm, reflecting serious mental health concerns. Meanwhile, in Australia, Sulaiman-Hill and Thompson [34] observed high levels of psychological distress and poor mental well-being, mirroring the broader trend of psychological stress seen across various host countries.

Trends in mental health disorders among Kurdish migrants over time

The timeline analysis of mental health problems among Kurdish migrants from 2001 to 2022 revealed significant variation in prevalence rates across different countries and mental health disorders. PTSD consistently showed high prevalence, with notable rates reported in Sweden (2001) and the USA (2018), reaching up to 58%. Depression also demonstrated substantial fluctuation over the years, with particularly high rates recorded in Switzerland (2005) at 60% and in the USA (2011) at 68%, followed by a sharp decline in Finland (2020) at approximately 14%. Anxiety symptoms appeared relatively stable, yet moderately prevalent, with the highest reported in Switzerland (2005) at 50%, gradually decreasing to approximately 33% in Finland (2022). Reports of suicidal ideation were also considerable, with Switzerland (2005) and Finland (2022) documenting rates of 40% and 35%, respectively. Insomnia was studied less frequently but was reported at 35% in Sweden (2007). This visual representation helps us to understand the changing rates of these mental health problems over time among Kurdish migration to western countries Fig. 4.

Fig. 4.

Timeline of mental health problems among Kurdish migrants from 2001 to 2022, showing prevalence rates of PTSD, depression, anxiety, insomnia, and suicidal ideation in different host countries. Data points are labelled with the country of study

Discussion

Our study aimed to explore the mental health challenges experienced by Kurdish migrants, paying particular attention to pre- and post-migration stressors and the prevalence of psychological disorders. Guided by the study’s research objectives, the review demonstrated clear patterns of mental health problems among Kurdish migrants, but the robustness and reliability of the findings were limited. Most of the included studies were cross-sectional, restricting causal interpretation. There was also considerable methodological heterogeneity, with different diagnostic tools, sampling methods, and cut-off thresholds, which probably contributed to variation in prevalence estimates. Contextual factors in host countries further shaped the results: higher rates of PTSD and depression were reported in the USA and Sweden, where asylum procedures were lengthy and integration barriers more pronounced [18, 35], while a lower prevalence was observed in the UK and the Netherlands, where access to healthcare and welfare systems was comparatively stronger [7, 20]. Gender differences were consistent, and women more frequently reporting depression, anxiety, and fatigue, reflecting both cumulative stress exposure and gender-specific vulnerabilities [28, 36], Salama et al. [29]. Kurdish populations migrated primarily due to political oppression, violence, economic hardship, and war-related persecution [7, 16, 20]. Economic factors such as unemployment and poor living conditions also played a critical role [20, 28]. These findings are consistent with broader evidence from displaced populations, where exposure to conflict and socioeconomic instability increases the risk of poor mental health outcomes [10, 22]. Post-migration, Kurdish migrants continued to face significant traumatic life events that exacerbated psychological distress. Issues such as family separation, fear of deportation, discrimination, unemployment, and social isolation were commonly reported [1, 18]. Such difficulties are consistent with studies showing that legal uncertainty, hostile asylum environments, and limited access to resources negatively impact the well-being [15, 21]. The persistence of these stressors highlights that migration is not a single traumatic event but an ongoing process that interacts with prior trauma to produce cumulative distress. Across the included studies, Kurdish migrants showed high rates of psychological disorders. The prevalence of PTSD was particularly elevated in Sweden and the USA [18, 27, 35], while depression and anxiety were consistently reported in different contexts [11, 28, 36]. Affective symptoms, suicidal ideation, and poor well-being were also observed (Gilgen et al. [14]; Salama et al. [29]), indicating a severe and multifaceted mental health burden. These findings align with the broader evidence that forced migration increases the risk of both trauma-related and mood disorders [6]. Compared to other migrant groups, the experiences of Kurdish migrants appear consistent with global patterns. For example, refugees in Australia demonstrated strong associations between pre-migration trauma, post-migration stressors, and poor mental health (Stuart and Nowosad [33]). Syrian refugees in Sweden reported similar high levels of PTSD, depression, and anxiety [30]. Somali refugees in the United States also exhibited a high prevalence of PTSD and depression, driven by trauma and compounded by discrimination and social isolation (Heidi et al. [17]). A global meta-analysis confirmed a high prevalence of PTSD and depression among asylum seekers and refugees in all settings [6]. More recent findings on Ukrainian refugees in Germany indicated elevated anxiety, depression, and poor quality of life (Buchcik et al. [8]). Somali migrants in the UK also showed high rates of psychiatric disorders and suicidal ideation, directly linked to war and economic hardship (Bhui et al. [5]). On the contrary, Beiser et al. [2] found that Chinese migrants in Canada had a comparatively lower prevalence of PTSD and depression, suggesting that less severe trauma histories and stronger social support may buffer against poor psychological outcomes. The significance of this review lies in its population-specific focus. Although high rates of PTSD, depression, and anxiety are well documented among displaced populations, the Kurdish case is unique due to recurrent displacement, statelessness, and systemic political oppression. When situated within global meta-analyses, our findings place Kurdish migrants at the upper end of prevalence estimates. Fazel et al. [13] reported a pooled prevalence of 9% for PTSD and 5% for depression in resettled refugees, Steel et al. [32] found approximately 30% for both disorders, and Blackmore et al. [6] confirmed similar levels (31% PTSD, 32% depression). Compared to other studies, this review found a mean prevalence of 36.9% for PTSD, 36.3% for depression and 27.7% for anxiety, highlighting that Kurdish migrants face a particularly disproportionate psychological burden.Theoretical models provide important context for these findings. Berry’s acculturation theory proposes that marginalization and separation strategies are linked to poorer mental health outcomes, a pattern visible among Kurdish migrants facing systemic discrimination and integration barriers [3]. Similarly, Silove’s ADAPT model explains how displacement erodes the psychosocial pillars, safety, justice, social bonds, roles, and meaning, producing long-term vulnerability to psychological distress [31]. These frameworks highlight that the difficulties faced by Kurdish migrants are not solely clinical problems but embedded in structural and social contexts that compound trauma exposure.

