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JAMA. 2005;294:523.

VIOLENCE AND HUMAN RIGHTS
A JAMA THEME ISSUE

Edited by Annette Flanagin, RN, MA, and Thomas B. Cole, MD, MPH

Adult Schizophrenia Following Famine
The Wuhu region of Anhui province, People’s Republic of China, was seriously affected during the Chinese famine of 1959-1961. St Clair and colleagues (SEE ARTICLE) examined medical records for patients evaluated at the single psychiatric hospital serving the region and found a 2-fold increased risk of schizophrenia among persons born during the famine years compared with persons born in the years before or after. In an editorial, Neugebauer (SEE ARTICLE) discusses past and present famines and a potential link between nutritional folate deficiency and schizophrenia.

Mental Illness and Violent Death
Suicide and homicide prevention are the focus of 2 articles in this issue of JAMA. First, Brown and colleagues (SEE ARTICLE) found that a cognitive therapy program was more effective than usual care in preventing repeat suicide attempts in adults. In a second article, Cook and colleagues (SEE ARTICLE) calculated the proportion of homicides that might be eliminated by a hypothetical intervention targeted at individuals with a prior criminal record. They concluded that this strategy would reduce the homicide rate by 31%. In an editorial, Cole and Glass (SEE ARTICLE) discuss public health strategies to reduce violent deaths.

Refugees’ Mental Health 20 Years After Resettlement
War refugees have a high risk of acute psychiatric distress, but whether this risk persists years later and after resettlement in a resource-rich country is not known. Marshall and colleagues (SEE ARTICLE) interviewed refugees who had lived in Cambodia during the Khmer Rouge reign and immigrated to the United States prior to 1993, on average 22 years ago. Nearly all surveyed persons had experienced serious trauma before immigration, and 70% reported exposure to violence after settlement in the United States. The authors found high rates of past-year posttraumatic stress disorder (62%) and major depression (51%) in this population.

Trauma, Redress, and Mental Health in War Survivors
From a survey of survivors of war in the former Yugoslavia who had experienced at least 1 war-related trauma, Baolu and colleagues (SEE ARTICLE) assessed whether redress for trauma and beliefs about justice, safety, sense of control, and other factors were related to the risk of posttraumatic stress disorder (PTSD) and depression in these persons. They found that concerns about personal safety and a feeling of loss of control over life but not a sense of injustice arising from a perceived lack of redress for the trauma experienced were associated with PTSD and depression.

Malnutrition Mortality in Hospitalized Children
Severe malnutrition has a high mortality rate among hospitalized children in sub-Saharan Africa, but appropriate assessment of malnutrition is not always feasible. In a cohort study of severely malnourished children aged 1 to 5 years who were hospitalized in rural Kenya, Berkley and colleagues (SEE ARTICLE) evaluated middle upper arm circumference (MUAC) and visible severe wasting as predictors of inpatient mortality and compared these with the weight-for-height z score (WHZ) and determined that the MUAC is a practical assessment tool that performs at least as well as WHZ.

Medical News & Perspectives
Violence and other human rights abuses take many forms, from modern-day slavery in the United States and elsewhere to the widespread use of rape as a weapon of terror in Darfur, Sudan.

(SEE ARTICLE)

CLINICIAN’S CORNER
Refugee Mental Health
Clinical Review
The mental health of refugees is influenced by exposure to certain social and political factors before and after displacement.

(SEE ARTICLE)

Caring for Women in Rwanda
Rwandan women and the Women’s Equity in Access to Care and Treatment (WE-ACTx) have created a counseling and care system after the 1994 genocide to help surviving women who were raped and are infected with the human immunodeficiency virus.

(SEE ARTICLE)

Binge Drinking and Violence
Strategies for preventing binge drinking, an avoidable cause of violent behavior.

(SEE ARTICLE)

Family Violence Research
Collaborative efforts between researchers studying child maltreatment and others studying intimate partner violence could lead to a greater understanding of the risks and consequences of both categories of family violence.

(SEE ARTICLE)

JAMA Patient Page
For your patients: Information about refugee mental health.

(SEE ARTICLE)

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