Some of the most important factors in producing psychological morbidity in refugees may be alleviated by planned, integrated rehabilitation programmes and attention to social support and family reunion.

The case notes documenting the psychological well-being of 100 survivors of torture and other forms of organised state violence were analysed retrospectively. The most common diagnoses were post-traumatic stress disorder (PTSD), major depression, and somatoform disorders. Of these, PTSD showed the strongest association with experience of torture. It is possible that PTSD has a dimensional nature, and that reactions to different stressors are heterogeneous.

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Torture is one of the most important preventable causes of psychological morbidity. Amnesty International (1987) has reported the use of “brutal torture and ill-treatment” in over 90 countries in the 1980s. In some countries torture has been applied on such a widespread scale and in such an arbitrary manner that whole populations are affected. In Kampuchea under the Pol Pot regime, for example, genocide and torture took place on a massive scale; indeed, merely wearing spectacles became for many a capital offence (Amnesty International, 1983). Similar reports abound from many other countries and regions.

Sixty patients, with a history of torture or other repressive state violence, newly referred to two psychiatrists, were assessed using a standard instrument. Thirty one met the diagnostic criteria for posttraumatic stress disorder (PTSD) and 21 met the criteria for MDD. Relationships between these diagnoses and history of trauma, loss of health, and social losses were investigated. Sexual torture is associated with an avoidance reaction.