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Psychiatric Disorders Among Tortured Bhutanese Refugees in Nepal
Mark Van Ommeren, PhD;
Joop T. V. M. de Jong, MD, PhD;
Bhogendra Sharma, MBBS, MSc;
Ivan Komproe, PhD;
Suraj B. Thapa, MBBS;
Etzel Cardeña, PhD
Arch Gen Psychiatry. 2001;58:475-482.
Background The impact of torture on the distribution of psychiatric disorders among
refugees is unknown.
Methods We surveyed a population-based sample of 418 tortured and 392 nontortured
Bhutanese refugees living in camps in Nepal. Trained interviewers assessed International Classification of Diseases, 10th Revision (ICD-10) disorders through structured diagnostic psychiatric interviews.
Results Except for male sex, history of torture was not associated with demographics.
Tortured refugees, compared with nontortured refugees, were more likely to
report 12-month ICD-10 posttraumatic stress disorder,
persistent somatoform pain disorder, and dissociative (amnesia and conversion)
disorders. In addition, tortured refugees were more likely to report lifetime
posttraumatic stress disorder, persistent somatoform pain disorder, affective
disorder, generalized anxiety disorder, and dissociative (amnesia and conversion)
disorders. Tortured women, compared with tortured men, were more likely to
report lifetime generalized anxiety disorder, persistent somatoform pain disorder,
affective disorder, and dissociative (amnesia and conversion) disorders.
Conclusions Among Bhutanese refugees, the survivors had higher lifetime and 12-month
rates of ICD-10 psychiatric disorder. Men were more
likely to report torture, but tortured women were more likely to report certain
disorders. The results indicate the increased need for attention to the mental
health of refugees, specifically posttraumatic stress disorder, persistent
somatoform pain disorder, and dissociative (amnesia and conversion) disorders
among those reporting torture.
From the Center for Victims of Torture, Kathmandu, Nepal (Drs Van Ommeren,
Sharma, and Thapa); Transcultural Psychosocial Organization, World Health
Organization Collaborating Centre for Refugees and Ethnic Minorities, Vrije
Universiteit, Amsterdam, the Netherlands (Drs Van Ommeren, de Jong, and Komproe);
and Department of Psychology and Anthropology, The University of Texas–Pan
American, Edinburg (Dr Cardeña).
Corresponding author and reprints: Mark Van Ommeren, PhD, Center
for Victims of Torture, PO Box 5839, Kathmandu, Nepal (e-mail: mark_van_ommeren{at}hotmail.com).
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