Symptoms, Quality of Life and level of functioning of traumatized refugees at Psychiatric Trauma Clinic in Copenhagen
DOI:
https://doi.org/10.7146/torture.v24i1.109717Palabras clave:
PTSD, refugee, war, co-morbiditiesResumen
Objective: To characterize physical and mental health in trauma-exposed refugees by describing a population of patients with regard to background, mental health history, and current health problems; and to identify pre- and post-migratory predictors of mental health.
Method: All patients receiving treatment at the Psychiatric Trauma Clinic for Refugees in Copenhagen from April 2008 to February 2010 completed self-rating inventories on symptoms of PTSD, depression, and anxiety as well as level of functioning and quality of life before treatment. Then, associations of pre and post-migratory factors with mental health were explored using linear and logistic regression and Pearson’s correlation coefficients.
Results: Among the patients, the prevalence of depression, somatic disease, pain, psychotic symptoms co-existing with PTSD and very low level of functioning was high. Persecution, being an ex-combatant and living currently in social isolation were significantly associated with PTSD arousal symptoms and self-reported pain.
Conclusions: New treatment modalities should seek to address all of the symptoms and challenges of the patients including psychotic and somatic symptoms and social isolation, and studies of treatment effect should clarify all co-morbidities so that comparable populations can be included in treatment evaluation studies.
Citas
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2. Olsen DR, Montgomery E, Bøjholm S, Foldspang A. Prevalent musculoskeletal pain as a correlate of previous exposure to torture. ScandJPublic Health. 2006;34(5):496-503.
3. Palic S, Elklit A. An explorative outcome study of CBT-based multidisciplinary treatment in a diverse group of refugees from a Danish treatment centre for rehabilitation of traumatized refugees. Torture. 2009;19(3):248-70.
4. Carlsson JM, Mortensen EL, Kastrup M. A follow-up study of mental health and health-related quality of life in tortured refugees in multidisciplinary treatment. JNervMentDis. 2005;193(10):651-7.
5. Van Ommeren M, Sharma B, Sharma GK, Komproe I, Cardeña E, de Jong JT. The relationship between somatic and PTSD symptoms among Bhutanese refugee torture survivors: examination of comorbidity with anxiety and depression. JTrauma Stress. 2002;15(5):415-21.
6. Jamil H, Hakim-Larson J, Farrag M, Kafaji T, Jamil LH, Hammad A. Medical complaints among Iraqi American refugees with mental disorders. JImmigrHealth. 2005;7(3):145-52.
7. Asmundson GJ, Katz J. Understanding the co-occurrence of anxiety disorders and chronic pain: state-of-the-art. DepressAnxiety. 2009;26(10):888-901.
8. Morina N, Ford JD, Risch AK, Morina B, Stangier U. Somatic distress among Kosovar civilian war survivors: relationship to trauma exposure and the mediating role of experiential avoidance. SocPsychiatry PsychiatrEpidemiol. 2010;45(12):1167-77.
9. Norredam M, Jensen M, Ekstrøm M. Psychotic symptoms in refugees diagnosed with PTSD: a series of case reports. NordJPsychiatry. 2011;65(4):283-8.
10. Coentre R, Power P. A diagnostic dilemma between psychosis and post-traumatic stress disorder: a case report and review of the literature. JMedCaseRep. 2011;5:97.
11. Braakman MH, Kortmann FA, van den Brink W. Validity of 'post-traumatic stress disorder with secondary psychotic features': a review of the evidence. Acta PsychiatrScand. 2009;119(1):15-24.
12. Shevlin M, Armour C, Murphy J, Houston JE, Adamson G. Evidence for a psychotic posttraumatic stress disorder subtype based on the National Comorbidity Survey. SocPsychiatry PsychiatrEpidemiol. 2011;46(11):1069-78.
13. Otto MW, Hinton D, Korbly NB, Chea A, Ba P, Gershuny BS, et al. Treatment of pharmacotherapy-refractory posttraumatic stress disorder among Cambodian refugees: a pilot study of combination treatment with cognitive-behavior therapy vs sertraline alone. BehavResTher. 2003;41(11):1271-6.
14. Hinton DE, Chhean D, Pich V, Safren SA, Hofmann SG, Pollack MH. A randomized controlled trial of cognitive-behavior therapy for Cambodian refugees with treatment-resistant PTSD and panic attacks: a cross-over design. JTrauma Stress. 2005;18(6):617-29.
15. Paunovic N, Ost LG. Cognitive-behavior therapy vs exposure therapy in the treatment of PTSD in refugees. BehavResTher. 2001;39(10):1183-97.
16. Kruse J, Joksimovic L, Cavka M, Wöller W, Schmitz N. Effects of trauma-focused psychotherapy upon war refugees. JTrauma Stress. 2009;22(6):585-92.
