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Milewski A, Weinstein E, Lurie J, Lee A, Taki F, Pilato T, Jedlicka C, Kaur G. Reported Methods, Distributions, and Frequencies of Torture Globally: A Systematic Review and Meta-Analysis. JAMA Netw Open 2023; 6:e2336629. [PMID: 37787994 PMCID: PMC10548313 DOI: 10.1001/jamanetworkopen.2023.36629] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/24/2023] [Indexed: 10/04/2023] Open
Abstract
Importance Despite its prohibition by the United Nations Convention against Torture and other international treaties, torture has been perpetrated against countless individuals worldwide, and health care practitioners globally are increasingly encountering refugee torture survivors in their clinical practices. The methods, geographic distribution, and frequency of torture globally are not well described, which limits health care practitioners' ability to adequately diagnose and treat the sequelae of torture. Objective To rank the commonness of torture methods and identify the regions of the world with which they are associated. Data Sources For this systematic review and meta-analysis, Ovid MEDLINE, Ovid Embase, Web of Science, and The Cochrane Library were searched from inception to July 2021. Study Selection Included studies were peer-reviewed articles in English, contained an independent sample population of individuals who experienced torture, and outlined the type(s) of torture experienced. Excluded studies were not peer reviewed, lacked an independent sample population, or did not specify torture methods. Articles were chosen for inclusion by 2 independent and blinded reviewers, and a third, independent reviewer resolved discrepancies. Overall, 266 articles-15.3% of the 1739 studies initially identified for full review-met the inclusion criteria. Data Extraction and Synthesis Data abstraction and quality assessment followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were extracted by 2 independent and blinded reviewers into predefined templates, and a third, independent reviewer resolved discrepancies. The risk of bias was evaluated using the Downs and Black Checklist. Main Outcomes and Measures Torture methods were ranked by their average frequencies, numbers of reporting studies, and numbers of countries wherein the methods occurred. Results A total of 9937 titles and abstracts were screened, and 266 studies encompassing 103 604 individuals (13 350 men, 5610 women, and 84 644 unspecified) were analyzed. Torture was reported for 105 countries; 21 methods accounted for 84% of all reported methods and 10 methods accounted for 78% of all physical tortures. The top 3 methods were beating or blunt-force trauma (reported in 208 studies and 59 countries; average frequency, 62.4%; 95% CI, 57.7%-67.1%), electrical torture (reported in 114 studies and 28 countries; average frequency, 17.2%; 95% CI, 15.0%-19.4%), and starvation or dehydration (reported in 65 studies in 26 countries; average frequency, 12.7%; 95% CI, 10.2%-15.2%). According to the Downs and Black appraisal tool, 50 studies were rated as good or excellent and 216 as fair or poor. Conclusions and Relevance The findings of this study suggest that torture remains widespread. Although innumerable torture methods exist, a limited number account for the vast majority of reported tortures. So that targeted therapies may be developed, additional investigation is needed to better elucidate the sequelae associated with the most common torture methods, described here.
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Affiliation(s)
- Andrew Milewski
- Department of Anesthesiology, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Eliana Weinstein
- Department of Anesthesiology, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Jacob Lurie
- Department of Anesthesiology, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Annabel Lee
- Weill Cornell Medicine Medical College, New York, New York
| | - Faten Taki
- Department of Anesthesiology, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Tara Pilato
- Samuel J. Wood Library, Weill Cornell Medicine, New York, New York
| | - Caroline Jedlicka
- Kingsborough Community College, City University of New York, Brooklyn
| | - Gunisha Kaur
- Department of Anesthesiology, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
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Rainone GJ, Zelmanovich R, Laurent D, Lucke-Wold B. How War Has Shaped Neurosurgery. World Neurosurg 2023; 178:136-144. [PMID: 37506839 DOI: 10.1016/j.wneu.2023.07.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023]
Abstract
Many strides have been made in neurosurgery during times of war, helping to improve the outcomes of patients in dire circumstances. World War I introduced the concepts of early operation for trauma, forward-operating hospitals, and galeal sutures as well as techniques for careful debridement. It laid the groundwork for neurosurgery to become a specialty within medicine as well. World War II brought about the use of expedited medical evacuation, mobile neurosurgical units, improved resuscitation strategies, cranioplasty, and early laminectomy with decompression. The Korean and Vietnam Wars built on concepts from World Wars I and II, helping to establish the importance of watertight dural closure, external drainage systems after cranial trauma, multidisciplinary care, and infection prevention strategies. In the post-Vietnam period, we have seen significant technological advances allowing neurosurgeons to move farther ahead than most throughout history could have imagined. The significance of secondary brain injury, vascular injury, and the underlying pathophysiology of traumatic insults has been elucidated over the years since the Vietnam War, allowing for great advances in the care of our patients. Each major war throughout history has contributed greatly to the specialty of neurosurgery, each with its own innovations culminating in guidelines, strategies, and standards of practice that allow us to deliver the highest standard of care to our patients.