Implications for mental health interventions

The findings highlight the need to translate the evidence into practical interventions that can be broadly implemented in clinical and community settings. First, mental health professionals can use the results of this review to better identify high-risk groups among Kurdish migrants, particularly those exposed to severe pre-migration trauma (e.g., political persecution, torture, war exposure) and those facing significant post-migration stressors (e.g., discrimination, unemployment, family separation). Routine clinical screening for PTSD, depression, and anxiety using validated tools should be incorporated into health assessments of Kurdish migrants to enable early detection and timely support. Second, the findings settle the importance of culturally tailored and trauma-informed care. Mental health professionals should integrate interpreters, cultural mediators, and psychoeducation programmes to ensure accessibility and trust. Interventions should be adapted to account for Kurdish cultural values, social networks, and stigma around mental health, which may otherwise hinder help seeker. Third, at the intervention and policy level, services should adopt a stepped care approach that provides low-intensity psychosocial interventions (eg, peer support, group-based programmes, psychoeducation) alongside specialized therapies (e.g., trauma-focused CBT, EMDR) for severe cases. This layered strategy can expand reach while conserving specialist resources. Community-based initiatives, such as peer-led groups, integration support, and antidiscrimination programs, are also crucial to mitigate post-migration stressors that contribute to psychological distress.

An important implication also concerns return migration. Many Kurdish migrants who are deported or who voluntarily return to their home country continue to suffer from mental health problems, which may even be aggravated by stigma, unemployment, and loss of social support. Upon returning, mental health programmes should not only provide clinical care, but also create pathways for reintegration into society and rebuilding social cohesion, especially through the work of NGOs and community organizations. Programmes focussing on livelihood support, community acceptance, and rebuilding trust can reduce isolation and prevent the long-term deterioration of mental health.

