To investigate the relationship between the length of stay in a western host country and psychiatric disorders among asylum seekers from Iraq.

Two groups of Iraqi asylum seekers, respectively less than 6 months (n=143) and more than 2 years (n=151) in The Netherlands were interviewed The sampling was at random. The health status was measured and evaluated in relation with pre-and post-migration adverse life events. Riskfactor analyses were done and adjusted Odds Ratio's were assessed. Moreover data were collected about physical health, functional disability and quality of life and their relationship with psychopathology as well as with length of stay were assessed.

The overall prevalence of psychiatric disorders was 42% in the group that just arrived and 66.2% in the group that stayed more than 2 years in the Netherlands. On logistic regression of all relevant riskfactors, a long asylum procedure showed an odds ratio of 2.16 (CI=1.15-4.08) for psychopathology. Except for female sex, this odds ratio was higher than those from life events in Iraq. Furthermore: the ‘long stay’ group had higher scores on physical complaints and disability and lower scores on quality of life. The post migration living problems were all directly related to psychopathology. Health service use was low and inadequate.

A long asylum procedure is a very important risk factor for psychiatric disorders, physical health problems, disability and low quality of life. The risk for common psychiatric problems is higher than the adverse life events in the country of origin.