title: Asylum seekers seeking mental health services in the United States: clinical and legal implications.
abstract: 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%).
authors.affiliation: 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
authors.forename: Linda
authors.initials: L
authors.lastname: Piwowarczyk
mesh_terms: 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