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挪威受创伤者、难民及奥斯陆其他移民患者的精神疾病发病率差异

Variations in psychiatric morbidity between traumatized Norwegian, refugees and other immigrant patients in Oslo.

作者信息

Søegaard Erik Ganesh Iyer, Kan Zhanna, Koirala Rishav, Hauff Edvard, Thapa Suraj Bahadur

机构信息

Department of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.

Department of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

出版信息

Nord J Psychiatry. 2020 Aug;74(6):390-399. doi: 10.1080/08039488.2020.1714724. Epub 2020 Jan 21.

Abstract

There is a lack of clinical studies that focus on different psychiatric disorders after trauma and the relationship with migration status. To examine differences in psychiatric morbidity in traumatized patients referred to psychiatric treatment in Southern Oslo. Hundred and ten patients with trauma background attending an outpatient clinic in Southern Oslo were studied. Forty-four of the participants (40%) were ethnic Norwegians, 25 (22.7%) had refugee background and 41 (37.3%) were first- or second-generation immigrants without refugee background. Thorough diagnostic assessment was done by experienced psychiatrists through several structured clinical interviews and self-report questionnaires. Ninety-eight patients (89%) were diagnosed with at least one Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) disorder. There was a clear difference in the presentation of certain psychiatric disorders between the groups. Ethnic Norwegian patients were more likely to have anxiety disorders: agoraphobia, social phobia and panic disorder than non-refugee immigrant patients. They also had higher rates of alcohol abuse/dependence. Somatoform pain disorder was more common in both the refugee and other-immigrant groups than among the ethnic Norwegian patients. The refugee patients had significantly more major depressive disorder, post-traumatic stress disorder (PTSD) and both co-occurring. Trauma is frequently associated with depression, anxiety disorders, somatoform pain disorder and PTSD in a clinical population. The clinical presentation and comorbidity of these disorders seem to vary significantly between traumatized patients with Norwegian, refugee and non-refugee immigrant backgrounds. After a major trauma, refugees may be at greater risk for both PTSD and depression than other immigrants and the native population.

摘要

目前缺乏关注创伤后不同精神疾病及其与移民身份关系的临床研究。为了研究在奥斯陆南部接受精神科治疗的创伤患者的精神疾病发病率差异。对110名有创伤背景且在奥斯陆南部一家门诊就诊的患者进行了研究。其中44名参与者(40%)是挪威本地人,25名(22.7%)有难民背景,41名(37.3%)是无难民背景的第一代或第二代移民。经验丰富的精神科医生通过多次结构化临床访谈和自我报告问卷进行了全面的诊断评估。98名患者(89%)被诊断患有一种及以上《精神疾病诊断与统计手册》第四版,修订本(DSM-IV-TR)中的疾病。不同组之间某些精神疾病的表现存在明显差异。挪威本地患者比非难民移民患者更易患焦虑症:广场恐惧症、社交恐惧症和惊恐障碍。他们的酒精滥用/依赖率也更高。躯体形式疼痛障碍在难民和其他移民组中比挪威本地患者中更常见。难民患者的重度抑郁症、创伤后应激障碍(PTSD)以及两者共病的情况明显更多。在临床人群中,创伤常与抑郁症、焦虑症、躯体形式疼痛障碍和PTSD相关。这些疾病的临床表现和共病情况在有挪威、难民和非难民移民背景的创伤患者之间似乎有显著差异。经历重大创伤后,难民患PTSD和抑郁症的风险可能比其他移民和本地人群更高。

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