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Acute posttraumatic stress: nonacceptance of early intervention.

https://arctichealth.org/en/permalink/ahliterature71884
Source
J Clin Psychiatry. 2001;62 Suppl 17:35-40
Publication Type
Article
Date
2001
Author
L. Weisaeth
Author Affiliation
Division of Disaster Psychiatry, Institute of Psychiatry, University of Oslo, Norway. lars.weisath@psykiatri.uio.no
Source
J Clin Psychiatry. 2001;62 Suppl 17:35-40
Date
2001
Language
English
Publication Type
Article
Keywords
Accidents, Occupational - psychology - statistics & numerical data
Acute Disease
Adaptation, Psychological
Anxiety - diagnosis - epidemiology
Cohort Studies
Cooperative Behavior
Cross-Sectional Studies
Dreams - psychology
Explosions - statistics & numerical data
False Negative Reactions
False Positive Reactions
Fear - psychology
Female
Follow-Up Studies
Humans
Life Change Events
Male
Mass Screening - psychology - statistics & numerical data
Norway - epidemiology
Patient Acceptance of Health Care - psychology
Psychiatric Status Rating Scales - statistics & numerical data
Sleep Disorders - diagnosis - epidemiology
Social Isolation - psychology
Startle Reaction - physiology
Stress Disorders, Post-Traumatic - diagnosis - epidemiology - psychology
Abstract
Psychological resistance may be of considerable importance in the posttraumatic stress disorder (PTSD) population, considering that researchers in the field of traumatic stress are frequently unsuccessful in achieving high response rates, that many subjects suffering from PTSD never seek help, and that dropouts from therapy are frequent. This article presents data on the main complaints reported in the acute aftermath of an industrial disaster by 246 employees who had been exposed to the disaster. The dominant concerns were symptomatic complaints related to posttraumatic stress reactions rather than external problems. Sleep disturbance, anxiety/fear responses, and physical symptoms were reported by individuals with complaints in the acute phase as most problematic, while irritability and depressive symptoms appeared very infrequently among the reported main complaints. A high specificity and sensitivity were achieved in predicting later PTSD (as defined by DSM-III criteria) by applying early response variables: thus, there were few false-positives and false-negatives. There was a considerable overlap between the PTSD predictors and the main symptom complaints. From a prevention point of view, this should be advantageous, since it would bring the right people to seek help. However, in a significant proportion of the acutely distressed, the reluctance to seek help was motivated by the very symptoms that predicted PTSD. Even a relatively high rate of subjects agreeing to be screened (82.8%) would have lost 42% of those who qualified for a diagnosis of PTSD, and more than half of the subjects with severe outcomes would not have been included. For primary and secondary prevention, the findings suggest that early screening and outreach should be very active.
PubMed ID
11495094 View in PubMed
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Alexithymia, emotions and PTSD; findings from a longitudinal study of refugees.

https://arctichealth.org/en/permalink/ahliterature45803
Source
Nord J Psychiatry. 2004;58(3):185-91
Publication Type
Article
Date
2004
Author
Hans Peter Söndergaard
Töres Theorell
Author Affiliation
Swedish National Institute for Psychosocial Factors and Health, Stockholm. hans.peter.sondergaard@phs.ki.se
Source
Nord J Psychiatry. 2004;58(3):185-91
Date
2004
Language
English
Publication Type
Article
Keywords
Adult
Affective Symptoms - diagnosis - epidemiology - psychology
Cross-Sectional Studies
Depressive Disorder - diagnosis - epidemiology - psychology
Emotions
Female
Humans
Incidence
Iraq - ethnology
Longitudinal Studies
Male
Middle Aged
Personality Inventory - statistics & numerical data
Psychometrics - statistics & numerical data
Refugees - psychology - statistics & numerical data
Reproducibility of Results
Research Support, Non-U.S. Gov't
Stress Disorders, Post-Traumatic - diagnosis - epidemiology - psychology
Sweden - epidemiology
Abstract
The objective of the present study was to assess alexithymia by means of the Toronto Alexithymia Scale (TAS-20) and The Emotion Protocol (EP) in a group of refugees. Eighty-six subjects were willing to participate. At last follow-up, 33 non-PTSD and 22 PTSD subjects had complete data. Subjects with PTSD had higher scores on the TAS-20 (F = 4.314, df = 77, p = 0.041), but on the subscale level, this was significant only with regard to Factor I, difficulties identifying feelings (F = 5.316, df = 77, p = 0.024). TAS Factor I and to a lower extent TAS Factor II (difficulties naming feelings) were significantly associated with the self-rated presence of dysphoric affects. At follow-up, an increase in TAS Factor I score was associated with increased prevalence of self-rated symptoms of PTSD, but not depression. Decrease in prolactin was associated with significant increase of TAS Factor I (rho = -0.396, n = 54, p = 0.003). The present study indicates that alexithymia as measured by TAS-20 is indeed associated with symptoms of PTSD. This association is almost exclusively explained by the TAS Factor I subscale and is in turn associated with a high level of self-reported dysphoric affect. The longitudinal inverse correlation with prolactin points to the possibility of an underlying disturbance in serotonergic and/or dopaminergic systems. The results thus indicate that secondary, or post-traumatic, alexithymia is a measure of suppressed or warded-off negative affects.
