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

BMC Psychiatry

Per Bech⁴  Jessica Carlsson¹  Monica Stougaard Nielsen³  Michelle Lind Kappel³  Sabina Palic² 

[1] Competence Center for Transcultural Psychiatry Denmark, Psychiatric Center Ballerup, The Mental Health Services of the Capital Region of Denmark, Copenhagen, Denmark;National Centre for Psychotraumatology, University of Southern Denmark, Odense, Denmark;Clinic for PTSD and Transcultural Psychiatry (CPTP), Aarhus University Hospital, Aarhus, Denmark;Psychiatric Research Unit, Psychiatric Center North Zealand, Hillerød, Denmark

关键词: Treatment;    Trauma;    Refugee;    HoNOS;    Psychiatric disability;   

Others  :  1091142
DOI  :  10.1186/s12888-014-0330-8

 received in 2014-04-08, accepted in 2014-11-10,  发布年份 2014

【 摘 要 】

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.

【 授权许可】

   
2014 Palic et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 6.

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