The Neuropsychological Consequences of Armed Conflicts and Torture

Weisleder, Pedro; Rublee, Caitlin

doi:10.1007/s11910-018-0818-6

Cited by 16 publications

(17 citation statements)

References 29 publications

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“…Conversely, none of the patients had presented with an established diagnosis or a suspicion of a psychiatric disorder on admission, thus suggesting that these diagnoses were established for the first time during the visit in the emergency department. It has been shown repeatedly that refugees frequently suffer from post-traumatic stress disorder (PTSD) and affective disorders (8, 9, 35). Moreover, there appear to be close pathophysiological links between psychogenic non-epileptic seizures and PTSD (34).…”

Section: Discussionmentioning

confidence: 99%

Neurological Emergencies in Refugees

et al. 2018

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Objective: Health care personnel in Europe is increasingly involved in care of displaced persons from non-European countries; we investigated the spectrum of neurological disorders and medical management in refugees presenting to the emergency room (ER) of a German university hospital.Methods: We retrospectively studied ER-patients with refugee status (R-patients) during the peak of the European refugee crisis between July 2015 and February 2016 (N = 100). Complaints on admission, medical management and diagnoses at discharge were compared to matched groups of German residents with migrational background (M-patients; N = 96) and to native Germans (N-patients; N = 95).Results: R-patients were mostly male young adults (75% male; mean age 33.2 years). Headache was the most frequent complaint in all groups (R-patients 38%; M-patients 43%; N-patients 24%). R-patients, however, presented much more often with possible or definite seizures (R-patients 27%; M-patients 9%; N-patients 15%). Initial triage, length of medical history and examination records, utilization of laboratory tests and cranial imaging did not differ between groups. However, time to diagnosis was considerably longer in R-patients (220 min; M-patients 151 min, N-patients 123 min). While strokes and other life-threatening emergencies were rare final diagnoses in R-patients, a substantial proportion was discharged with a diagnosis of non-epileptic seizures or a psychiatric disorder (20%; M-patients 6%; N-patients 7%).Conclusions: Refugee patients present with a spectrum of neurological disorders that not solely results from cultural differences but rather reflects the consequences of forced displacement. ER management of refugees requires more time, language skills and critically depends on psychosomatic/psychiatric expertise.

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Section: Discussionmentioning

confidence: 99%

Neurological Emergencies in Refugees

et al. 2018

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“…The most prevalent trauma-related disorders among torture survivors are major depression and PTSD. It is not unusual for a survivor to have more than one disorder or to transition from one to another (Carinci et al, 2010;Nickerson et al, 2017;Weisleder & Rublee, 2018). Most survivors suffer depression, which has been associated with the experience of loss resulting from torture.…”

Section: Psychological Effects Of Torturementioning

confidence: 99%

The potential of epigenetic methods to provide evidence of torture

Suárez‐López

2020

torture

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Introduction: The last five decades have wit- nessed a transition from brutal forms of physi- cal torture to other physical and psychological methods that do not leave marks on the body. Providing evidence of these types of torture is often a challenge. Finding biological markers of torture would potentially contribute to solve this problem. Methods: Scientific literature review. Results: Methods to analyse certain biological marks present in the genetic material (the DNA), called epigenetic marks, have been developed in recent years. These marks can change in response to environmental factors, but these changes do not alter the genetic information contained in the DNA. Changes in epigenetic marks have been correlated with traumatic stress. Given that torture is an extreme form of trauma, this article argues that torture may also be associated with epigenetic changes. Discussion: Epigenetic methods offer a new tool that might be useful for the medico-legal documentation of cases of torture. Given that these methods have not been used for this purpose yet, they should be tested. Whether they have potential to contribute to determine the severity of suffering, establish a severity threshold or design strategies for the rehabilitation of torture survivors is discussed. The advantages and limitations of these methods, as well as ethical implications, must be taken into account.

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“…Abundant psychological and psychiatric research has considered post-war settings, with post-traumatic stress disorder being probably the main theme. However, when reporting on “war neurosis” (in the older psychiatric terminology), some authors, referring particularly to Balkan culture and setting, have even talked about a specific ‘partisan hysteria’ (6, 7, 21).…”

Section: Conclusive Remarksmentioning

confidence: 99%

“…The psychiatric and mental consequences in individuals following war, post-war, chronic exposure to hostilities, ill-treatment, and torture related to belligerencies, have been studied among Holocaust survivors (5). Other authors have enlarged their scope of study, and even of the diagnostic notions depicting war-related disorders (6, 7). However, large-scale studies on war impact are usually limited to a simple PTSD model of impact, without consideration of the complex impact of an imaginary of impending war, leading to continuous fear, avoidance behavior, and maladaptive coping styles that will potentially affect generations of a post-war society, even when there is overlapping symptomatology between PTSD and this complex changes in the large group's members (8).…”

Section: Introductionmentioning

confidence: 99%