Weinstein H M, Dansky L, Iacopino V
Survivors International, San Francisco, California, USA.
West J Med. 1996 Sep;165(3):112-8.
Close to 1 million refugees from around the world have entered the United States, fleeing repression, war, terrorism, and disease. It has been estimated that among these are thousands who have experienced torture. Many refugees and immigrants will appear in the offices of health care professionals with symptoms that may be related either directly or indirectly to torture. Both physical and psychological torture may result in long-term sequelae. Physical effects may be found in every organ system, but psychological effects are most commonly manifest in the symptoms of the post-traumatic stress disorder. For physicians to recognize how torture can affect health status, it is important to understand that history taking may be difficult and that little information may emerge that would explain the origins of scars, fractures, or disabilities. Recognizing the clues to a torture history allows physicians to assist patients in describing the trauma. In addition, knowing the subacute and chronic signs and symptoms of torture enables physicians to diagnose and treat often obscure symptoms with a much clearer understanding of the sources of the difficulty. Paying special attention to the interview process will support torture survivors in detailing often horrific events.
近100万来自世界各地的难民进入美国，以逃离镇压、战争、恐怖主义和疾病。据估计，其中有成千上万的人遭受过酷刑。许多难民和移民会出现在医疗保健专业人员的办公室，其症状可能直接或间接与酷刑有关。身体和心理上的酷刑都可能导致长期后遗症。身体影响可能出现在每个器官系统中，但心理影响最常见地表现为创伤后应激障碍的症状。对于医生来说，要认识到酷刑如何影响健康状况，重要的是要明白病史采集可能很困难，而且可能几乎没有信息能解释伤疤、骨折或残疾的成因。识别酷刑史的线索能让医生帮助患者描述创伤。此外，了解酷刑的亚急性和慢性体征及症状能使医生在诊断和治疗常常模糊不清的症状时，更清楚地理解问题的根源。特别关注问诊过程将有助于酷刑幸存者详细讲述往往很可怕的事件。
