Background: Migrants and refugees/asylum seekers, as a large part of the European work force, are often confronted with unfavorable working conditions in the host country. Main aim of this systematic review was to compare the association of these working conditions with mental health between migrants and refugees/asylum seekers due to their diverse migration experiences and cultural origins, and between different European host countries. Methods: Systematic search for eligible primary studies was conducted in three electronic databases (PubMed/MEDLINE, PsycINFO and CINAHL) using quantitative study designs written in English, German, French, Italian, Polish, Spanish or Turkish and published from January 1, 2016 to October 27, 2022. Primary health outcomes were diagnosed psychiatric and psychological disorders, suicide and suicide attempts, psychiatric and psychological symptoms, and perceived distress. Secondary health outcomes were more general concepts of mental health such as well-being, life satisfaction and quality of life. Two reviewers independently completed screening, data extraction and the methodological quality assessment of primary studies using the Newcastle-Ottawa-Scale. Descriptive summary of primary studies on working conditions and their relationship with mental health were conducted, comparing migrants and refugees/asylum seekers, migrants and refugees/asylum seekers of different cultural backgrounds (collectivistic and individualistic) and migrants and refugees/asylum seekers living in different host countries. Results: Inclusion criteria were met by 19 primary studies. Voluntary migrants are more likely to experience overqualification in the host country than refugees. In all examined host countries, migrants and refugees suffer from unfavorable working conditions, with migrants from collectivistic countries being slightly at risk compared to migrants from individualistic countries. Most unfavorable working conditions are related to poor mental health, regardless of migrant status, cultural origin or host country. Conclusions: Although the results should be interpreted with caution due to the small number of studies, it is evident that to maintain both the mental health and labor force of migrants and refugees/asylum seekers, their working conditions in host countries should be controlled and improved. Special attention should be paid to specific subgroups such as migrants from collectivistic societies. Ethics and dissemination: This systematic review is excluded from ethical approval because it used previously approved published data from primary studies. Trial registration number: CRD42021244840.

Objective: Migrants and refugees/asylum seekers make up a significant proportion of the European workforce. They often suffer from poor working conditions, which might impact mental health. The main objective of this systematic review was to summarize and analyze existing research on working conditions of migrants and refugees/asylum seekers in European host countries and compare them to those of natives. Furthermore, the relationship between working conditions and mental health of migrants/refugees/asylum seekers and natives will be compared. Methods: Three electronic databases (PubMed/MEDLINE, PsycInfo and CINAHL) were systematically searched for eligible articles using quantitative study designs written in English, German, French, Italian, Polish, Spanish or Turkish and published from January 1, 2016 to October 27, 2022. Primary health outcomes were diagnosed psychiatric and psychological disorders, suicide (attempts), psychiatric and psychological symptoms, and perceived distress. Secondary health outcomes were more general concepts of mental health such as well-being, life satisfaction and quality of life. Screening, data extraction and the methodological quality assessment of primary studies by using the Newcastle–Ottawa Scale were done independently by two reviewers. The results of the primary studies were summarized descriptively. Migrants and refugees/asylum seekers were compared with natives in terms of the association between working conditions and mental health. Results: Migrants and refugees often face disadvantages at work concerning organizational (low-skilled work, overqualification, fixed-term contracts, shift work, lower reward levels) and social conditions (discrimination experiences) in contrast to natives. Most unfavorable working conditions are associated with worse mental health for migrants as well as for natives. Conclusions: Even if the results are to be taken with caution, it is necessary to control and improve the working conditions of migrants and refugees/asylum seekers and adapt them to those of the native population to maintain their mental health and thus their labor force.

Background and objective: The impairments and duration of PASC (post-acute sequelae of COVID-19) symptoms in mental health have, to date, not been comprehensively examined. Our objective is to provide longitudinal data on the mental health of Post-COVID patients and to identify risk and protective factors associated with a severe or prolonged course. Methods: The mental health of 265 Post-COVID patients of the outpatient Post-COVID centre of the University Hospital Erlangen was assessed 17.1 (T0) and 22.5 months after infection (T1). An online survey with validated questionnaires for Post-COVID symptoms (Post-COVID Syndrome Score), depression (Patient Health Questionnaire-9), somatic symptoms (Patient Health Questionnaire-15), anxiety (Generalized Anxiety Disorder-7), fatigue (Fatigue Severity Scale) and Post-Exertional Malaise (PEM) (DePaul Post-Exertional Malaise Screening) was conducted in the home environment. Results: In total, 80% of patients experienced severe PASC at follow-up. Clinically relevant symptoms of depression, persistent somatic symptoms, anxiety and fatigue were reported by 55.8%, 72.5%, 18.9% and 89.4% of patients, respectively. Depressive, anxiety and somatic symptom severity decreased significantly over time; fatigue and PEM remained at an unchanged high level. The risk factor for higher depression scores was older age; prior psychiatric illness treated with psychotherapy was associated with more severe depressive, somatic, anxiety and PASC symptoms. PEM symptoms were significantly associated with longer duration between acute infection and initial presentation in the Post-COVID centre. Conclusions: Our findings align with previous research, claiming severe mental health symptoms in PASC syndrome, lasting for months after infection. In-depth assessment of risk and protective factors for the mental health implications of PASC is needed for the planning of health services and disease prevention.