PubMed ID
15204204 View in PubMed
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An evaluation of the mental status of rejected asylum seekers in two Danish asylum centers.

https://arctichealth.org/en/permalink/ahliterature88826
Source
Torture. 2009;19(1):51-9
Publication Type
Article
Date
2009
Author
Schwarz-Nielsen Kathrine Hvid
Elklitt Ask
Author Affiliation
University of Copenhagen, Panum Institute, Copenhagen, Denmark. trine_hvid@hotmail.com
Source
Torture. 2009;19(1):51-9
Date
2009
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adolescent
Adult
Age Distribution
Aged
Anxiety - diagnosis - epidemiology - psychology
Cross-Sectional Studies
Denmark - epidemiology
Depressive Disorder - diagnosis - epidemiology - psychology
Female
Follow-Up Studies
Humans
Incidence
Iraq - ethnology
Male
Mental Status Schedule
Middle Aged
Probability
Questionnaires
Refugees - psychology - statistics & numerical data
Risk assessment
Severity of Illness Index
Sex Distribution
Statistics, nonparametric
Stress Disorders, Post-Traumatic - diagnosis - epidemiology - psychology
Stress, Psychological
Time Factors
War
Young Adult
Abstract
INTRODUCTION: International studies have shown high incidences of symptoms regarding anxiety, depression, and post traumatic stress disorder (PTSD) among asylum seekers of different ethnicities. The aim of the present study was to investigate the presence of symptoms of anxiety, depression, and PTSD among rejected Iraqi asylum seekers in two Danish Red Cross asylum centers. Factors such as the length of stay in an asylum center and the number of traumatic events were considered as risk factors associated with the degree of psychological morbidity. METHOD: In 2007, 53 rejected Iraqi asylum seekers from two Danish Red Cross centers completed a survey based on the Harvard Trauma Questionnaire-IV (HTQ) and the Hopkins Symptom Checklist 25 (HSCL-25). The response rate was 36%. The analyses focused on the impact of gender, age, marriage, religion, the length of stay at the asylum center, and the number of traumatic events on the severity of symptoms of anxiety, depression, and PTSD. FINDINGS: Of all participants, 94% were found to have symptoms of anxiety, 100% had symptoms of depression, and 77% had symptoms of PTSD. The participants had experienced or witnessed an average of 8.5 traumatic events before their arrival in Denmark. There was no significant association between the number of traumatic events, and the symptoms of PTSD. In addition, there was no significant difference in the length of stay and symptoms of anxiety, depression, and PTSD despite the fact that 79% of the participants had stayed in an asylum center for 5-10 years or more. CONCLUSION: Despite the limitations of the data, such as the small sample, this study showed that the prevalence rates of psychopathology in Iraqi asylum seekers in Denmark were alarmingly high. Therefore, it is recommended that systematic screening of all detained asylum seekers in Denmark is introduced. Given the degree of mental health problems it is also recommended that procedures be changed and that treatment should be offered to asylum seekers who are detained in Danish asylum centers.