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Affiliation(s)
- Gersham J Rainone
- Department of Neurosurgery, University of South Florida, Tampa, Florida, USA.
| | - Rebecca Zelmanovich
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Dimitri Laurent
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
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Saadi A, Williams J, Parvez A, Alegría M, Vranceanu AMM. Head Trauma in Refugees and Asylum Seekers: A Systematic Review. Neurology 2023; 100:e2155-e2169. [PMID: 37019660 PMCID: PMC10238158 DOI: 10.1212/wnl.0000000000207261] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 02/21/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Refugees and asylum seekers are at risk of head trauma. They endure blows to the head due to exigent circumstances necessitating resettlement (e.g., torture, war, interpersonal violence) and during their dangerous journeys to refuge. Our objective was to assess the global prevalence of head trauma in refugees and asylum seekers and describe its clinical characteristics in this population. METHODS The protocol was registered in the PROSPERO International Prospective Register of Systematic Reviews (CRD42020173534). PubMed/MEDLINE, PsycInfo, Web of Science, Embase, and Google Scholar databases were searched for relevant studies. We included all studies in English that comprised refugees or asylum seekers of any age and examined the prevalence or characteristics of head trauma. We excluded studies that were not peer-reviewed original research. Information was recorded on the prevalence of head trauma, method of ascertaining head trauma, severity, mechanism of injury, other trauma exposures, and comorbidities. Descriptive analyses and narrative syntheses were performed. RESULTS A total of 22 studies were included, of which 13 with 6,038 refugees and asylum seekers reported head trauma prevalence. Prevalence estimates ranged from 9% to 78%. Heterogeneity among studies precluded meta-analysis. Most studies were US based (n = 9, 41%), followed by the Middle East (n = 5, 23%). Most refugees or asylum seekers were from the Middle East (n = 9, 41%), with those from Latin America least represented (n = 3, 14%). Studies disproportionately involved younger (pooled mean age = 29 years) adult samples composed of men. Recruitment settings were predominantly hospitals/clinics (n = 14, 64%), followed by refugee camps (n = 3, 14%). The most common mechanism of injury was direct impact through a beating or blow to the head. Studies varied greatly in how head trauma was defined and ascertained; no study used a validated traumatic brain injury (TBI)-specific screening tool. Similarly, TBI severity was not uniformly assessed, although hospital-based samples captured more moderate-to-severe head injuries. Mental health comorbidities were more frequently documented rather than physical health ones. Only 2 studies included a comparison with local populations. DISCUSSION Refugees and asylum seekers are vulnerable to head trauma, but studies using systematic approaches to screening are lacking. Increased attention to head trauma in displaced populations will allow for optimizing equitable care for this growing vulnerable population.
