Asylum seekers seeking mental health services in the United States: clinical and legal implications.
Asylum seekers flee their countries in search of safety due to persecution at home. Characteristics were assessed of 134 consecutive asylum seekers who sought mental health services at a program caring for survivors of torture and refugee trauma, using a chart review of patients seen between January 1999 and December 2002. Two-thirds of the sample were female, and 82% came from Africa. Eighty-four percent of the sample reported a history of torture, and one-half experienced rape or attempted rape. Most common diagnoses included posttraumatic stress disorder and depression. Predictors of torture included: posttraumatic stress disorder [odds ratio (OR) = 4.93, p = 0.03], rape (OR = 4.23, p = 0.035), and political persecution (OR = 9.28, p = 0.006). Most common self-reported health problems were headaches (29.9%), sexual dysfunction (26.1%), chronic pain (12.7%), and gastrointestinal symptoms (11.2%).
Piwowarczyk
Linda
L
Boston University School of Medicine, Department of Psychiatry, Boston Center for Refugee Health and Human Rights, Boston Medical Center, Boston, Massachusetts 02118, USA. piwo@bu.edu
D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003866:Depressive Disorder / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008605:Mental Health Services / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012036:Refugees / Q000331:legislation & jurisprudence / Q000523:psychology*; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology; D017741:Survivors / Q000331:legislation & jurisprudence / Q000523:psychology; D014104:Torture / Q000331:legislation & jurisprudence / Q000523:psychology; D014481:United States