Literature DB >> 9701080

Impact of torture on refugees displaced within the developing world: symptomatology among Bhutanese refugees in Nepal.

N M Shrestha1, B Sharma, M Van Ommeren, S Regmi, R Makaju, I Komproe, G B Shrestha, J T de Jong.   

Abstract

CONTEXT: Most of the world's refugees are displaced within the developing world. The impact of torture on such refugees is unknown.
OBJECTIVE: To examine the impact of torture on Bhutanese refugees in Nepal.
DESIGN: Case-control survey. Interviews were conducted by local physicians and included demographics, questions related to the torture experienced, a checklist of 40 medical complaints, and measures of posttraumatic stress disorder (PTSD), anxiety, and depression.
SETTING: Bhutanese refugee community in the United Nations refugee camps in the Terai in eastern Nepal. PARTICIPANTS: A random sample of 526 tortured refugees and a control group of 526 nontortured refugees matched for age and sex. MAIN OUTCOME MEASURES: The Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R) criteria for PTSD and the Hopkins Symptom Checklist-25 (HSCL-25) for depression and anxiety.
RESULTS: The 2 groups were similar on most demographic variables. The tortured refugees, as a group, suffered more on 15 of 17 DSM-III-RPTSD symptoms (P<.005) and had higher HSCL-25 anxiety and depression scores (P<.001) than nontortured refugees. Logistic regression analysis showed that history of torture predicted PTSD symptoms (odds ratio [OR], 4.6; 95% confidence interval [CI], 2.7-8.0), depression symptoms (OR, 1.9; 95% CI, 1.4-2.6), and anxiety symptoms (OR, 1.5; 95% CI, 1.1-1.9). Torture survivors who were Buddhist were less likely to be depressed (OR, 0.5; 95% CI, 0.3-0.9) or anxious (OR, 0.7; 95% CI, 0.4-1.0). Those who were male were less likely to experience anxiety (OR, 0.66; 95% CI, 0.44-1.00). Tortured refugees also presented more musculoskeletal system- and respiratory system-related complaints (P<.001 for both).
CONCLUSION: Torture plays a significant role in the development of PTSD, depression, and anxiety symptoms among refugees from Bhutan living in the developing world.

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Mesh:

Year:  1998        PMID: 9701080     DOI: 10.1001/jama.280.5.443

Source DB:  PubMed          Journal:  JAMA        ISSN: 0098-7484            Impact factor:   56.272


  64 in total

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4.  Premigration persecution, postmigration stressors and resources, and postmigration mental health: a study of severely traumatized U.S. Arab immigrant women.

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7.  Commentary: deconstructing critiques on the internationalization of PTSD.

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8.  Understanding Bhutanese refugee suicide through the interpersonal-psychological theory of suicidal behavior.

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9.  Symptom Presentation and Symptom Meaning Among Traumatized Cambodian Refugees: Relevance to a Somatically Focused Cognitive-Behavior Therapy.

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Review 10.  Treating survivors of torture and refugee trauma: a preliminary case series using qigong and t'ai chi.

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