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Affiliation(s)
- Altaf Saadi
- From the Department of Neurology (A.S.), Massachusetts General Hospital; Harvard Medical School (A.S., M.A., A.-M.M.V.), Boston, MA; University of Connecticut School of Medicine (J.W.), Farmington; University College London Medical School (A.P.), United Kingdom; and Disparities Research Unit (M.A.), Department of Medicine, and Center for Health Outcomes and Interdisciplinary Research (A.-M.M.V.), Massachusetts General Hospital, Boston.
| | - Jasmin Williams
- From the Department of Neurology (A.S.), Massachusetts General Hospital; Harvard Medical School (A.S., M.A., A.-M.M.V.), Boston, MA; University of Connecticut School of Medicine (J.W.), Farmington; University College London Medical School (A.P.), United Kingdom; and Disparities Research Unit (M.A.), Department of Medicine, and Center for Health Outcomes and Interdisciplinary Research (A.-M.M.V.), Massachusetts General Hospital, Boston
| | - Ameerah Parvez
- From the Department of Neurology (A.S.), Massachusetts General Hospital; Harvard Medical School (A.S., M.A., A.-M.M.V.), Boston, MA; University of Connecticut School of Medicine (J.W.), Farmington; University College London Medical School (A.P.), United Kingdom; and Disparities Research Unit (M.A.), Department of Medicine, and Center for Health Outcomes and Interdisciplinary Research (A.-M.M.V.), Massachusetts General Hospital, Boston
| | - Margarita Alegría
- From the Department of Neurology (A.S.), Massachusetts General Hospital; Harvard Medical School (A.S., M.A., A.-M.M.V.), Boston, MA; University of Connecticut School of Medicine (J.W.), Farmington; University College London Medical School (A.P.), United Kingdom; and Disparities Research Unit (M.A.), Department of Medicine, and Center for Health Outcomes and Interdisciplinary Research (A.-M.M.V.), Massachusetts General Hospital, Boston
| | - Ana-Maria M Vranceanu
- From the Department of Neurology (A.S.), Massachusetts General Hospital; Harvard Medical School (A.S., M.A., A.-M.M.V.), Boston, MA; University of Connecticut School of Medicine (J.W.), Farmington; University College London Medical School (A.P.), United Kingdom; and Disparities Research Unit (M.A.), Department of Medicine, and Center for Health Outcomes and Interdisciplinary Research (A.-M.M.V.), Massachusetts General Hospital, Boston
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Sacha M, Sandahl H, Harck L, Carlsson J. Treatment adherence to psychotropic drugs among non-Western migrants: a systematic review. Nord J Psychiatry 2022; 76:250-262. [PMID: 34369289 DOI: 10.1080/08039488.2021.1954689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Low medication adherence is a significant challenge in all medical fields and particularly in mental health treatment, where a lack of insight into one's own disease can repress the ability to adhere. In recent years, the increase in migration combined with a high prevalence of mental illnesses among migrants and the possible consequences of nonadherence, point towards the need for a focus on adherence with psychotropic drugs among migrants. AIM To review current literature, exploring the potential impact of being a migrant from a non-Western country living in a Western country on the level of adherence to psychotropic medication and subsequently to discuss these findings. METHODS A systematic review of studies investigating adherence among non-western migrants was conducted. The literature search was conducted using PubMed and Embase databases in October 2020. RESULTS Seven observational studies were included, all ranging from moderate to high-quality. Six out of seven studies found an association between being a non-Western migrant in a Western country and low adherence to psychotropic drugs. CONCLUSION Studies indicate an association between being a non-Western migrant in a Western country and low adherence to psychotropic drugs. None of the included studies investigated possible causes of the low adherence in migrants. Communication difficulties are, however, considered possible barriers to healthcare access and a contributing factor to nonadherence. There is a need for studies assessing the possible impact of interventions aiming at increasing adherence such as intercultural mediators and training of healthcare providers in cultural competencies.
