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Kohut AO, Chaban OS, Dolynskyi RG, Sandal OS, Bursa AI, Bobryk MI, Vertel AV. THE FEATURES OF POSTTRAUMATIC STRESS DISORDER DEVELOPMENT IN PATIENTS WITH DIABETES MELLITUS 2 TYPE. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:1903-1907. [PMID: 36089877 DOI: 10.36740/wlek202208115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim: The revealing of the development of stress-related disorders in patients with type 2 diabetes mellitus (DM 2) to: identify the prevalence of stress-related disorders, particularly, posttraumatic stress disorder (PTSD); study the influence of psychosocial factors on the occurrence and course of stress-related disorders and increase the effectiveness of treatment in DM 2. PATIENTS AND METHODS Materials and methods: Research papers have been found by searching the PubMed database using the keywords ``ptsd and diabetes 2 type" with the result of 74 studies. Totally 25 of selected publications were analysed based on our criteria about the mechanisms through which the influence of psychosocial factors, permanent stressful or traumatic events on the probable risk of PTSD development and their analysis and relationships for the improvement of treatment effectiveness in DM 2 patients who have not been the veterans. CONCLUSION Conclusions: Given the complex neurophysiological relationships between the long-term stress and pathophysiological mechanisms of DM 2 - this group of patients has the higher risk of developing stress-related disorders, including PTSD.
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Affiliation(s)
- Anna O Kohut
- BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE
| | - Oleg S Chaban
- BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE
| | | | - Olha S Sandal
- KOSTIUK INSTITUTE OF PSYCHOLOGY OF NATIONAL ACADEMY OF EDUCATIONAL SCIENCES OF UKRAINE, KYIV, UKRAINE
| | | | | | - Anton V Vertel
- SUMY STATE PEDAGOGICAL UNIVERSITY NAMED AFTER A.S. MAKARENKO, SUMY, UKRAINE
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Opaas M, Wentzel-Larsen T, Varvin S. The 10-year course of mental health, quality of life, and exile life functioning in traumatized refugees from treatment start. PLoS One 2020; 15:e0244730. [PMID: 33382807 PMCID: PMC7775068 DOI: 10.1371/journal.pone.0244730] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 12/15/2020] [Indexed: 11/19/2022] Open
Abstract
Refugee patients with severe traumatic experiences may need mental health treatment, but treatment results vary, and there is scarcity of studies demonstrating refugees' long-term health and well-being after treatment. In a 10-year naturalistic and longitudinal study, 54 multi-origin traumatized adult refugee patients, with a background of war and persecution, and with a mean stay in Norway of 10.5 years, were recruited as they entered psychological treatment in mental health specialist services. The participants were interviewed face-to-face with multiple methods at admittance, and at varying points in time during and after psychotherapy. The aim was to study the participants' trajectories of symptoms of post-traumatic stress, anxiety and depression, four aspects of quality of life, and two aspects of exile life functioning. Linear mixed effects analyses included all symptoms and quality of life measures obtained at different times and intervals for the participants. Changes in exile life functioning was investigated by exact McNemar tests. Participants responded to the quantitative assessments up to eight times. Length of therapy varied, with a mean of 61.3 sessions (SD = 74.5). The participants improved significantly in symptoms, quality of life, and exile life functioning. Improvement in symptoms of posttraumatic stress, anxiety, and depression yielded small effect sizes (r = .05 to .13), while improvement in quality of psychological and physical health yielded medium effect sizes (r = .38 and .32). Thus, long-time improvement after psychological therapy in these severely traumatized and mostly chronified refugee patients, was more notable in quality of life and exile life functioning than in symptom reduction. The results imply that major symptom reduction may not be attainable, and may not be the most important indication of long-term improvement among refugees with long-standing trauma-related suffering. Other indications of beneficial effects should be applied as well.