Zusammenfassung: Hintergrund: Risikofaktoren für die psychische Gesundheit sind häufig in sozioökonomischen, geschlechter- und migrationsspezifischen Ungleichheiten begründet. Diese sowie die Ausprägung der Depressivität, Ängstlichkeit und Somatisierung von Beschäftigten wurden in der vorliegenden Studie untersucht. Methoden: Im Rahmen der friaa-Studie („Frühe Intervention am Arbeitsplatz“) wurden psychisch belastete Beschäftigte an 5 Standorten in Deutschland zu soziodemografischen, arbeits-, migrations- und gesundheitsbezogenen Inhalten befragt. Mittels Regressionsanalysen wurde der Zusammenhang dieser Faktoren mit Depressivität (Patient-Health-Questionnaire-9, PHQ-9), Ängstlichkeit (Generalized Anxiety Disorder-2, GAD-2) und Somatisierung (Somatic Symptom Scale-8, SSS-8) an der gesamten Stichprobe sowie bei Personen mit Migrationshintergrund (MH) untersucht. Bei Letzteren wurden zusätzlich die Akkulturation (Frankfurter Akkulturationsskala, FRAKK) und das Belastungsempfinden gegenüber Migrationsanforderungen (Demands of Immigration Scale, DIS) berücksichtigt. Ergebnisse: Die 550 Beschäftigten (12 % mit MH) wiesen im Durchschnitt eine klinisch relevante Depressivität (M = 13,0, SD = 5,1) (PHQ-9 ≥ 10), Ängstlichkeit (M = 3,5, SD = 1,7) (GAD ≥ 3) sowie Somatisierung (M = 13,0, SD = 5,8) (SSS-8 ≥ 12) auf. Das weibliche Geschlecht war mit höheren Werten für Ängstlichkeit und Somatisierung assoziiert. Höheres Alter und Nachtschichtarbeit hingen mit stärkerer Somatisierung zusammen. Diskussion: Die Ergebnisse bestätigen die hohe psychische Belastung der Beschäftigten in dieser Stichprobe aus Deutschland. Um deren psychische Gesundheit aufrechtzuerhalten, sollten Unterstützungsmaßnahmen insbesondere für vulnerable Gruppen wie Frauen, ältere Beschäftigte und Nachtschichtarbeitende angeboten werden.

Background: Persistent cognitive difficulties are among the most prevalent symptoms observed after COVID-19. This study examined the neuropsychological characteristics, mental health and risk factors associated with cognitive impairment in patients with Post-Acute Sequelae of COVID-19 (PASC). In addition, differences regarding the cognitive dysfunctions between individuals with PASC and Post-Vaccination Syndrome (PVS) were explored. Methods: Participants were consecutively recruited at the Post-COVID Center of the University Hospital Erlangen in Germany (12/2022–02/2025). Assessments included a broad neuropsychological assessment: d2 Test of Attention, digit span backwards from the Wechsler Memory Scale-Revised (WMS-R) and module 1 (formal lexical fluency) of the Regensburger Verbal Fluency Test (RWT), along with assessments of depression, fatigue, and inflammatory markers (C-reactive protein). Results: The sample (N = 793, mean age: 46.1 ± 12.4 years; 66.8% women) included n = 723 PASC patients and n = 70 PVS patients. In the total sample, deficits were most frequent in working speed (61.7%), attention (54.7%) and verbal fluency (48.8%); 30.3% showed multidomain impairment. Clinically significant depressive symptoms (64.5%) and fatigue (92.4%) were common. Cognitive patterns, depressive symptoms and fatigue in the PVS group closely resembled those observed in PASC. In PASC, lower education, older age, depressive symptoms, and elevated CRP were associated with cognitive impairment. Conclusion: Cognitive impairment is highly prevalent in PASC and PVS and appears to be influenced by both psychological and biological factors. Similar patterns identified in PVS suggest possible shared mechanisms. Further research is needed to clarify trajectories and optimize treatment strategies.