PubMed ID
19491487 View in PubMed
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Are Posttraumatic Stress Symptoms Related to Mental Health Service Use? A Prospective Study of Danish Soldiers Deployed to Afghanistan.

https://arctichealth.org/en/permalink/ahliterature282788
Source
J Clin Psychiatry. 2016 Oct;77(10):e1226-e1232
Publication Type
Article
Date
Oct-2016
Author
Trine Madsen
Søren Bo Andersen
Karen-Inge Karstoft
Source
J Clin Psychiatry. 2016 Oct;77(10):e1226-e1232
Date
Oct-2016
Language
English
Publication Type
Article
Keywords
Adult
Cohort Studies
Cross-Sectional Studies
Denmark
Drug Utilization - statistics & numerical data
Female
Follow-Up Studies
Health Services Needs and Demand - statistics & numerical data
Humans
Male
Mental Health Services - utilization
Patient Admission - statistics & numerical data
Prospective Studies
Psychotherapy - statistics & numerical data
Psychotropic Drugs - therapeutic use
Statistics as Topic
Stress Disorders, Post-Traumatic - diagnosis - epidemiology - psychology - therapy
Surveys and Questionnaires
Utilization Review - statistics & numerical data
Veterans - psychology - statistics & numerical data
Abstract
Investigating the use of mental health services by combat veterans can help illuminate utilization and unmet needs of this population. The aims of this study were to estimate the use of mental health services and to examine how such use is associated with self-reported symptoms of posttraumatic stress disorder (PTSD) in soldiers before and after deployment to Afghanistan.
Prospectively, 703 Danish soldiers who deployed from January 2009 to August 2009 were followed up with 6 assessments from predeployment to 2.5 years postdeployment in 2012. At assessments, the soldiers responded to a comprehensive questionnaire including a measure of PTSD symptoms (the PTSD Checklist-Civilian version). These self-reported data were combined with individual-level records of receiving psychotherapy from the Military Psychological Division at the Danish Defense and psychiatric treatment from the Danish registers.
The prevalence of PTSD symptoms increased over time, and almost 10% of the sample reported high levels of PTSD symptoms 2.5 years postdeployment. Overall, 37% of the soldiers utilized mental health services; 6% utilized psychiatric services, and 12.4% redeemed a prescription for psychiatric medicine. Approximately one-third received psychotherapy at the Military Psychological Division. In those reporting high PTSD symptomatology, 83% utilized 1 or more types of mental health service. At predeployment and homecoming, high PTSD symptomatology was significantly (P
PubMed ID
27529142 View in PubMed
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Source
J Interpers Violence. 2010 Aug;25(8):1470-88
Publication Type
Article
Date
Aug-2010
Author
Ask Elklit
Dorte M Christiansen
Author Affiliation
University of Aarhus, Aarhus, Denmark. aske@psy.au.dk
Source
J Interpers Violence. 2010 Aug;25(8):1470-88
Date
Aug-2010
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adolescent
Adult
Aged
Aged, 80 and over
Child
Crime - psychology
Denmark - epidemiology
Female
Humans
Middle Aged
Prevalence
Psychiatric Status Rating Scales
Psychometrics - statistics & numerical data
Rape - psychology
Regression Analysis
Risk factors
Severity of Illness Index
Stress Disorders, Post-Traumatic - diagnosis - epidemiology - psychology
Stress Disorders, Traumatic, Acute - diagnosis - epidemiology - psychology
Young Adult
Abstract
In recent years, a number of studies have investigated the prediction of posttraumatic stress disorder (PTSD) through the presence of acute stress disorder (ASD). The predictive power of ASD on PTSD was examined in a population of 148 female rape victims who visited a center for rape victims shortly after the rape or attempted rape. The PTSD diagnosis based solely on the three core symptom clusters was best identified by a subclinical ASD diagnosis based on all ASD criteria except dissociation. However, a full PTSD diagnosis including the A( 2) and F criteria was best identified by classifying victims according to a full ASD diagnosis. Regardless of whether cases were classified according to full PTSD status or according to meeting the criteria for the three PTSD core symptom clusters, the classification was correct only in approximately two thirds of the cases. A regression analysis based on ASD severity and sexual problems following the rape accounted for only 28% of the PTSD severity variance. In conclusion, the ASD diagnosis is not an optimal method for identifying those most at risk for PTSD. It remains to be seen whether a better way can be found.