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Affiliation(s)
- Marianne Opaas
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
| | - Tore Wentzel-Larsen
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
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Falck L, Zoller M, Rosemann T, Martínez-González NA, Chmiel C. Toward Standardized Monitoring of Patients With Chronic Diseases in Primary Care Using Electronic Medical Records: Systematic Review. JMIR Med Inform 2019; 7:e10879. [PMID: 31127717 PMCID: PMC6555125 DOI: 10.2196/10879] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 03/20/2019] [Accepted: 04/07/2019] [Indexed: 12/21/2022] Open
Abstract
Background Long-term care for patients with chronic diseases poses a huge challenge in primary care. In particular, there is a deficit regarding monitoring and structured follow-up. Appropriate electronic medical records (EMRs) could help improving this but, so far, there are no evidence-based specifications concerning the indicators that should be monitored at regular intervals. Objective The aim was to identify and collect a set of evidence-based indicators that could be used for monitoring chronic conditions at regular intervals in primary care using EMRs. Methods We searched MEDLINE (Ovid), Embase (Elsevier), the Cochrane Library (Wiley), the reference lists of included studies and relevant reviews, and the content of clinical guidelines. We included primary studies and guidelines reporting about indicators that allow for the assessment of care and help monitor the status and process of disease for five chronic conditions, including type 2 diabetes mellitus, asthma, arterial hypertension, chronic heart failure, and osteoarthritis. Results The use of the term “monitoring” in terms of disease management and long-term care for patients with chronic diseases is not widely used in the literature. Nevertheless, we identified a substantial number of disease-specific indicators that can be used for routine monitoring of chronic diseases in primary care by means of EMRs. Conclusions To our knowledge, this is the first systematic review summarizing the existing scientific evidence on the standardized long-term monitoring of chronic diseases using EMRs. In a second step, our extensive set of indicators will serve as a generic template for evaluating their usability by means of an adapted Delphi procedure. In a third step, the indicators will be summarized into a user-friendly EMR layout.
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Affiliation(s)
- Leandra Falck
- Institute of Primary Care, University of Zurich and University Hospital of Zurich, Zurich, Switzerland
| | - Marco Zoller
- Institute of Primary Care, University of Zurich and University Hospital of Zurich, Zurich, Switzerland
| | - Thomas Rosemann
- Institute of Primary Care, University of Zurich and University Hospital of Zurich, Zurich, Switzerland
| | | | - Corinne Chmiel
- Institute of Primary Care, University of Zurich and University Hospital of Zurich, Zurich, Switzerland
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Giacco D, Priebe S. Mental health care for adult refugees in high-income countries. Epidemiol Psychiatr Sci 2018; 27:109-116. [PMID: 29067899 PMCID: PMC6998959 DOI: 10.1017/s2045796017000609] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 09/24/2017] [Indexed: 01/18/2023] Open
Abstract
Approximately one-third of people who have obtained refugee status live in high-income countries. Over recent years, the number of refugees has been increasing, and there are questions on how many of them need mental health care and which type of interventions are beneficial. Meta-analyses showed highly variable rates of mental disorders in adult refugees. This variability is likely to reflect both real differences between groups and contexts, and methodological inconsistencies across studies. Overall prevalence rates after resettlement are similar to those in host populations. Only post-traumatic stress disorder (PTSD) is more prevalent in refugees. In long-term resettled refugees, rates of anxiety and depressive disorders are higher and linked to poor social integration. Research on mental health care for refugees in high-income countries has been extensive, but often of limited methodological quality and with very context-specific findings. The existing evidence suggests several general principles of good practice: promoting social integration, overcoming barriers to care, facilitating engagement with treatment and, when required, providing specific psychological treatments to deal with traumatic memories. With respect to the treatment of defined disorders, only for the treatment of PTSD there has been substantial refugee-specific research. For other diagnostic categories, the same treatment guidelines apply as to other groups. More systematic research is required to explore how precisely the general principles can be specified and implemented for different groups of refugees and in different societal contexts in host countries, and which specific interventions are beneficial and cost-effective. Such interventions may utilise new communication technologies. Of particular importance are long-term studies to identify when mental health interventions are appropriate and to assess outcomes over several years. Such research would benefit from sufficient funding, wide international collaboration and continuous learning over time and across different refugee groups.
