Guidelines for Psychiatric Care of Torture Survivors

Year Published:

Abstract

Refugees and asylum seekers who are torture survivors have a high risk of psychiatric disorders. A great deal is known about the biology of these disorders and their treatments. Psychotropic medications can provide rapid improvement in symptoms and therefore need to be initiated early in treatment. All survivors who have positive symptoms should have a full psychiatric evaluation including current history, past psychosocial history, medical history, mental status examination, and a 5-axis diagnosis. There is very strong evidence that associated depression of torture victims may be effectively treated by antidepressant medication. There is good evidence that nightmares and sleep disturbance may be relieved by adrenergic blocking agents, such as clonidine and prazosin. There is some evidence that low doses of an antipsychotic medication, such as risperidone, helps agitation and irritability. There is no evidence that medication can help avoidance and numbing symptoms or prevent exacerbations of symptoms after new trauma.

Citation

Relevant Evidence Summaries

The evidence was reviewed and included in the following summaries: 

What works to improve mental health of refugee children and adults?

There is very strong evidence that numerous interventions are effective in improving the mental health of child and adult refugees. Specifically, cognitive behavioral therapy (CBT), trauma-focused interventions (TF), and psycho-education (PE) have been shown to improve symptoms related to anxiety, depression, post-traumatic stress disorder, and/or general distress in refugee populations. Furthermore, cultural adaptations of these…

About this study

AGE: Multiple Age Groups

DIRECTION OF EVIDENCE: Inconclusive or mixed impact

DIRECTION OF EVIDENCE: Positive impact

FULL TEXT AVAILABILITY: Free

HOST COUNTRY: Multiple countries

HOST COUNTRY INCOME: High Income

HOST COUNTRY INCOME: Upper Middle Income

INTERVENTION DURATION: Varies by study

INTERVENTION: Mental health and psychosocial support services

OUTCOME AREA: Anxiety Reduction

OUTCOME AREA: Depression Reduction

OUTCOME AREA: Post-traumatic Stress Disorder (PTSD) Reduction

POPULATION: Unaccompanied Minors

REGION OF ORIGIN OF PARTICIPANT(S): Multiple Regions

STRENGTH OF EVIDENCE: Strong

TYPE OF STUDY: Systematic review

YEAR PUBLISHED: 2011

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