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Affiliation(s)
- Maria Sacha
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Ballerup, Denmark
| | - Hinuga Sandahl
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Ballerup, Denmark
| | - Line Harck
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Ballerup, Denmark
| | - Jessica Carlsson
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Ballerup, Denmark
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Berthold SM, Mollica RF, Silove D, Tay AK, Lavelle J, Lindert J. The HTQ-5: revision of the Harvard Trauma Questionnaire for measuring torture, trauma and DSM-5 PTSD symptoms in refugee populations. Eur J Public Health 2020; 29:468-474. [PMID: 30561573 DOI: 10.1093/eurpub/cky256] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The Harvard Trauma Questionnaire (HTQ) was developed 25 years ago as a cross-cultural screening instrument to document trauma exposure, head trauma and trauma-related symptoms in refugees. This article aims to: (i) outline the process of revision of Part IV of the HTQ to (a) include the new DSM-5 diagnostic criteria for PTSD, and (b) separate out and more fully develop the refugee-specific functioning items; and (ii) promote a consistent approach to the validation of the HTQ-5 when adapted for use in other cultures and language groups. METHODS Our process involved item mapping; expert consultations; generating items according to the new DSM-5 criteria; and drafting, refinement and finalization of the revised measure focusing closely on issues of meaning, future translation into multiple languages and comprehension amongst groups with low literacy and little or no exposure to Western trauma concepts. Validity and reliability testing of the new HTQ-5 is underway. RESULTS The HTQ symptom checklist was modified consistent with current DSM-5 diagnostic criteria to identify those refugees at risk for mental health and other symptoms associated with traumatic life events, disability and dysfunction. CONCLUSIONS Accurate screening of post-traumatic distress and dysfunction enables those working with refugees to triage them more effectively to scarce health and mental health resources. When developing screening measures to inform public health policy and practice, it is vital that these measures can bridge the gap between western (etic) nosologies and indigenous (emic) understandings of traumatic stress.
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Affiliation(s)
- S Megan Berthold
- School of Social Work, University of Connecticut, Hartford, CT, USA
| | - Richard F Mollica
- Harvard Program in Refugee Trauma, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Cambridge, MA, USA
| | - Derrick Silove
- Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia
| | - Alvin Kuowei Tay
- Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia
| | - James Lavelle
- Harvard Program in Refugee Trauma, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Cambridge, MA, USA
| | - Jutta Lindert
- Department of Health and Social Work, University of Applied Sciences Emden, Emden, Germany; Women's Research Center, Brandeis University, Waltham, MA, United States
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McMurry HS, Tsang DC, Lin N, Symes SN, Dong C, Monteith TS. Head injury and neuropsychiatric sequelae in asylum seekers. Neurology 2020; 95:e2605-e2609. [PMID: 33004606 DOI: 10.1212/wnl.0000000000010929] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 07/14/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Asylum seekers experience a high burden of physical and psychological trauma, yet there is a scarcity of literature regarding the epidemiology and sequelae of head injury (HI) in asylum seekers. We examined HI prevalence and association with neuropsychiatric comorbidities in asylum seekers. METHODS A retrospective cross-sectional study was performed through review of 139 medical affidavits from an affidavit database. Affidavits written from 2010 to 2018 were included. Demographic and case-related data were collected and classified based on the presence of HI. For neuropsychiatric sequelae, the primary study outcome was headache and the secondary outcomes were depression, posttraumatic stress disorder, and anxiety. Multivariable logistic regression was performed to examine the association between HI and neuropsychiatric sequelae, adjusted for demographic and clinical characteristics. RESULTS A total of 139 medical affidavits of asylum seekers were included. The mean age was 27.4 ± 12.1 years, 56.8% were female, and 38.8% were <19 years. Almost half (42.5%) explicitly self-reported history of HI. Compared to clients who did not report HI, clients with HI were older and more likely to report a history of headache, physical abuse, physical trauma, concussion, and loss of consciousness. After adjustment for demographic and clinical characteristics, clients with HI had greater odds for neuropsychological sequelae such as headache (odds ratio [OR] 4.2, 95% confidence interval [CI] 2.0-8.7) and depression (OR 2.5, 95% CI 1.1-5.7). CONCLUSIONS We observed a high prevalence of HI in asylum seekers. Comprehensive screening for HI and neuropsychiatric comorbidities is encouraged when evaluating asylum seekers.