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Affiliation(s)
- D. Giacco
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Service Development), Queen Mary University of London, London, UK
| | - S. Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Service Development), Queen Mary University of London, London, UK
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Silbermann M, Daher M, Kebudi R, Nimri O, Al-Jadiry M, Baider L. Middle Eastern Conflicts: Implications for Refugee Health in the European Union and Middle Eastern Host Countries. J Glob Oncol 2016; 2:422-430. [PMID: 28717729 PMCID: PMC5493250 DOI: 10.1200/jgo.2016.005173] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Until very recently, health care in conflict settings was based on a model developed in the second half of the twentieth century. Things have changed, and present civil wars, such as those that are currently taking place in the Middle East, do not address the complexity of the ongoing armed conflicts in countries such as Syria, Iraq, and Afghanistan. These conflicts have caused a significant increase in the number of refugees in the region, as well as in Europe. Hundreds of thousands of refugees succeed in settling in mid- and north-European countries, and their health issues are becoming of great importance. Refugees in Europe in the twenty-first century do not suffer so much from infectious diseases but more from noninfectious chronic diseases such as diabetes, cardiac disease, and cancer. These facts profoundly alter the demographics and disease burden of hostility-derived migrants. Thus, host European countries face situations they have never faced before. Hence, new approaches and strategies are urgently needed to cope with this new situation. The efforts to absorb refugees of different traditions and cultural backgrounds often cause increasing ethnic and religious tensions, which frequently escort the emergence of social violence. To date, little attention has been paid to the overall load of distress being experienced, especially among the first-generation refugees. The current ongoing hostilities in the Middle East induce a long-term health impact on people expelled from their homes, communities, traditions, and cultural environment. The realization of collective suffering forces communities and governmental health agencies to develop new programs that include social determinants to overcome the severe cultural gaps of the newcomers in their new European host countries.
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Affiliation(s)
- Michael Silbermann
- , Technion-Israel Institute of Technology, Middle East Cancer Consortium, Haifa; , Assuta Medical Center, Tel Aviv, Israel; , University of Balamand, Saint George Hospital, Beirut, Lebanon; , Oncology Institute, Istanbul, Turkey; , Ministry of Health, Amman, Jordan; and , Children's Welfare Teaching Hospital, Medical City, Baghdad, Iraq
| | - Michel Daher
- , Technion-Israel Institute of Technology, Middle East Cancer Consortium, Haifa; , Assuta Medical Center, Tel Aviv, Israel; , University of Balamand, Saint George Hospital, Beirut, Lebanon; , Oncology Institute, Istanbul, Turkey; , Ministry of Health, Amman, Jordan; and , Children's Welfare Teaching Hospital, Medical City, Baghdad, Iraq
| | - Rejin Kebudi
- , Technion-Israel Institute of Technology, Middle East Cancer Consortium, Haifa; , Assuta Medical Center, Tel Aviv, Israel; , University of Balamand, Saint George Hospital, Beirut, Lebanon; , Oncology Institute, Istanbul, Turkey; , Ministry of Health, Amman, Jordan; and , Children's Welfare Teaching Hospital, Medical City, Baghdad, Iraq
| | - Omar Nimri
- , Technion-Israel Institute of Technology, Middle East Cancer Consortium, Haifa; , Assuta Medical Center, Tel Aviv, Israel; , University of Balamand, Saint George Hospital, Beirut, Lebanon; , Oncology Institute, Istanbul, Turkey; , Ministry of Health, Amman, Jordan; and , Children's Welfare Teaching Hospital, Medical City, Baghdad, Iraq
| | - Mazin Al-Jadiry
- , Technion-Israel Institute of Technology, Middle East Cancer Consortium, Haifa; , Assuta Medical Center, Tel Aviv, Israel; , University of Balamand, Saint George Hospital, Beirut, Lebanon; , Oncology Institute, Istanbul, Turkey; , Ministry of Health, Amman, Jordan; and , Children's Welfare Teaching Hospital, Medical City, Baghdad, Iraq
| | - Lea Baider
- , Technion-Israel Institute of Technology, Middle East Cancer Consortium, Haifa; , Assuta Medical Center, Tel Aviv, Israel; , University of Balamand, Saint George Hospital, Beirut, Lebanon; , Oncology Institute, Istanbul, Turkey; , Ministry of Health, Amman, Jordan; and , Children's Welfare Teaching Hospital, Medical City, Baghdad, Iraq
