The mental health sequelae of traumatic head injury in South Vietnamese ex-political detainees who survived torture

• Published in: Comprehensive psychiatry 2014-10, Vol.55 (7), p.1626-1638
• Main Authors: Mollica, Richard F, Chernoff, Miriam C, Megan Berthold, S, Lavelle, James, Lyoo, In Kyoon, Renshaw, Perry
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Aged; Asian Continental Ancestry Group - psychology; Biological and medical sciences; Brain damage; Brain research; Consciousness; Craniocerebral Trauma - complications; Craniocerebral Trauma - psychology; Depression - complications; Depression - psychology; Disability; Head injuries; Health Status; Hospitalization; Hospitals; Human subjects; Humans; Hypotheses; Injuries of the nervous system and the skull. Diseases due to physical agents; Male; Medical sciences; Mental health; Middle Aged; Organic mental disorders. Neuropsychology; Politics; Population; Prisoners - psychology; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Stress Disorders, Post-Traumatic - complications; Stress Disorders, Post-Traumatic - psychology; Studies; Survivors - psychology; Torture; Torture - psychology; Trauma; Traumas. Diseases due to physical agents; Vietnam; Violence
• ISSN: 0010-440X; 1532-8384
• DOI: 10.1016/j.comppsych.2014.04.014

Abstract Little is known about the relationship between traumatic head injury (THI) and psychiatric morbidity in torture survivors. We examine the relationship between THI and depression, PTSD, post-concussive syndrome (PCS), disability and poor health status in Vietnamese ex-political detainees who survived incarceration in Vietnamese re-education camps. A community sample of ex-political detainees ( n = 337) and a non-THI, non-ex-detainee comparison group ( n = 82) were surveyed. Seventy-eight percent of the ex-political detainees had experienced THI; 90.6% of the ex-political detainees and 3.6% of the comparison group had experienced 7 or more trauma events. Depression and PTSD were greater in ex-detainees than in the comparison group (40.9% vs 23.2% and 13.4% vs 0%). Dose–effect relationships for THI and trauma/torture in the ex-political detainee group were significant. Logistic regression in the pooled sample of ex-detainees and the comparison group confirmed the independent impact of THI from trauma/torture on psychiatric morbidity (OR for PTSD = 22.4; 95% CI: 3.0–165.8). These results demonstrate important effects of THI on depression and PTSD in Vietnamese ex-detainees who have survived torture.