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Affiliation(s)
- Hannah S McMurry
- From the Division of Infectious Diseases and Immunology/Allergy (S.N.S.) and Clinical Translational Research Division (C.D.) and Headache Division (T.S.M.), Department of Neurology, University of Miami Miller School of Medicine (H.S.M., D.C.T., N.L., S.N.S., C.D., T.S.M.), FL
| | - Darren C Tsang
- From the Division of Infectious Diseases and Immunology/Allergy (S.N.S.) and Clinical Translational Research Division (C.D.) and Headache Division (T.S.M.), Department of Neurology, University of Miami Miller School of Medicine (H.S.M., D.C.T., N.L., S.N.S., C.D., T.S.M.), FL
| | - Nicole Lin
- From the Division of Infectious Diseases and Immunology/Allergy (S.N.S.) and Clinical Translational Research Division (C.D.) and Headache Division (T.S.M.), Department of Neurology, University of Miami Miller School of Medicine (H.S.M., D.C.T., N.L., S.N.S., C.D., T.S.M.), FL
| | - Stephen N Symes
- From the Division of Infectious Diseases and Immunology/Allergy (S.N.S.) and Clinical Translational Research Division (C.D.) and Headache Division (T.S.M.), Department of Neurology, University of Miami Miller School of Medicine (H.S.M., D.C.T., N.L., S.N.S., C.D., T.S.M.), FL
| | - Chuanhui Dong
- From the Division of Infectious Diseases and Immunology/Allergy (S.N.S.) and Clinical Translational Research Division (C.D.) and Headache Division (T.S.M.), Department of Neurology, University of Miami Miller School of Medicine (H.S.M., D.C.T., N.L., S.N.S., C.D., T.S.M.), FL
| | - Teshamae S Monteith
- From the Division of Infectious Diseases and Immunology/Allergy (S.N.S.) and Clinical Translational Research Division (C.D.) and Headache Division (T.S.M.), Department of Neurology, University of Miami Miller School of Medicine (H.S.M., D.C.T., N.L., S.N.S., C.D., T.S.M.), FL.
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Sandahl H, Vindbjerg E, Carlsson J. Treatment of sleep disturbances in refugees suffering from post-traumatic stress disorder. Transcult Psychiatry 2017; 54:806-823. [PMID: 29226795 DOI: 10.1177/1363461517746314] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sleep disturbances are often referred to as the hallmark of Post-Traumatic Stress Disorder (PTSD). Although PTSD is prevalent in refugees, studies on sleep disturbances in trauma-affected refugees are scarce. This article presents the results of two studies: a systematic review of the literature on treatment of sleep disturbances in adult trauma-affected refugees and a study of the role of sleep disturbances in the PTSD symptom structure. Study 1, the literature review, identified five studies on treatment of sleep disturbances: four studies were on pharmacological treatment and one study on music therapy. The identified studies had small sample sizes and few carried out statistical analysis. It was not possible from the available literature to recommend any specific treatment of sleep disturbances. In Study 2, a clinical sample of 752 refugees, fulfilling criteria for PTSD and enrolled in treatment at the Competence Centre for Transcultural Psychiatry, Denmark, completed the Harvard Trauma Questionnaire (HTQ) before and after treatment. To determine item discrimination, the data was tested with a Rasch model. 99.1% reported trouble sleeping and 98.7% reported recurrent nightmares. The Rasch analysis displayed fit residuals of 0.05 for trouble sleeping and -1.16 for nightmares, indicating sufficient discrimination. Trouble sleeping and nightmares proved important parts of the HTQ response structure. This study indicates that sleep disturbances are a prominent part of the PTSD symptom structure in refugees but that research on treatment of sleep disturbances is limited. Further research on sleep disturbances in trauma-affected refugees is therefore needed.
