Between Displacement and Uncertainty: Depressive Symptoms and Quality of Life in Refugees in Serbia—A Cross-Sectional Study

Refugees are exposed to cumulative pre-migration, migration, and post-migration stressors that increase vulnerability to depressive disorders and impaired quality of life. This study assessed the prevalence and severity of depressive symptoms among adult refugees in Serbia and examined associations with sociodemographic characteristics, traumatic experiences, social support, and Health Related Quality of Life (HQoL). The study included 324 refugees residing in four reception centers in Serbia. Data were collected between April 2023 and November 2024 using self-report questionnaires. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), while HQoL was evaluated using the SF-36 Health Survey. The mean PHQ-9 score indicated mild-to-moderate depressive symptomatology. Clinically significant depressive symptoms were present in 41.4% of participants, while more than 70% reported at least mild symptoms. Depressive symptom severity was negatively associated with energy/fatigue, emotional well-being, social functioning, general health, and pain. The Energy/Fatigue domain emerged as the most prominent independent correlate of depressive symptom severity. Depressive symptoms were highly prevalent and were associated with impaired quality of life and psychosocial stressors. These findings highlight the importance of systematic mental health screening and psychosocial support among refugees.