AUTHOR=Jesuthasan Jenny , Moran James K. , Döring-Brandl Eva J. , Abels Ingar , Kurmeyer Christine , Starck Annabelle , Stangier Ulrich , Gutermann Jana , Zier Ulrike , Wollny Anja , Krüger Antje , Richter Kneginja , Oertelt-Prigione Sabine , Schouler-Ocak Meryam 

TITLE=Relationship between traumatic events, somatization, psychological distress, and quality of life in female refugees in Germany

JOURNAL=Frontiers in Psychiatry

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1627665

DOI=10.3389/fpsyt.2025.1627665

ISSN=1664-0640

ABSTRACT=Theoretical backgroundFemale refugees often experience traumatic events leading to mental health problems such as depression, anxiety, and somatization which can impact their quality of life. However, the interplay between these factors has rarely been studied to date.ObjectivesThis study investigates factors that contribute to the symptoms of psychological distress, somatization, and quality of life and the relationship between them.Methods594 female refugees in five different reception centers in Germany were included. The cumulative number of traumatic events experienced was defined using the Harvard Trauma Questionnaire and the Posttraumatic Diagnostic Scale. Information from the Hopkins Symptom Checklist, the Symptom Checklist-90, and Eurohis-QoL was used to perform hierarchical regression analysis and serial mediation analysis was conducted using PROCESS Model 6 and bootstrapping.ResultsTraumatic experiences had an impact on quality of life, both independently and as well as being mediated by somatization and psychological distress. Furthermore, our study reveals that cumulative trauma influences somatization, which then mediates psychological distress, ultimately leading to a lower quality of life. Cumulative trauma had the highest negative impact on mental health outcomes.ConclusionOur findings suggest that future research and treatment of female refugees should focus on the role of somatization. Clinical assessments should be broadened with culturally sensitive tools to encompass both somatic and psychological dimensions of distress.