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Affiliation(s)
- Hinuga Sandahl
- Competence Centre for Transcultural Psychiatry, Mental Health Services in the Capital Region of Denmark, Denmark
| | - Erik Vindbjerg
- Competence Centre for Transcultural Psychiatry, Mental Health Services in the Capital Region of Denmark, Denmark
| | - Jessica Carlsson
- Competence Centre for Transcultural Psychiatry, Mental Health Services in the Capital Region of Denmark, Denmark
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8
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Durand E, Chevignard M, Ruet A, Dereix A, Jourdan C, Pradat-Diehl P. History of traumatic brain injury in prison populations: A systematic review. Ann Phys Rehabil Med 2017; 60:95-101. [PMID: 28359842 DOI: 10.1016/j.rehab.2017.02.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 02/28/2017] [Accepted: 02/28/2017] [Indexed: 11/19/2022]
Abstract
Traumatic brain injury (TBI) can lead to cognitive, behavioural and social impairments. The relationship between criminality and a history of TBI has been addressed on several occasions. OBJECTIVE The objective of this review was to present an update on current knowledge concerning the existence of a history of TBI in prison populations. METHODS PubMed and PsycINFO databases were searched for relevant papers, using the PRISMA guidelines. We selected papers describing TBI prevalence among incarcerated individuals and some that also discussed the validity of such studies. RESULTS Thirty-three papers were selected. The majority of the papers were on prison populations in Australia (3/33), Europe (5/33) and the USA (22/33). The selected studies found prevalence rates of the history of TBI ranging from 9.7% and 100%, with an average of 46% (calculated on a total population of 9342). However, the level of evidence provided by the literature was poor according to the French national health authority scale. The majority of the prisoners were males with an average age of 37. In most of the papers (25/33), prevalence was evaluated using a questionnaire. The influence of TBI severity on criminality could not be analysed because of a lack of data in the majority of papers. Twelve papers mentioned that several comorbidities (mental health problems, use of alcohol…) were frequently found among prisoners with a history of TBI. Two papers established the validity of the use of questionnaires to screen for a history of TBI. CONCLUSION These results confirmed the high prevalence of a history of TBI in prison populations. However, they do not allow conclusions to be drawn about a possible link between criminality and TBI. Specific surveys need to be performed to study this issue. The authors suggest ways of improving the screening and healthcare made available to these patients.
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Affiliation(s)
- E Durand
- CNRS UMR 7371, Inserm UMR S 1146, Laboratory of Biomedical Imaging (LIB), Sorbonne University, UPMC University, Paris 06, 75005 Paris, France; GRC-UPMC n(o) 18 Cognitive Handicap and Rehabilitation HanCRe, 75013 Paris, France.
| | - M Chevignard
- CNRS UMR 7371, Inserm UMR S 1146, Laboratory of Biomedical Imaging (LIB), Sorbonne University, UPMC University, Paris 06, 75005 Paris, France; GRC-UPMC n(o) 18 Cognitive Handicap and Rehabilitation HanCRe, 75013 Paris, France; Rehabilitation Unit for acquired neurological pathologies in children, Saint-Maurice Hospital, 94410 Saint-Maurice, France
| | - A Ruet
- Physical medicine and rehabilitation unit, Caen University Hospital, 14000 Caen, France
| | - A Dereix
- General Medicine Intern, 75012 Paris, France
| | - C Jourdan
- Physical Medicine and Rehabilitation Unit, Raymond-Poincaré University Hospital, AP-HP, 92380 Garches, France
| | - P Pradat-Diehl
- CNRS UMR 7371, Inserm UMR S 1146, Laboratory of Biomedical Imaging (LIB), Sorbonne University, UPMC University, Paris 06, 75005 Paris, France; GRC-UPMC n(o) 18 Cognitive Handicap and Rehabilitation HanCRe, 75013 Paris, France; Paris Resource Centre for Traumatic Brain Injury, Paris, France; Physical Medicine and Rehabilitation Unit, Pitié-Salpêtrière - Charles-Foix University Hospital, AP-HP, 75013 Paris, France
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Augusterfer EF, Mollica RF, Lavelle J. A review of telemental health in international and post-disaster settings. Int Rev Psychiatry 2016; 27:540-6. [PMID: 26576720 DOI: 10.3109/09540261.2015.1082985] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Telemental health (TMH) is an important component in meeting critical mental health needs of the global population. Mental health is an issue of global importance; an estimated 450 million people worldwide have mental or behavioural disorders, accounting for 12% of the World Health Organization's (WHO) global burden of disease. However, it is reported that 75% of people suffering from mental disorders in the Developing World receive no treatment or care. In this paper, the authors review global mental health needs with a focus on the use of TMH to meet mental health needs in international and post-disaster settings. Telemedicine and TMH have the capacity to bring evidence-based best practices in medicine and mental health to the under-served and difficult to reach areas of the world, including post-disaster settings. The authors will also report on the mental health impact of the Haiti 2010 earthquake and on the limited use of telemedicine in post-disaster Haiti. The paper will underscore the point that published papers on the use of TMH in post-disaster settings are lacking. Finally, the paper will review considerations before working in TMH in international and post-disaster settings.
