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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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