"My head is like a bag full of rubbish": concepts of illness and treatment expectations in traumatized migrants.

Traumatized migrants increasingly burden health care services in industrialized countries. These patients usually suffer from a broad range of physical and psychological symptoms, with assessment and treatment being complicated and often unsatisfactory. A large potential for misunderstandings between clinicians and traumatized individuals is not only because of a language barrier; very little is known about the concepts of illness and treatment expectations in these patients. We performed semistructured interviews with 13 traumatized migrants, focusing on their concepts of illness and expectations concerning medical treatment. An analysis of the recorded and transcribed statements revealed that most participants had no clear or defined expectations concerning appropriate treatment. The patients knew very little about psychotherapy, and usually had negative prejudices. Nevertheless, participants firmly believed that medical treatment would help them and considered their current suffering to be the result of a multitude of stressors impacting their lives over long periods of time. The patients did not identify single traumatic events as the causes of their complaints. The prevailing concepts of illness among traumatized migrants can be characterized as multifactorial and psychosocial.