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Affiliation(s)
| | - Richard F Mollica
- a Harvard Program in Refugee Trauma , Cambridge, Massachusetts , USA , and.,b Department of Psychiatry , Harvard Medical School , Cambridge, Massachusetts , USA
| | - James Lavelle
- a Harvard Program in Refugee Trauma , Cambridge, Massachusetts , USA , and
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10
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Head injury in asylum seekers and refugees referred with psychological trauma. Glob Ment Health (Camb) 2016; 3:e28. [PMID: 28596896 PMCID: PMC5454765 DOI: 10.1017/gmh.2016.23] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 07/20/2016] [Accepted: 07/25/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Individuals who seek asylum are frequently fleeing violent persecution and may experience head injury (HI). However, little is known about the prevalence of HI in asylum seekers and refugees (ASR) despite the potential for HI to significantly affect cognitive and emotional functioning and to compromise asylum outcomes. This preliminary study investigates the prevalence of HI in ASR referred to a complex psychological trauma service. METHOD Participants were 115 adult ASR referred to a community psychological trauma service with moderate to severe mental health problems associated with psychological trauma. They were screened for a history of HI using a questionnaire developed for the study. Interpreters were used when required. RESULTS The overall prevalence of HI was 51%. At least 38% of those with HI had a moderate-severe HI that could cause persisting disability. In 53% of those with HI, the cause was torture, human trafficking or domestic violence. Repeat HI can have cumulative effects on function; it was common, and was reported in 68% of those with HI. An injury to the head was not known to mental health clinicians prior to screening in 64% of cases. CONCLUSION The emotional and cognitive consequences of HI in ASR may increase the vulnerability of this disadvantaged group, and can be associated with neurobehavioural problems affecting daily life and may compromise asylum outcomes. Routine screening for HI in ASR is needed, as are links to neuropsychology and brain injury services for advice, assessment and intervention.
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11
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Kim SY, Shen Y, Hou Y, Tilton KE, Juang L, Wang Y. Annual Review of Asian American Psychology, 2014. ASIAN AMERICAN JOURNAL OF PSYCHOLOGY 2015; 6:291-332. [PMID: 26925199 PMCID: PMC4765738 DOI: 10.1037/aap0000031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
This 2014 review of Asian American psychology is the sixth review in the series. It includes 316 articles that met the inclusion criteria established by the past five annual reviews. Featured articles were derived from three sources: 137 were generated via the search term "Asian American" in PyscINFO, 111 were generated via a search for specific Asian American ethnic groups, and 32 were generated via author searches of articles that met the inclusion criteria. The top primary topic was health and health-related behaviors, the most frequently employed study design was cross-sectional, and the most studied Asian American ethnic group was Chinese. This year's review includes information on the target population of the primary topic, the age range and developmental period of participants, and whether the study design was cross-sectional or longitudinal. It also identifies top authors and journals contributing to the 2014 annual review. These new features reveal that the most common target population of the primary topic was youths; studies most commonly included emerging adults ages 18-25; cross-sectional study design was employed more often than longitudinal design; the top contributor to the 2014 review was Stephen Chen, who authored the highest number of papers included; and the Asian American Journal of Psychology generated the highest number of publications for this review.