17. Carlsson JM, Mortensen EL, Kastrup M. Predictors of mental health and quality of life in male tortured refugees. NordJPsychiatry. 2006;60(1):51-7.
18. Neuner F, Kurreck S, Ruf M, Odenwald M, Elbert T, Schauer M. Can asylum-seekers with posttraumatic stress disorder be successfully treated? A randomized controlled pilot study. Cogn Behav Ther. 2010;39(2):81-91.
19. Blair RG. Risk factors associated with PTSD and major depression among Cambodian refugees in Utah. Health SocWork. 2000;25(1):23-30.
20. Steel Z, Chey T, Silove D, Marnane C, Bryant RA, Van Ommeren M. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. JAMA. 2009;302(5):53749.
21. Carswell K, Blackburn P, Barker C. The relationship between trauma, post-migration problems and the psychological well-being of refugees and asylum seekers. IntJSocPsychiatry. 2011;57(2):107-19.
22. Marshall GN, Schell TL, Elliott MN, Berthold SM, Chun CA. Mental health of Cambodian refugees 2 decades after resettlement in the United States. JAMA. 2005;294(5):571-9.
23. Lie B. A 3-year follow-up study of psychosocial functioning and general symptoms in settled refugees. Acta PsychiatrScand. 2002;106(6):415-25.
24. Oruc L, Kapetanovic A, Culhane M, Lavelle J, Miley K, Forstbauer S, et al. Screening for PTSD and depression in Bosnia and Herzegovina: validating the Harvard Trauma Questionnaire and the Hopkins Symptom Cheklist. IntJCulture MentHealth. 2008;1(2):105-116.
25. Kleijn WC, Hovens JE, Rodenburg JJ. Posttraumatic stress symptoms in refugees: assessments with the Harvard Trauma Questionnaire and the Hopkins symptom Checklist-25 in different languages. PsycholRep. 2001;88(2):527-32.
26. Shoeb M, Weinstein H, Mollica R. The Harvard trauma questionnaire: adapting a cross-cultural instrument for measuring torture, trauma and posttraumatic stress disorder in Iraqi refugees. IntJSocPsychiatry. 2007;53(5):447-63.
27. Hollifield M, Warner TD, Lian N, Krakow B, Jenkins JH, Kesler J, et al. Measuring trauma and health status in refugees: a critical review. JAMA. 2002;288(5):611-21.
28. WHO. Info package; mastering depression in primary care Frederiksborg, Denmark: World Health Organisation, Regiona Office for Europe, Psychiatric Research Unit; 1998 [updated 1998]. Available from: http://www.who-5.org.
29. Sheehan KH, Sheehan DV. Assessing treatment effects in clinical trials with the discan metric of the Sheehan Disability Scale. IntClinPsychopharmacol. 2008;23(2):70-83.
30. Aragona M, Pucci D, Carrer S, Catino E, Tomaselli A, Colosimo F, et al. The role of post-migration living difficulties on somatization among firstgeneration immigrants visited in a primary care service. AnnIstSuperSanita. 2011;47(2):207-13.
31. Pace TW, Heim CM. A short review on the psychoneuroimmunology of posttraumatic stress disorder: from risk factors to medical comorbidities. Brain BehavImmun. 2011;25(1):6-13.
32. Dedert EA, Calhoun PS, Watkins LL, Sherwood A, Beckham JC. Posttraumatic stress disorder, cardiovascular, and metabolic disease: a review of the evidence. AnnBehavMed. 2010;39(1):61-78.
33. Vaage AB, Thomsen PH, Silove D, WentzelLarsen T, Van Ta T, Hauff E. Long-term mental health of Vietnamese refugees in the aftermath of trauma. BrJPsychiatry. 2010;196(2):122-5.
34. Schweitzer RD, Brough M, Vromans L, AsicKobe M. Mental health of newly arrived Burmese refugees in Australia: contributions of pre-migration and post-migration experience. AustNZJPsychiatry. 2011;45(4):299-307.
35. Laban CJ, Komproe IH, Gernaat HB, de Jong JT. The impact of a long asylum procedure on quality of life, disability and physical health in Iraqi asylum seekers in the Netherlands. SocPsychiatry PsychiatrEpidemiol. 2008;43(7):507-15.
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2018-10-08
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Buhman, C., Mortensen, E. L., Lundstrøm, S., Ryberg, J., Nordentoft, M., & Ekstrøm, M. (2018). Symptoms, Quality of Life and level of functioning of traumatized refugees at Psychiatric Trauma Clinic in Copenhagen. Torture Journal, 24(1), 15. https://doi.org/10.7146/torture.v24i1.109717
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