BMC Psychiatry
Volume 14, Issue 1, 2014

Comparison of psychiatric disability on the health of nation outcome scales (HoNOS) in resettled traumatized refugee outpatients and Danish inpatients (Article) (Open Access)

Palic S.* , Kappel M.L. , Nielsen M.S. , Carlsson J. , Bech P.
  • a National Centre for Psychotraumatology, University of Southern Denmark, Odense, Denmark
  • b Clinic for PTSD and Transcultural Psychiatry (CPTP), Aarhus University Hospital, Aarhus, Denmark
  • c Clinic for PTSD and Transcultural Psychiatry (CPTP), Aarhus University Hospital, Aarhus, Denmark
  • d Competence Center for Transcultural Psychiatry Denmark, Psychiatric Center Ballerup, The Mental Health Services of the Capital Region of Denmark, Copenhagen, Denmark
  • e Psychiatric Research Unit, Psychiatric Center North Zealand, Hillerød, Denmark

Abstract

Background: 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. Methods: 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). Results: 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. Conclusions: 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. © 2014 Palic et al.

Author Keywords

HoNOS Psychiatric disability Treatment Refugee trauma

Index Keywords

anxiety mental deficiency rating scale depression hospital patient refugee multicenter study clinical trial Outpatients Disabled Persons human Refugees middle aged disabled person trends Denmark health service controlled study comparative study Aged outpatient Social Work Health Services Needs and Demand Humans psychology Treatment Outcome male social problem female Article major clinical study adult migration posttraumatic stress disorder Stress Disorders, Post-Traumatic Emigration and Immigration Inpatients Health of Nation Outcome Scale

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84924404704&doi=10.1186%2fs12888-014-0330-8&partnerID=40&md5=f283cb1afb947f1e8a000b5bf1398e81

DOI: 10.1186/s12888-014-0330-8
ISSN: 1471244X
Cited by: 4
Original Language: English