PubMed ID
20068117 View in PubMed
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Association of PTSD and depression with medical and specialist care utilization in modern peacekeeping veterans in Canada with health-related disabilities.

https://arctichealth.org/en/permalink/ahliterature167586
Source
J Clin Psychiatry. 2006 Aug;67(8):1240-5
Publication Type
Article
Date
Aug-2006
Author
J Don Richardson
Jon D Elhai
David J Pedlar
Author Affiliation
Operational Stress Injury Clinic, St. Joseph's Health Care London, Parkwood Hospital, London, Ontario, Canada. Don.Richardson@sjhc.london.on.ca
Source
J Clin Psychiatry. 2006 Aug;67(8):1240-5
Date
Aug-2006
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Comorbidity
Depressive Disorder - diagnosis - epidemiology - psychology
Disabled Persons - psychology - statistics & numerical data
Health Services - economics - utilization
Health status
Health Surveys
Humans
Male
Medicine - statistics & numerical data
Middle Aged
Military Personnel - psychology - statistics & numerical data
Multivariate Analysis
Personality Inventory
Primary Health Care
Psychiatric Status Rating Scales
Questionnaires
Sampling Studies
Severity of Illness Index
Specialization
Stress Disorders, Post-Traumatic - diagnosis - epidemiology - psychology
Veterans - psychology - statistics & numerical data
Abstract
We examined the relative associations between posttraumatic stress disorder (PTSD) and depression severity with medical and specialist care use in modern peacekeeping veterans with health-related disabilities.
The participants consisted of 1016 male veterans who served in the Canadian Forces from 1990 to 1999, selected from a larger random sample of 1968 veterans who voluntarily completed an anonymous general health survey conducted by Veterans Affairs Canada in 1999. Survey instruments included the PTSD Checklist-Military Version (PCL-M), Center for Epidemiological Studies-Depression Scale, and questionnaires of health problems and service use, sociodemographic characteristics, and military history.
Among peacekeeping veterans with health disabilities, "probable" PTSD (PCL-M score > or = 50) was associated with significantly more medical service use (primary and specialty care combined), with a mean of 16.4 times (SD = 17.4) compared with 6.0 times (SD = 6.6), p
PubMed ID
16965202 View in PubMed
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Associations between dimensions of anxiety sensitivity and PTSD symptom clusters in active-duty police officers.

https://arctichealth.org/en/permalink/ahliterature157237
Source
Cogn Behav Ther. 2008;37(2):66-75
Publication Type
Article
Date
2008
Author
Gordon J G Asmundson
Jennifer A Stapleton
Author Affiliation
Anxiety and Illness Behaviours Laboratory and The Traumatic Stress Group, University of Regina, Regina, Saskatchewan, Canada. gordon.asmundson@uregina.ca
Source
Cogn Behav Ther. 2008;37(2):66-75
Date
2008
Language
English
Publication Type
Article
Keywords
Adult
Anxiety - psychology
Case-Control Studies
Comorbidity
Depression - psychology
Female
Humans
Male
Panic Disorder - epidemiology - psychology
Police
Prevalence
Regression Analysis
Saskatchewan - epidemiology
Stress Disorders, Post-Traumatic - diagnosis - epidemiology - psychology
Abstract
Prior studies have shown that anxiety sensitivity (AS) plays an important role in posttraumatic stress disorder (PTSD) symptom severity. The purpose of this study was to evaluate associations between empirically supported PTSD symptom clusters (i.e. reexperiencing, avoidance, numbing, hyperarousal) and AS dimensions (i.e. psychological concerns, social concerns, somatic concerns). Participants were 138 active-duty police officers (70.7% female; mean age = 38.9 years; mean time policing = 173.8 months) who, as a part of a larger study, completed measures of trauma exposure, PTSD symptoms, AS, and depressive symptoms. All participants reported experiencing at least one event that they perceived as traumatic, and 44 (31.9%) screened positive for PTSD. Officers with probable PTSD scored significantly higher on AS total as well as the somatic and psychological concerns dimensional scores than did those without PTSD. As well, a higher percentage of officers with probable PTSD scored positively on the AS-derived Brief Screen for Panic Disorder (Apfeldorf et al., 1994) compared with those without PTSD. A series of regression analyses revealed that depressive symptoms, number of reported traumas, and AS somatic concerns were significant predictors of PTSD total symptom severity as well as severity of reexperiencing. Avoidance was predicted by depressive symptoms and AS somatic concerns. Only depressive symptoms were significantly predictive of numbing and hyperarousal cluster scores. These findings contribute to understanding the nature of association between AS and PTSD symptom clusters. Implications for the treatment of individuals having PTSD with and without panic-related symptomatology are discussed.
