Psychological, social and welfare interventions for psychological health and well-being of torture survivors

Patel, Nimisha; Këllezi, Blerina; Williams, Amanda

doi:10.1002/14651858.cd009317

Cited by 16 publications

(19 citation statements)

References 22 publications

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“…In addition, the authors called for studies of more homogeneous patient populations. While research on other groups of PTSD patients has burgeoned since, intervention studies concerning trauma-affected refugees are still limited in number and quality, and the vast majority are on psychological interventions only [12, 13]. …”

Section: Introductionmentioning

confidence: 99%

Treatment of trauma-affected refugees with venlafaxine versus sertraline combined with psychotherapy - a randomised study

et al. 2016

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BackgroundThe prevalence of trauma-related psychiatric disorders is high among refugees. Despite this, little is known about the effect of pharmacological treatment for this patient group. The objective of the present study was therefore to examine differences in the effects of venlafaxine and sertraline on Post-Traumatic Stress Disorder (PTSD), depression and functional impairment in trauma-affected refugees.MethodsThe study was a randomised pragmatic trial comparing venlafaxine and sertraline in combination with psychotherapy and social counselling. PTSD symptoms were measured on the Harvard Trauma Questionnaire – part IV, which was the primary outcome measure. Other outcome measures included: Hopkins Symptom Check List-25 (depression and anxiety), Social Adjustment Scale – short version (social functioning), WHO-5 Well-being Index (quality of life), Crisis Support Scale (support from social network), Sheehan Disability Scale (disability in three areas of functioning), Hamilton Depression and Anxiety scale, the somatisation items of the Symptoms Checklist-90, Global Assessment of Functioning scales and the summarised score of pain in four body areas rated on visual analogue scales.ResultsTwo hundred seven adult refugee patients were included in the trial (98 in the venlafaxine and 109 in the sertraline group). Of these, 195 patients were eligible for intention-to-treat analyses. Small but significant pre-treatment to post-treatment differences were found on the Harvard Trauma Questionnaire and a number of other ratings in both groups. On the primary outcome measure, no difference was found in treatment effect between the sertraline and venlafaxine group. A significant group difference was found in favour of sertraline on the Sheehan Disability Scale.ConclusionSertraline had a slightly better outcome than venlafaxine on some of the secondary outcome measures, but not on the primary outcome measure. Furthermore, a higher percentage of dropouts was found in the venlafaxine group compared to the sertraline group. Although this could indicate that sertraline was better tolerated, which is supported by other studies, a final conclusion on tolerability cannot be drawn from the current study due to lack of systematic reporting of side effects.Trial RegistrationClinicalTrials.gov NCT01569685. Registration date: 28/2/12Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-1081-5) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Treatment of trauma-affected refugees with venlafaxine versus sertraline combined with psychotherapy - a randomised study

et al. 2016

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“…What the clinician assessing and treating pain needs to appreciate is that the field of post-traumatic stress is subject to strongly held beliefs, with some vested interests propagating particular treatment models [66], without either evidence for their superiority in general [67] or their suitability for torture survivors and military veterans. A systematic review and meta-analysis [67] found no immediate treatment effects of psychological treatments in nine randomised controlled trials on post-traumatic symptoms, general distress, or quality of life in torture survivors, and only very weak effects on post-traumatic symptoms and distress at follow-up.…”

Section: Psychological Statementioning

confidence: 99%

“…A systematic review and meta-analysis [67] found no immediate treatment effects of psychological treatments in nine randomised controlled trials on post-traumatic symptoms, general distress, or quality of life in torture survivors, and only very weak effects on post-traumatic symptoms and distress at follow-up. The trials were mostly of narrative exposure therapy, currently the dominant model and subject to critical commentary [67, 68, 69•].…”

Section: Psychological Statementioning

confidence: 99%

Special Considerations for the Treatment of Pain from Torture and War

Williams

Baird

2016

Curr Anesthesiol Rep

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Pain care for survivors of torture and of war shows similarities and marked differences. For both, pain can be complex with unfamiliar presentations and the pains hard to assign to known disorders. For many survivors, pain and associated disability are overshadowed by psychological distress, often by post-traumatic stress symptoms that can be frightening and isolating. Pain medicine in war can exemplify best techniques and organisation, reducing suffering, but many military veterans have persistent pain that undermines their readjustment. By contrast, survivors of torture rarely have any acute health care; their risk for developing chronic pain is high. Even when settled as refugees in a well-resourced country, their access to healthcare may be restricted. Recent evidence is reviewed that informs assessment and treatment of pain in both groups, with the broader context of psychological distress addressed at the end. Clinical and research implications are briefly outlined.

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“…Für Folteropfer, die eine weitere Subgruppe komplex traumatisierter Menschen darstellen, kommen Patel et al (2014) in einem Cochrane-Review von 9 kontrollierten und randomisierten Studien zu der Aussage, dass eine vergleichsweise schlechte und hinsichtlich der genutzten Methoden und Verfahren inhomogene Datenlage vorliegt. Zumindest in den Follow-up-Messungen nach 6 Monaten lassen sich für 3 berücksichtigte Studien zur narrativen Expositionstherapie und für eine Studie zur kognitiven Verhaltenstherapie mittlere Effektstärken in der Reduktion von PTBS-Symptomen (0,52) zeigen.…”

Section: Kriterien/symptome Erläuterungenunclassified

Konzept der komplexen posttraumatischen Belastungsstörung

Freyberger

Terock

2016

Psychotherapeut

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Psychological, social and welfare interventions for psychological health and well-being of torture survivors

Abstract: Johnson 2008 Johnson H, Thompson A. The development and maintenance of post-traumatic stress disorder (PTSD) in civilian adult survivors of war trauma and torture: a review.

Cited by 16 publications

References 22 publications

Treatment of trauma-affected refugees with venlafaxine versus sertraline combined with psychotherapy - a randomised study

Treatment of trauma-affected refugees with venlafaxine versus sertraline combined with psychotherapy - a randomised study

Special Considerations for the Treatment of Pain from Torture and War

Konzept der komplexen posttraumatischen Belastungsstörung

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