 |
|
Impact of Torture on Refugees Displaced Within the Developing World
Symptomatology Among Bhutanese Refugees in Nepal
Nirakar Man Shrestha, MD, DAB;
Bhogendra Sharma, MBBS;
Mark Van Ommeren, MA;
Shyam Regmi, MBBS;
Ramesh Makaju, MBBS;
Ivan Komproe, PhD;
Ganesh B. Shrestha, MBBS;
Joop T. V. M. de Jong, MD, PhD
JAMA. 1998;280:443-448.
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-R PTSD 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.
From the Center for Victims of Torture, Kathmandu, Nepal (Drs N. Shrestha, Sharma, Regmi, Makaju, and G. Shrestha and Mr Van Ommeren); and the Free University (Drs Sharma, Komproe, and de Jong and Mr Van Ommeren) and the Transcultural Psychosocial Organization (Mr Van Ommeren and Drs Komproe and de Jong), Amsterdam, the Netherlands.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Brief Multi-Disciplinary Treatment for Torture Survivors in Nepal: a Naturalistic Comparative Study
Tol et al.
Int J Soc Psychiatry 2009;55:39-56.
ABSTRACT
Buddhist Psychology, Psychotherapy and the Brain: A Critical Introduction
Kelly
Transcultural Psychiatry 2008;45:5-30.
ABSTRACT
Classifying the Torture Experiences of Refugees Living in the United States
Hooberman et al.
J Interpers Violence 2007;22:108-123.
ABSTRACT
Prevalent musculoskeletal pain as a correlate of previous exposure to torture
Olsen et al.
Scand J Public Health 2006;34:496-503.
ABSTRACT
Mental health problems among adults in tsunami-affected areas in southern Thailand.
van Griensven et al.
JAMA 2006;296:537-548.
ABSTRACT
| FULL TEXT
Cultural and Spiritual Constructions of Mental Distress and Associated Coping Mechanisms of Tibetans in Exile: Implications for Western Interventions
Ruwanpura et al.
Journal of Refugee Studies 2006;19:187-202.
ABSTRACT
| FULL TEXT
Mental Health of Cambodian Refugees 2 Decades After Resettlement in the United States
Marshall et al.
JAMA 2005;294:571-579.
ABSTRACT
| FULL TEXT
Mental Health, Social Functioning, and Disability in Postwar Afghanistan
Cardozo et al.
JAMA 2004;292:575-584.
ABSTRACT
| FULL TEXT
Mental Health Symptoms Following War and Repression in Eastern Afghanistan
Scholte et al.
JAMA 2004;292:585-593.
ABSTRACT
| FULL TEXT
Somali and Oromo Refugees: Correlates of Torture and Trauma History
Jaranson et al.
Am. J. Public Health 2004;94:591-598.
ABSTRACT
| FULL TEXT
Reconceptualizing the Sequelae of Political Torture: Limitations of a Psychiatric Paradigm
Kagee and Naidoo
Transcultural Psychiatry 2004;41:46-61.
ABSTRACT
Psychiatric Disability Among Tortured Bhutanese Refugees in Nepal
Thapa et al.
Am. J. Psychiatry 2003;160:2032-2037.
ABSTRACT
| FULL TEXT
Mental Health and Health-Related Quality of Life Among Adult Latino Primary Care Patients Living in the United States With Previous Exposure to Political Violence
Eisenman et al.
JAMA 2003;290:627-634.
ABSTRACT
| FULL TEXT
Validity issues in transcultural epidemiology
VAN OMMEREN
Br. J. Psychiatry 2003;182:376-378.
FULL TEXT
Mental health of Kosovan Albanian refugees in the UK
TURNER et al.
Br. J. Psychiatry 2003;182:444-448.
ABSTRACT
| FULL TEXT
Measuring Trauma and Health Status in Refugees: A Critical Review
Hollifield et al.
JAMA 2002;288:611-621.
ABSTRACT
| FULL TEXT
Post-Traumatic Stress Disorder and Sleep
Van Ommeren et al.
NEJM 2002;346:1334-1335.
FULL TEXT
Longitudinal Study of Psychiatric Symptoms, Disability, Mortality, and Emigration Among Bosnian Refugees
Mollica et al.
JAMA 2001;286:546-554.
ABSTRACT
| FULL TEXT
Psychiatric Disorders Among Tortured Bhutanese Refugees in Nepal
Van Ommeren et al.
Arch Gen Psychiatry 2001;58:475-482.
ABSTRACT
| FULL TEXT
Traumatic Life Events in Primary Care Patients: A Study in an Ethnically Diverse Sample
Holman et al.
Arch Fam Med 2000;9:802-810.
ABSTRACT
| FULL TEXT
Policies of Deterrence and the Mental Health of Asylum Seekers
Silove et al.
JAMA 2000;284:604-611.
ABSTRACT
| FULL TEXT
Limited Cultural Validity of the Composite International Diagnostic Interview's Probe Flow Chart
van Ommeren et al.
Transcultural Psychiatry 2000;37:119-129.
ABSTRACT
Preparing Instruments for Transcultural Research: Use of the Translation Monitoring Form with Nepali-Speaking Bhutanese Refugees
van Ommeren et al.
Transcultural Psychiatry 1999;36:285-301.
ABSTRACT
Disability Associated With Psychiatric Comorbidity and Health Status in Bosnian Refugees Living in Croatia
Mollica et al.
JAMA 1999;282:433-439.
ABSTRACT
| FULL TEXT
Violence--Ubiquitous, Threatening, and Preventable
Cole and Flanagin
JAMA 1998;280:468-468.
FULL TEXT
|
