Thapa Suraj Bahadur, Van Ommeren Mark, Sharma Bhogendra, de Jong Joop T V M, Hauff Edvard
Center for Victims of Torture-Nepal, Kathmandu, Nepal.
Am J Psychiatry. 2003 Nov;160(11):2032-7. doi: 10.1176/appi.ajp.160.11.2032.
Most refugees live in low-income countries. There is a lack of data on psychiatric disability among such refugees. The authors compared psychiatric disability in tortured and nontortured Bhutanese refugees living in Nepal and examined factors associated with psychiatric disability among the tortured refugees.
A cross-sectional survey was conducted among 418 tortured and 392 nontortured Bhutanese refugees, matched for age and gender. The Composite International Diagnostic Interview, version 2.1, and the World Health Organization Short Disability Assessment Schedule were used to measure ICD-10 psychiatric disorders and disability, respectively.
Approximately one in five tortured and nontortured Bhutanese refugees were found to be disabled. Posttraumatic stress disorder, specific phobia, and present physical disease were identified as factors associated with disability among the tortured refugees. On the other hand, present physical disease, greater age, and generalized anxiety disorder were associated with disability among the nontortured group.
These findings show that the tortured and nontortured refugees were equally likely to be disabled. Different sets of predictors were identified among tortured and nontortured refugees, indicating the need for comprehensive psychiatric assessment of both tortured and nontortured refugees in clinical practice.
大多数难民生活在低收入国家。关于这类难民的精神残疾情况缺乏数据。作者比较了生活在尼泊尔的受折磨和未受折磨的不丹难民的精神残疾情况，并研究了受折磨难民中与精神残疾相关的因素。
对418名受折磨的和392名未受折磨的不丹难民进行了横断面调查，这些难民在年龄和性别上进行了匹配。分别使用综合国际诊断访谈第2.1版和世界卫生组织简短残疾评估量表来测量ICD - 10精神障碍和残疾情况。
大约五分之一的受折磨和未受折磨的不丹难民被发现有残疾。创伤后应激障碍、特定恐惧症和当前身体疾病被确定为受折磨难民中与残疾相关的因素。另一方面，当前身体疾病、年龄较大和广泛性焦虑障碍与未受折磨组的残疾有关。
这些发现表明，受折磨和未受折磨的难民残疾的可能性相同。在受折磨和未受折磨的难民中发现了不同的预测因素集，这表明在临床实践中需要对受折磨和未受折磨的难民进行全面的精神评估。