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Affiliation(s)
- Su Yeong Kim
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 471-5524
| | - Yishan Shen
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 983-7551
| | - Yang Hou
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 660-2236
| | - Kelsey E Tilton
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 956-459-4212
| | - Linda Juang
- University of Potsdam, College of Human Sciences, Education, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany, +49 (0)172 1882255,
| | - Yijie Wang
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 289-8136
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Nordbrandt MS, Carlsson J, Lindberg LG, Sandahl H, Mortensen EL. Treatment of traumatised refugees with basic body awareness therapy versus mixed physical activity as add-on treatment: Study protocol of a randomised controlled trial. Trials 2015; 16:477. [PMID: 26492879 PMCID: PMC4619210 DOI: 10.1186/s13063-015-0974-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 09/23/2015] [Indexed: 11/23/2022] Open
Abstract
Background Treatment of traumatised refugees is one of the fields within psychiatry, which has received little scientific attention. Evidence based treatment and knowledge on the efficiency of the treatment for this complex patient group is therefore scarce. This leads to uncertainty as to which treatment should be offered and potentially lowers the quality of life for the patients. Chronic pain is very common among traumatised refugees and it is believed to maintain the mental symptoms of trauma. Hence, treating chronic pain is believed to be of high clinical value for this patient group. In clinical studies, physical activity has shown a positive effect on psychiatric illnesses such as depression and anxiety and for patients with chronic pain. However, scientific knowledge about physical activity as part of the treatment for traumatised refugees is very limited and no guidelines exist on this topic. Methods/design This study will include approximately 310 patients, randomised into three groups. All three groups receive psychiatric treatment as usual for the duration of 6–7 months, consisting of consultations with a medical doctor including pharmacological treatment and manual-based Cognitive Behavioural Therapy. The first group only receives treatment as usual while the second and the third groups receive either Basic-Body Awareness Therapy or mixed physical activity as add-on treatments. Each physical activity is provided for an individual 1-hour consultation per week, for the duration of 20 weeks. The study is being conducted at the Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup in the Capital Region of Denmark. The primary endpoint of the study is symptoms of Post Traumatic Stress Disorder; the secondary endpoints are depression and anxiety as well as quality of life, functional capacity, coping with pain, body awareness and physical fitness. Discussion This study will examine the effect of physical activity for traumatised refugees. This has not yet been done in a randomised controlled setting on such a large scale before. Hereby the study will contribute to important knowledge that is expected to be used in future clinical guidelines and reference programs. Trial registration ClinicalTrials.gov NCT01955538. Date of registration: 18 September 2013. Electronic supplementary material The online version of this article (doi:10.1186/s13063-015-0974-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maja Sticker Nordbrandt
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Maglevænget 2, 2750, Ballerup, Denmark.
| | - Jessica Carlsson
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Maglevænget 2, 2750, Ballerup, Denmark.
| | - Laura Glahder Lindberg
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Maglevænget 2, 2750, Ballerup, Denmark.
| | - Hinuga Sandahl
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Maglevænget 2, 2750, Ballerup, Denmark.
| | - Erik Lykke Mortensen
- Section of Occupational and Environmental Health, Øster Farimagsgade 5, building 5, 1., 1353, København K, Denmark.
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Abstract
Violence has been shown to be a global challenge resulting in long-lasting social, medical, and mental health sequelae. In this article, we focus on massive social violence, such as war and civil war. Social suffering and mental health problems related to violence as a global public health problem can be tackled only with a holistic approach that addresses the specific region, culture and group and the limited resources available in most countries. Research that can give a reliable assessment of complex long-term outcomes is still largely missing, and can be seen as a major and complex challenge for future study.
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Affiliation(s)
- Thomas Wenzel
- Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Waehringer Guertel 18, Vienna A-1090, Austria.
| | - Hanna Kienzler
- Department of Social Science, Health and Medicine, King's College London, Strand, London WC2R 2LS, UK
| | - Andreas Wollmann
- Sigmund Freud University, Schnirchgasse 3A, Vienna A-1030, Austria
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