PubMed ID
18470738 View in PubMed
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Combat and peacekeeping operations in relation to prevalence of mental disorders and perceived need for mental health care: findings from a large representative sample of military personnel.

https://arctichealth.org/en/permalink/ahliterature162700
Source
Arch Gen Psychiatry. 2007 Jul;64(7):843-52
Publication Type
Article
Date
Jul-2007
Author
Jitender Sareen
Brian J Cox
Tracie O Afifi
Murray B Stein
Shay-Lee Belik
Graham Meadows
Gordon J G Asmundson
Author Affiliation
Department of Psychiatry, University of Manitoba, 771 Bannatyne Ave, Winnipeg, MB PZ430, Canada R3E 3N4. sareen@cc.umanitoba.ca
Source
Arch Gen Psychiatry. 2007 Jul;64(7):843-52
Date
Jul-2007
Language
English
Publication Type
Article
Keywords
Attitude to Health
Canada - epidemiology
Combat Disorders - diagnosis - epidemiology - psychology
Diagnostic and Statistical Manual of Mental Disorders
Health Services Accessibility
Health services needs and demand
Health Surveys
Humans
Life Change Events
Male
Mental Disorders - diagnosis - epidemiology - therapy
Mental Health Services - supply & distribution - utilization
Military Personnel - psychology - statistics & numerical data
Patient Acceptance of Health Care
Prevalence
Psychiatric Status Rating Scales
Stress Disorders, Post-Traumatic - diagnosis - epidemiology - psychology
Suicide - psychology
Violence - psychology
War
Abstract
Although military personnel are trained for combat and peacekeeping operations, accumulating evidence indicates that deployment-related exposure to traumatic events is associated with mental health problems and mental health service use.
To examine the relationships between combat and peacekeeping operations and the prevalence of mental disorders, self-perceived need for mental health care, mental health service use, and suicidality.
Cross-sectional, population-based survey.
Canadian military.
A total of 8441 currently active military personnel (aged 16-54 years).
The DSM-IV mental disorders (major depressive disorder, posttraumatic stress disorder, generalized anxiety disorder, panic disorder, social phobia, and alcohol dependence) were assessed using the World Mental Health version of the World Health Organization Composite International Diagnostic Interview, a fully structured lay-administered psychiatric interview. The survey included validated measures of self-perceived need for mental health treatment, mental health service use, and suicidal ideation. Lifetime exposure to peacekeeping and combat operations and witnessing atrocities or massacres (ie, mutilated bodies or mass killings) were assessed.
The prevalences of any past-year mental disorder assessed in the survey and self-perceived need for care were 14.9% and 23.2%, respectively. Most individuals meeting the criteria for a mental disorder diagnosis did not use any mental health services. Deployment to combat operations and witnessing atrocities were associated with increased prevalence of mental disorders and perceived need for care. After adjusting for the effects of exposure to combat and witnessing atrocities, deployment to peacekeeping operations was not associated with increased prevalence of mental disorders.
This is the first study to use a representative sample of active military personnel to examine the relationship between deployment-related experiences and mental health problems. It provides evidence of a positive association between combat exposure and witnessing atrocities and mental disorders and self-perceived need for treatment.
PubMed ID
17606818 View in PubMed
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Comparing dissociation and PTSD in sexually abused school-aged girls.

https://arctichealth.org/en/permalink/ahliterature176442
Source
J Nerv Ment Dis. 2005 Jan;193(1):47-52
Publication Type
Article
Date
Jan-2005
Author
Delphine Collin-Vézina
Martine Hébert
Author Affiliation
Université du Québec à Montréal, Montréal, Québec, Canada, H3C 3P8.
