Shrestha N M, Sharma B, Van Ommeren M, Regmi S, Makaju R, Komproe I, Shrestha G B, de Jong J T
Center for Victims of Torture, Kathmandu, Nepal.
JAMA. 1998 Aug 5;280(5):443-8. doi: 10.1001/jama.280.5.443.
Most of the world's refugees are displaced within the developing world. The impact of torture on such refugees is unknown.
To examine the impact of torture on Bhutanese refugees in Nepal.
Case-control survey. Interviews were conducted by local physicians and included demographics, questions related to the torture experienced, a checklist of 40 medical complaints, and measures of posttraumatic stress disorder (PTSD), anxiety, and depression.
Bhutanese refugee community in the United Nations refugee camps in the Terai in eastern Nepal.
A random sample of 526 tortured refugees and a control group of 526 nontortured refugees matched for age and sex.
The Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R) criteria for PTSD and the Hopkins Symptom Checklist-25 (HSCL-25) for depression and anxiety.
The 2 groups were similar on most demographic variables. The tortured refugees, as a group, suffered more on 15 of 17 DSM-III-RPTSD symptoms (P<.005) and had higher HSCL-25 anxiety and depression scores (P<.001) than nontortured refugees. Logistic regression analysis showed that history of torture predicted PTSD symptoms (odds ratio [OR], 4.6; 95% confidence interval [CI], 2.7-8.0), depression symptoms (OR, 1.9; 95% CI, 1.4-2.6), and anxiety symptoms (OR, 1.5; 95% CI, 1.1-1.9). Torture survivors who were Buddhist were less likely to be depressed (OR, 0.5; 95% CI, 0.3-0.9) or anxious (OR, 0.7; 95% CI, 0.4-1.0). Those who were male were less likely to experience anxiety (OR, 0.66; 95% CI, 0.44-1.00). Tortured refugees also presented more musculoskeletal system- and respiratory system-related complaints (P<.001 for both).
Torture plays a significant role in the development of PTSD, depression, and anxiety symptoms among refugees from Bhutan living in the developing world.
世界上大多数难民是在发展中国家境内流离失所。酷刑对这类难民的影响尚不清楚。
研究酷刑对尼泊尔不丹难民的影响。
病例对照研究。由当地医生进行访谈，内容包括人口统计学信息、与所遭受酷刑相关的问题、一份包含40种医学症状的清单，以及创伤后应激障碍（PTSD）、焦虑和抑郁的测量指标。
尼泊尔东部特莱地区联合国难民营中的不丹难民社区。
526名遭受酷刑的难民的随机样本以及526名年龄和性别相匹配的未遭受酷刑的难民作为对照组。
《精神障碍诊断与统计手册》第三版修订本（DSM - III - R）中PTSD的诊断标准以及用于抑郁和焦虑的霍普金斯症状清单 - 25（HSCL - 25）。
两组在大多数人口统计学变量上相似。作为一个群体，遭受酷刑的难民在17项DSM - III - R PTSD症状中的15项上症状更严重（P <.005），并且HSCL - 25焦虑和抑郁得分高于未遭受酷刑的难民（P <.001）。逻辑回归分析表明，酷刑史可预测PTSD症状（优势比[OR]，4.6；95%置信区间[CI]，2.7 - 8.0）、抑郁症状（OR，1.9；95% CI，1.4 - 2.6）和焦虑症状（OR，1.5；95% CI，1.1 - 1.9）。佛教徒酷刑幸存者抑郁（OR，0.5；95% CI，0.3 - 0.9）或焦虑（OR，0.7；95% CI，0.4 - 1.0）的可能性较小。男性遭受焦虑的可能性较小（OR，0.66；95% CI，0.44 - 1.00）。遭受酷刑的难民还表现出更多与肌肉骨骼系统和呼吸系统相关的症状（两者P <.001）。
酷刑在生活在发展中国家的不丹难民中PTSD、抑郁和焦虑症状的发生中起重要作用。
