Citation

Tol WA, Komproe IH, Thapa SB, Jordans MJD, Sharma B, de Jong JTVM. J. Nerv. Ment. Dis. 2007; 195(6): 463-469.

Affiliation

HealthNet TPO, Department of Public Health and Research, Tolstraat 127, Amsterdam, the Netherlands. wtol@healthnettpo.org

Copyright

(Copyright © 2007, Lippincott Williams and Wilkins)

DOI

10.1097/NMD.0b013e31802f5dac

PMID

17568293

Abstract

Our objective was to explore the relationships between psychiatric symptom categories (posttraumatic stress disorder (PTSD), anxiety, and depression) and disability among torture survivors. We conducted a cross-sectional study of help-seeking torture survivors in highly affected conflict areas in rural mid-Western Nepal, using rating scales to assess symptomatology and disability.Validated screening instruments for the Nepali setting revealed that a high amount of psychopathology was present. Exploration of the relationships between psychiatric symptomatology and disability showed a central role for PTSD and anxiety complaints, but not for depressive complaints. A recursive model in which PTSD has (a) a direct relationship with disability and (b) an indirect relationship with disability mediated by anxiety and depression best fits the data. Findings are consistent with research on tortured refugees, suggesting the importance of a PTSD-anxiety mechanism. Implications for refugees in Western settings are discussed. Complexity of the mental status of torture survivors indicates multidisciplinary treatment.

Language: en