BMC Public Health 2009, 9:214 http://www.biomedcentral.com/1471-2458/9/214 status from the model, the association between pre migra- tion stressors, post migration stressors and chronic condi- tions with PTSD remained. Residence status, pre migration stressors, post migration stressors and chronic conditions were retained in the regression model for depression/anxiety symptoms, however residence status was no longer a significant explanatory factor (OR 3.0, 95% CI: 0.9–9.8, Table 3). Post migration stressors were the most significant risk fac- tor for self reported PTSD and depression/anxiety symp- toms (OR 17.3, 95% CI: 4.9–60.8; OR 3.9, 95% CI: 1.2– 12.3 respectively). High levels of pre migration stressors and chronic conditions also had a significant positive association with the occurrence of these health outcomes. In contrast, residence status was not independently asso- ciated with the presence of PTSD or depression/anxiety symptoms, but appeared to act as a marker for other explanatory variables. Table 1 showed a strong relation- ship between residential status and levels of post migra- tion stressors, and to a lesser degree, residential status and pre migration stressors, suggesting that residential status most likely acts as a marker for the presence of migration stressors. Utilisation of Health Care Services and use of Medication Table 4 summarises and compares the use of health care services and medication between asylum seekers and ref- ugees. The only statistically significant difference between asylum seekers and refugees in terms of health care serv- ices and medication use was in their use of general prac- tice services (P = 0.03), with half of the refugees contacting their GP in last two months, compared to 73.3% of asy- lum seekers. No significant differences were found for hospital admissions, use of specialist services or the use of medications in the last 14 days. Discussion Principal findings The results of the present study suggest that asylum seek- ers suffer from a significantly higher level of post migra- tion stressors, have spent less time in Ireland and have a Table 2: Univariable association between the characteristics of the study population and health outcomes Characteristic Poor general health PTSD symptoms Depression/anxiety symptoms Number (%) of respondents with poor health Unadjusted OR (95% CI) Number (%) of respondents with symptoms Unadjusted OR (95% CI) Number (%) of respondents with symptoms Unadjusted OR (95% CI) 9 (32.1%) 44 (73.3%) 12 (33.3%) 41 (78.8%) 28 (50.0%) 25 (78.1%) 16 (41.0%) 37 (75.5%) 5.8 (2.2–15.4) P < 0.01 7.5 (2.9–19.5) P < 0.01 3.6 (1.3–9.6) P = 0.01 4.4 (1.8–11.0) P < 0.01 Page 6 of 10 (page number not for citation purposes) Residence Status (Asylum seekers compared to refugees) Refugees 12 (42.9%) Asylum seekers 36 (60.0%) Mean Score < 2.5 15 (41.7%) Mean Score = 2.5 33 (63.5%) Post Migration Stressors (mean score < 2.5 compared to ≥ 2.5) Pre Migration Stressors (mean number '0–7' compared to > 8 past traumatic events) 0–7 8+ 0 or 1 >1 29 (51.8%) 19 (59.4%) 18 (46.2%) 30 (61.2%) Chronic Conditions (mean number '0 or 1' compared to '>1' chronic conditions) OR Odds ratio, CI confidence interval, PTSD post traumatic stress disorder 2.0 (0.8–4.9) P = 0.14 2.4 (1.0–5.8) P = 0.05 1.4 (0.6–3.3) P = 0.49 1.8 (0.8–4.3) P = 0.16 6 (21.4%) 38 (63.3%) 5 (13.9%) 39 (75.0%) 23 (41.1%) 21 (65.6%) 11 (28.2%) 33 (67.3%) 6.3 (2.2–17.9) P < 0.01 18.6 (5.9–57.8) P < 0.01 2.7 (1.1–6.8) P = 0.03 5.3 (2.1–13.2) P < 0.01