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Schick M, Zumwald A, Knöpfli B, Nickerson A, Bryant RA, Schnyder U, Müller J, Morina N. Challenging future, challenging past: the relationship of social integration and psychological impairment in traumatized refugees. Eur J Psychotraumatol 2016; 7:28057. [PMID: 26886484 PMCID: PMC4756625 DOI: 10.3402/ejpt.v7.28057] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 12/28/2015] [Accepted: 12/28/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Refugees have been shown to present high prevalence rates of trauma-related mental disorders. Despite their psychological impairment, they are expected to meet high functional requirements in terms of social integration into, and financial independence from, the host society. METHODS This cross-sectional study examined the relationship of mental health problems, post-migration living difficulties (PMLD), and social integration in a sample of 104 refugees seeking treatment for severe posttraumatic stress and comorbid symptoms in two outpatient clinics in Switzerland. RESULTS Despite an average time of residence in Switzerland of over 10 years, participants showed poor integration and a high number of PMLD. Integration difficulties were closely associated with psychological symptoms, but not with socio-demographic parameters such as education or visa status. CONCLUSIONS Psychological impairment in treatment-seeking traumatized refugees is associated with poor integration. To foster social integration, it is crucial to better understand and address the specific needs of this highly vulnerable population.
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Affiliation(s)
- Matthis Schick
- Department of Psychiatry and Psychotherapy, University Hospital Zürich, Zürich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland;
| | - Andre Zumwald
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Outpatient Clinic for Victims of Torture and War, Swiss Red Cross, Bern, Switzerland
| | - Bina Knöpfli
- Department of Psychology, University of Bern, Bern, Switzerland
| | - Angela Nickerson
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Ulrich Schnyder
- Department of Psychiatry and Psychotherapy, University Hospital Zürich, Zürich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Julia Müller
- Psychiatric Services Thurgau, Münsterlingen, Switzerland
| | - Naser Morina
- Department of Psychiatry and Psychotherapy, University Hospital Zürich, Zürich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
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Schick M, Schönbucher V, Landolt MA, Schnyder U, Xu W, Maier T, Mohler-Kuo M. Child Maltreatment and Migration: A Population-Based Study Among Immigrant and Native Adolescents in Switzerland. CHILD MALTREATMENT 2016; 21:3-15. [PMID: 26590238 DOI: 10.1177/1077559515617019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Prevalence rates of child maltreatment (CM) can differ substantially between countries and ethnicities. Reasons, however, are complex and not sufficiently understood. METHOD This epidemiological study examined prevalence and risk factors of various types of CM in a population-based representative sample of native and immigrant adolescents in Switzerland (N = 6,787). RESULTS The prevalence of CM in general was lowest in the native group, higher in the Western immigrant group, and highest in the non-Western immigrant groups. An immigrant background was related to an overrepresentation of several risk factors for CM. Adjusted odds ratio of an immigrant background were still significant for physical and emotional abuse but not for neglect and sexual assault. CONCLUSIONS Differences in the prevalence of CM across ethnographic origins are at least partially related to socioeconomic and ecologic risk factors. The distribution of risk factors may vary depending on the contexts of migration.
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Affiliation(s)
- Matthis Schick
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Zürich, Switzerland
| | - Verena Schönbucher
- Psychiatric Services of the Canton of St. Gallen-North, Wil, Switzerland
| | - Markus A Landolt
- Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zürich, Switzerland Division of Child and Adolescent Health Psychology, Institute of Psychology, University of Zurich, Zürich, Switzerland
| | - Ulrich Schnyder
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Zürich, Switzerland
| | - Wenjie Xu
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zürich, Switzerland
| | - Thomas Maier
- Psychiatric Services of the Canton of St. Gallen-North, Wil, Switzerland These authors contributed equally to this publication
| | - Meichun Mohler-Kuo
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zürich, Switzerland These authors contributed equally to this publication
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