Finally, the results have implications for capacity building and training. The host and home-country mental health systems should train clinicians in refugee and returnee mental health, cultural psychiatry, and trauma-focused therapies. Strengthening the collaboration between healthcare providers, NGOs, and migrant community organisations will further enhance the effectiveness and sustainability of interventions.

Strengths and limitations

One key strength is that it is the first systematic review to examine the mental health problems faced by Kurdish migrants since they migrated. Furthermore, the review focused on three critical aspects, pre-migration factors, post-migration stressors, and psychological disorders, providing a thorough understanding of the multifaceted challenges faced by Kurdish migrants. However, it has several limitations that should be considered when interpreting the findings. First, most of the included studies used cross-sectional designs, restricting the ability to establish causal relationships between migration stressors and mental health outcomes. Second, there was considerable methodological heterogeneity, as the studies used a wide range of diagnostic instruments, sampling strategies and cut-off thresholds, which limited comparability and may have contributed to variation in prevalence estimates. Although validated tools such as the HTQ and HSCL-25 were frequently used, many studies relied on different or adapted measures, which introduces potential inconsistency. Third, several studies included in this review were conducted more than a decade ago, raising concerns about the relevance of the findings to more recent Kurdish migration waves linked to the Syrian conflict and the rise of ISIS. Fourth, not all studies reported sociodemographic distributions such as sex, age or migration pathway in detail, which limited subgroup analyses and nuanced interpretation of vulnerability factors. Finally, the geographic distribution of the studies was concentrated in a small number of host countries, particularly Sweden, Finland, and the United States, with fewer data from other European or non-Western contexts, potentially limiting generalisability.

Recommendation

Future research should more clearly differentiate between pre-migration and post-migration stressors, as each stage introduces distinct risks that require tailored policy and clinical responses. Longitudinal and follow-up studies are particularly needed, as most of the existing evidence is cross-sectional and cannot capture the long-term psychological trajectories of Kurdish migrants. In addition, there is a critical need for research on the effectiveness of psychosocial and mental health interventions, especially those designed to strengthen integration, social cohesion, and resilience in host societies. Given the recurrent displacement and statelessness of the Kurdish population, further studies should also explore how policy environments, asylum procedures, and access to healthcare shape mental health outcomes. Finally, intervention research led by NGOs and community actors could provide valuable evidence on scalable strategies to support the mental well-being of Kurdish migrants in Western countries and beyond.

Conclusion

This systematic review demonstrated that Kurdish migrants face a high burden of mental health problems, particularly PTSD, depression, and anxiety. These difficulties stem from both pre-migration trauma, such as war, persecution, and political oppression, and post-migration stressors, including discrimination, unemployment, family separation, and social isolation. The findings suggest the need for culturally sensitive and trauma-informed interventions that address the entire migration journey, including support in host societies and upon deportation or return to home countries. We suggest that special attention and sustained care be given to this population to safeguard their mental health and well-being.

Author contributions

1DRA contributed to conceptualization, study design, illustration, data interpretation, study selection, literature search, writing, and revising the manuscript. 2SK contributed to writing and the literature search. 3SMM contributed to the writing, literature search, and selection process. 4JFA contributed to quality assessment and risk of bias. 5RH provided crucial feedback and comments.

Funding

None.

Data availability

No datasets were generated or analysed during the current study.

Declarations

Ethics approval and consent to participate

This study is a systematic review of previously published research and did not involve the collection of primary data from human participants. Therefore, ethical approval was not required. Not applicable, as the study did not directly involve human participants.

Consent for publication

Not applicable, as the study did not involve data from individual participants.

Competing interests

The authors declare no competing interests.