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黎巴嫩住院外籍家政女工的精神疾病发病率、现象学及管理

Psychiatric morbidity, phenomenology and management in hospitalized female foreign domestic workers in Lebanon.

作者信息

Zahreddine Nada, Hady Rima Talaat, Chammai Rabih, Kazour François, Hachem Dory, Richa Sami

机构信息

Department of Psychiatry, Saint-Joseph University, Beirut, Lebanon,

出版信息

Community Ment Health J. 2014 Jul;50(5):619-28. doi: 10.1007/s10597-013-9682-7. Epub 2013 Dec 27.

Abstract

40 million female domestic workers worldwide experience the inhumane conditions associated with this unregulated occupation, a situation that induces psychiatric morbidities in many. The case in Lebanon is not any better where it is estimated that one foreign domestic worker (FDW) commits suicide weekly. 33 female FDW and 14 female Lebanese (control group, CG) were enrolled. Brief Psychotic Rating Scale (BPRS) and Clinical Global Impression (CGI) scales were administered on admission and discharge and socio-demographic, living conditions, mental health care data and phenomenological observations were collected. Sexual, physical, and verbal abuses were detected in FDW (12.5, 37.5, and 50.0 %. respectively). 66.7 % of them were diagnosed with brief psychotic episode. The mean duration of hospital stay (13.1 days) was significantly lower in the FDW group. The mean cumulative antipsychotic dose of the FDW was 337.1 mg of chlorpromazine equivalent and the mean BPRS total pre-score of FDW was 66.4 with a much improved state on the CGI global improvement scale, all of which were nonsignificantly different from the CG. Striking phenomenological findings among FDW were acute anorexia (39.4 %), nudity (30.3 %), catatonic features (21.2 %), and delusion of pregnancy (12.1 %). Inpatient FDW are more diagnosed with psychotic than affective disorders and receive approximately similar treatment as controls in spite of the trend to rapidly discharge and deport the worker to limit the costs. Both groups presented with similar severity, although the FDW had peculiar phenomenological observations.

摘要

全球有4000万女性家政工人面临着与这种缺乏规范的职业相关的不人道工作条件,这种情况导致许多人出现精神疾病。黎巴嫩的情况也好不到哪里去,据估计,每周有一名外籍家政工人自杀。研究招募了33名女性外籍家政工人和14名黎巴嫩女性(对照组)。在入院和出院时使用简明精神病评定量表(BPRS)和临床总体印象量表(CGI),并收集社会人口统计学、生活条件、精神卫生保健数据和现象学观察结果。在外籍家政工人中检测到性虐待、身体虐待和言语虐待(分别为12.5%、37.5%和50.0%)。其中66.7%被诊断为短暂精神病性发作。外籍家政工人群组的平均住院时间(13.1天)显著更短。外籍家政工人的平均累积抗精神病药物剂量为337.1毫克氯丙嗪当量,外籍家政工人的BPRS总分平均分是66.4,在CGI总体改善量表上状态有很大改善,所有这些与对照组相比均无显著差异。在外籍家政工人中显著的现象学发现包括急性厌食(39.4%)、裸体(30.3%)、紧张症特征(21.2%)和妊娠妄想(12.1%)。住院的外籍家政工人被诊断为精神病性障碍而非情感性障碍的比例更高,尽管有迅速出院并将工人驱逐以限制成本的趋势,但他们接受的治疗与对照组大致相似。两组的严重程度相似,尽管外籍家政工人有独特的现象学观察结果。

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