Abstract
Most research on refugee mental health has focused on posttraumatic stress disorder (PTSD). Besides PTSD, however, traumatised refugees are often burdened by comorbid somatic and psychiatric conditions, as well as postmigration living difficulties (PMLD). It is unclear how these conditions interfere with presentation and treatment of PTSD. This preliminary cross-sectional study investigated 134 severely traumatised refugees and asylum seekers in treatment in two psychiatric outpatient units in Switzerland. Trauma exposure, PMLD, somatisation and explosive anger were assessed and related to symptom severity of PTSD using correlation and regression analyses. PTSD symptoms were significantly related to somatisation, anger, PMLD and trauma exposure. Regression analysis revealed that PTSD symptoms were mainly predicted by somatisation and anger. Symptom severity of PTSD is associated with somatisation, explosive anger and, to a lesser extent, PMLD. Standard PTSD treatment may benefit from implementing targeted strategies to assess and address these factors in traumatised refugees.
Highlights
The many wars and armed conflicts of recent years, often targeting civilian populations, have led to a dramatic increase in the numbers of internally displaced persons and refugees worldwide [1]
The analysis showed significant correlations between posttraumatic stress disorder (PTSD) symptoms and somatisation, anger, postmigration living difficulties (PMLD) and trauma exposure
As well as previous research, demonstrates that traumatised refugees are often heavily burdened by a complex array of comorbid physical and psychological conditions resulting from pre- and postmigration experiences
Summary
The many wars and armed conflicts of recent years, often targeting civilian populations, have led to a dramatic increase in the numbers of internally displaced persons and refugees worldwide [1]. Besides symptom severity and chronicity of PTSD, comorbid psychiatric disorders, high anger scores and physical health problems have been associated with poorer treatment response in non-refugee groups [10,11,12,13,14,15,16,17]. Dysregulated anger is highly correlated with physical health problems, most notably coronary heart disease. It is associated with elevated risks of relationship problems including family impairment, aggressive interpersonal behaviour, workplace and employment difficulties, property damage and traffic injuries, as well as elevated risk of criminal acts (for overview see reference [25]). Several studies found anger to negatively predict PTSD treatment outcome in trauma survivors [12, 13, 26], and standard PTSD treatment appears
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