Allodi F A
Department of Psychiatry, University of Toronto, Ontario, Canada.
J Nerv Ment Dis. 1991 Jan;179(1):4-11. doi: 10.1097/00005053-199101000-00002.
This paper presents the main issues in the diagnosis and treatment of psychiatric sequelae in torture victims. The concept of post traumatic stress disorder is used to organize literature on psychiatric casualties resulting from massive psychic trauma, e.g., the Nazi Holocaust, the Vietnam and Israeli wars, and the current world epidemic of torture. Torture is a unique human made stressor resulting in category-specific diagnostic symptoms. Medical assessment can be complemented with photographs, x-rays, electroencephalograms, and sleep studies. Individual psychotherapy and group techniques focus on the issues of denial and trust, loss, survivor guilt, and reparation. Programs of psychological and social rehabilitation and treatment with benzodiazepines, tricyclic antidepressants, and other compounds are reviewed. Future research needs include the conceptualization of the trauma of torture and its sequelae in broader terms, the application of standardized measurements to facilitate international comparisons, and the testing of various approaches to intervention in an experimental design. An ethical physician must resist the pressures of totalitarian governments to assume neutrality in the presence of human rights violations affecting his/her patients.
本文介绍了酷刑受害者精神后遗症诊断与治疗中的主要问题。创伤后应激障碍的概念被用于整理关于大规模精神创伤所致精神伤亡的文献，例如纳粹大屠杀、越南战争和以色列战争，以及当前全球范围内的酷刑流行情况。酷刑是一种独特的人为应激源，会导致特定类别的诊断症状。医学评估可辅以照片、X光、脑电图和睡眠研究。个体心理治疗和团体治疗技术关注否认与信任、丧失、幸存者内疚和赔偿等问题。本文还综述了心理和社会康复计划以及使用苯二氮䓬类药物、三环类抗抑郁药和其他化合物进行治疗的情况。未来的研究需求包括从更广泛的角度对酷刑创伤及其后遗症进行概念化，应用标准化测量方法以促进国际比较，以及在实验设计中测试各种干预方法。有道德的医生必须抵制极权政府的压力，在其患者受到侵犯人权行为影响时不保持中立。