Source
J Nerv Ment Dis. 2005 Jan;193(1):47-52
Date
Jan-2005
Language
English
Publication Type
Article
Keywords
Age Factors
Child
Child Abuse, Sexual - diagnosis - psychology - statistics & numerical data
Comorbidity
Dissociative Disorders - diagnosis - epidemiology - psychology
Educational Status
Fathers - statistics & numerical data
Female
Humans
Incest - psychology - statistics & numerical data
Logistic Models
Mothers - statistics & numerical data
Prevalence
Psychiatric Status Rating Scales - statistics & numerical data
Quebec - epidemiology
Questionnaires
Risk factors
Severity of Illness Index
Stress Disorders, Post-Traumatic - diagnosis - epidemiology - psychology
Abstract
The aim of this study was to assess and contrast dissociation and posttraumatic stress disorder (PTSD) symptoms in a group of sexually abused school-aged girls compared with a matched group. Results from bivariate analyses show that the two symptom constellations represent distinct constructs. Logistic regression analysis indicates that sexual victimization significantly increases the odds of presenting with a clinical level of dissociation and PTSD symptoms, respectively, by eightfold and fourfold. On the basis of a multivariate design, abuse severity indicators, namely, penetration, relationship to perpetrator (intrafamilial versus extrafamilial abuse), and chronicity, did not prove predictive of dissociation symptoms. The least and the most severe forms of childhood sexual abuse both increase dissociative symptoms. The data indicate also that intrafamilial abuse and chronicity do not predict PTSD. However, abuse involving intrusive acts (penetration) does predict PTSD symptoms. Implications for intervention and further research are discussed.
PubMed ID
15674134 View in PubMed
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Comparison of psychiatric disability on the health of nation outcome scales (HoNOS) in resettled traumatized refugee outpatients and Danish inpatients.

https://arctichealth.org/en/permalink/ahliterature267219
Source
BMC Psychiatry. 2014;14:330
Publication Type
Article
Date
2014
Author
Sabina Palic
Michelle Lind Kappel
Monica Stougaard Nielsen
Jessica Carlsson
Per Bech
Source
BMC Psychiatry. 2014;14:330
Date
2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Denmark - epidemiology
Disabled Persons - psychology
Emigration and Immigration - trends
Female
Health Services Needs and Demand - trends
Humans
Inpatients - psychology
Male
Middle Aged
Outpatients - psychology
Refugees - psychology
Stress Disorders, Post-Traumatic - diagnosis - epidemiology - psychology
Treatment Outcome
Abstract
Currently, the mental health issues of traumatized refugees are mainly documented in terms of posttraumatic stress disorder, depression, and anxiety. Importantly, there are no reports of the level of psychiatric disability in treatment seeking traumatized refugees resettled in the West. Insufficient acknowledgment of the collective load of bio-psycho-social problems in this patient group hinders effective psychiatric and social service utilization outside the specialized clinics for traumatized refugees.
The level of psychiatric disability in traumatized refugees from Danish specialized clinics (N = 448) is documented using routine monitoring data from pre- and post-treatment on the Health of Nation Outcome Scales (HoNOS). Furthermore, the HoNOS ratings are compared with routine monitoring data from Danish inpatients with different diagnoses (N = 10.911).
The routinely collected data indicated that despite their outpatient status, traumatized refugees had higher levels of psychiatric disability at pre-treatment compared to most inpatients. Moreover, the traumatized refugees had a HoNOS profile characterized by an overall high problem level in various psychiatric and social domains. The rate of pre- to post-treatment improvement on the HoNOS was smaller for the traumatized refugees than it was for the psychiatric inpatients.
The level, and the versatile profile, of psychiatric disability on the HoNOS point to complex bio-psycho-social problems in resettled treatment seeking traumatized refugees. Thus, a broader assessment of symptoms and better cooperation between psychiatric, health care, and social systems is necessary in order to meet the treatment needs of this group.
Notes
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PubMed ID
25519423 View in PubMed
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55 records – page 1 of 6.