Late Mental Health Changes in Tortured Refugees in Multidisciplinary Treatment

Abstract

The aim of this study was to examine long-term changes in symptoms of post-traumatic stress disorder, depression, anxiety, and in health-related quality of life in traumatized refugees 23 months after admission to multidisciplinary treatment. The study group comprised 45 persons admitted to the Rehabilitation and Research Centre for Torture Victims in 2001 to 2002. Data on background, trauma, present social situation, mental symptoms (Hopkins Symptom Checklist-25, Hamilton Depression Scale, Harvard Trauma Questionnaire), and on health-related quality of life (World Health Organization Quality of Life-Bref) were collected before treatment and after 9 and 23 months. No substantial changes in mental health were observed at the 9-month follow-up, and the minor decrease in some symptoms observed between the 9 and 23 months may reflect regression toward the mean or the natural course of symptoms in this cohort. Thus, no clinically significant improvement was observed, but there is a need for further studies, in particular randomized trials evaluating the efficacy of various health-related and social interventions among severely traumatized refugees.

Multidisciplinary treatment for traumatized refugees in a naturalistic setting: symptom courses and predictors

“…It is well-known that specialized treatment centres often admit treatment-resistant refugees with higher symptom severity (Drozdek, 2015). In fact, the mean scale score of the investigated sample is comparable to those of other intervention studies on traumatized refugees in specialized treatment centres in terms of symptoms of depression, anxiety and PTSD (Carlsson et al, 2010; Neuner et al, 2010; Schock, Bottche, Rosner, Wenk-Ansohn, & Knaevelsrud, 2016). Thus, the results of the current study should be interpreted against this background.…”

“…To our knowledge only one multidisciplinary treatment study analysed changes in quality of life and found improvements only in the environmental scores from pre- to 9-months assessment (Carlsson et al, 2010). Also in other types of intervention studies, quality of life was rarely investigated and yielded inconsistent results (Buhmann et al, 2015; Ter Heide, Mooren, Kleijn, de Jongh, & Kleber, 2011).…”

“…Furthermore, high symptom loads after treatment were found in different studies including traumatized refugees (e.g. Buhmann et al, 2015; Carlsson et al, 2010; Neuner et al, 2010), suggesting that even after successful treatment, many patients still meet diagnostic criteria for trauma-related disorders and might still need low-threshold treatment options after therapy. To meet this need and to prevent strong and/or long-lasting symptom relapses (e.g.…”

“…Another multimodal intervention conducted at a specialized treatment centre for refugees in Denmark with refugees from various backgrounds showed no significant symptom changes after an average of nine months treatment (Carlsson, Mortensen, & Kastrup, 2005). After an average of 23 months treatment (Carlsson, Olsen, Kastrup, & Mortensen, 2010), symptoms of PTSD, depression and anxiety decreased significantly from baseline to follow-up, while quality of life did not change significantly. However, the effect sizes of treatment effects were rather low.…”

An evaluation of combined narrative exposure therapy and physiotherapy for comorbid PTSD and chronic pain in torture survivors

“…No treatment effect was found for PTSD, depression or quality of life. At the 23-month follow-up, Carlsson et al 18 found that approximately 1/3 of the participants reported reliable symptom improvement as measured by self-report.…”