Institute of Psychiatry, Kings College London, London, UK.
BMC Psychiatry. 2013 Aug 3;13:204. doi: 10.1186/1471-244X-13-204.
Previous studies have found high levels of symptoms of depression, anxiety, and post-traumatic stress disorder among women survivors of human trafficking. No previous research has described risk factors for diagnosed mental disorders in this population.
A historical cohort study of women survivors of trafficked women aged 18 and over who returned to Moldova and registered for assistance with the International Organisation for Migration (IOM). Women were approached by IOM social workers and, if they gave informed consented to participate in the study, interviewed by the research team. At 2-12 months post-return to Moldova, a psychiatrist assessed DSM-IV mental disorders blind to information about women's pre-trafficking and post-trafficking experiences using the Structured Clinical Interview for DSM-IV (SCID). A backwards stepwise selection procedure was used to create a multivariable regression model of risk factors for DSM-IV mental disorder measured at an average of 6 months post-return.
120/176 (68%) eligible women participated. At an average of 6 months post-return, 54% met criteria for any DSM-IV mental disorder: 35.8% of women had PTSD (alone or co-morbid), 12.5% had depression without PTSD and 5.8% had another anxiety disorder. Multivariable regression analysis found that childhood sexual abuse (Adjusted Odds Ratio [AOR] 4.68, 95% CI 1.04-20.92), increased number of post-trafficking unmet needs (AOR 1.80; 95% CI 1.28-2.52) and post-trafficking social support (AOR 0.64; 95% CI 0.52-0.79) were independent risk factors for mental disorder, and that duration of trafficking showed a borderline association with mental disorder (AOR 1.12, 95% CI 0.98-1.29).
Assessment for mental disorders should be part of re-integration follow-up care for women survivors of human trafficking. Mental disorders at that time, most commonly PTSD and depression, are likely to be influenced by a range of predisposing, precipitating and maintaining factors. Care plans for survivors of trafficking must be based on individual needs, and must apply clinical guidelines for the treatment of PTSD and of depression. Evidence is needed on the effectiveness of therapy for PTSD in survivors of human trafficking.
先前的研究发现，人口贩运女性幸存者中存在高水平的抑郁、焦虑和创伤后应激障碍症状。先前没有研究描述过该人群中被诊断为精神障碍的风险因素。
这是一项对 18 岁及以上返回摩尔多瓦并向国际移民组织（IOM）登记寻求援助的被贩卖女性幸存者的历史队列研究。IOM 社会工作者与女性接触，如果她们同意参与研究，研究团队将对其进行访谈。在返回摩尔多瓦后 2-12 个月，精神科医生使用 DSM-IV 结构临床访谈（SCID）对精神障碍进行盲法评估，该访谈不了解妇女的贩运前和贩运后的经历。采用向后逐步选择程序创建了一个多变量回归模型，以评估返回后平均 6 个月时 DSM-IV 精神障碍的风险因素。
176 名符合条件的女性中有 120 名（68%）参加了研究。返回后平均 6 个月时，54%的女性符合任何 DSM-IV 精神障碍标准：35.8%的女性患有 PTSD（单独或共病），12.5%的女性患有无 PTSD 的抑郁症，5.8%的女性患有其他焦虑症。多变量回归分析发现，童年性虐待（调整后的优势比[OR] 4.68，95%CI 1.04-20.92）、增加的贩运后未满足的需求数量（OR 1.80；95%CI 1.28-2.52）和贩运后社会支持（OR 0.64；95%CI 0.52-0.79）是精神障碍的独立风险因素，而贩运时间与精神障碍呈边缘关联（OR 1.12，95%CI 0.98-1.29）。
对精神障碍的评估应成为人口贩运女性幸存者重新融入社会后续护理的一部分。当时的精神障碍，最常见的是 PTSD 和抑郁症，很可能受到一系列易患、诱发和维持因素的影响。针对贩运幸存者的护理计划必须基于个人需求，并必须应用 PTSD 和抑郁症的治疗临床指南。需要有证据证明针对人口贩运幸存者的 PTSD 治疗的有效性。
