Psychological Medicine
Volume 31, Issue 7, 2001, Pages 1259-1267

Trauma and loss as determinants of medically unexplained epidemic illness in a Bhutanese refugee camp (Article)

Van Ommeren M.* , Sharma B. , Komproe I. , Poudyal B.N. , Sharma G.K. , Cardeña E. , De Jong J.T.V.M.
  • a Center for Victims of Torture Nepal in Kathmandu, Nepal, Transcultural Psychosocial Organization, Vrije Universiteit, Amsterdam, Netherlands, University of Texas, Pan American, TX, United States, Transcultural Psychosocial Organization, Keizersgracht 329, 1016EE Amsterdam, Netherlands
  • b Center for Victims of Torture Nepal in Kathmandu, Nepal, Transcultural Psychosocial Organization, Vrije Universiteit, Amsterdam, Netherlands, University of Texas, Pan American, TX, United States
  • c Center for Victims of Torture Nepal in Kathmandu, Nepal, Transcultural Psychosocial Organization, Vrije Universiteit, Amsterdam, Netherlands, University of Texas, Pan American, TX, United States
  • d Center for Victims of Torture Nepal in Kathmandu, Nepal, Transcultural Psychosocial Organization, Vrije Universiteit, Amsterdam, Netherlands, University of Texas, Pan American, TX, United States
  • e Center for Victims of Torture Nepal in Kathmandu, Nepal, Transcultural Psychosocial Organization, Vrije Universiteit, Amsterdam, Netherlands, University of Texas, Pan American, TX, United States
  • f Center for Victims of Torture Nepal in Kathmandu, Nepal, Transcultural Psychosocial Organization, Vrije Universiteit, Amsterdam, Netherlands, University of Texas, Pan American, TX, United States
  • g Center for Victims of Torture Nepal in Kathmandu, Nepal, Transcultural Psychosocial Organization, Vrije Universiteit, Amsterdam, Netherlands, University of Texas, Pan American, TX, United States

Abstract

Background. We sought to identify personal factors that placed people at risk during an epidemic of medically unexplained illness in a Bhutanese refugee camp in southeastern Nepal. Methods. We conducted a case-control study, involving 68 cases and 66 controls. Caseness was defined as experiencing at least one attack of medically unexplained fainting or dizziness during the time of the epidemic. We performed hierarchical logistic regression analysis to identify significant predictors of case status. Results. In terms of Western psychiatric constructs, the illness involved somatoform symptoms of both acute anxiety and dissociation. Sixty per cent reported visual and 28% reported auditory hallucinatory experiences. Cases and controls were similar on all demographic variables, school performance, number of attacks witnessed and psychopathology before the onset of the epidemic. Recent loss, early loss, childhood trauma and pulse-rate were predictors of case status. Conclusion. We identified trauma, early loss and, especially, recent loss as predictors of attacks during medically unexplained epidemic illness in a Bhutanese refugee community.

Author Keywords

[No Keywords available]

Index Keywords

emotional deprivation symptomatology idiopathic disease visual hallucination refugee regression analysis demography human Refugees syncope controlled study anxiety neurosis acute disease Bhutan academic achievement mental disease Humans vertigo Adolescent male female risk factor pulse rate Disease Outbreaks Article epidemic Questionnaires adult major clinical study Stress Disorders, Post-Traumatic Nepal neurosis Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-0034758319&doi=10.1017%2fS0033291701004470&partnerID=40&md5=c81ea19f2ef9b85ae0b8ec73f5f7b67f
DOI: 10.1017/S0033291701004470
ISSN: 00332917
Cited by: 36
Original Language: English