Skip to main content

Advertisement

Log in

Prevalence of torture survivors among foreign-born patients presenting to an urban ambulatory care practice

  • Original Articles
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

BACKGROUND: The prevalence of torture among foreign-born patients presenting to urban medical clinics is not well documented.

OBJECTIVE: To determine the prevalence of torture among foreign-born patients presenting to an urban primary care practice.

DESIGN: A survey of foreign-born patients.

PATIENTS: Foreign-born patients, age ≥ 18, presenting to the Primary Care Clinic at Boston Medical Center.

MEASUREMENTS: Self-reported history of torture as defined by the UN, and history of prior disclosure of torture.

RESULTS: Of the 308 eligible patients, 88 (29%) declined participation, and 78 (25%) were not included owing to lack of a translator. Par ticipants had a mean age of 47 years (range 19 to 76), were mostly female (82/142, 58%), had been in the United States for an average of 14 years (range 1 month to 53 years), and came from 35 countries. Fully, 11% (16/142, 95 percent confidence interval 7% to 18%) of participants reported a history of torture that was consistent with the UN definition of torture. Thirty-nine percent (9/23) of patients reported that their health care provider asked them about torture. While most patients (15/23, 67%) reported discussing their experience of torture with someone in the United States, 8 of 23 (33%) reported that this survey was their first disclosure to anyone in the United States.

CONCLUSION: Among foreign-born patients presenting to an urban primary care center, approximately 1 in 9 met the definition established by the UN Convention Against Torture. As survivors of torture may have significant psychological and physical sequelae, these data underscore the necessity for primary care physicians to screen for a torture history among foreign-born patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, Office of the High Commission for Human Rights, United Nations Web site. Available at: http://www.ohchr.org/english/countries/ratification/9.htm. Accessed March 1, 2005.

  2. American Medical Association. Code of Medical Ethics Current Opinions with Annotations, 2004–2005. American Medical Association; 2005.

  3. The role of the physician and the medical profession in the prevention of international torture and in the treatment of its survivors. American College of Physicians. Ann Intern Med. 1995;122:607–13.

  4. United Nations Convention against Torture and Other Cruel, Inhumane, or Degrading Treatment or Punishment, New York, 1984.

  5. United Nations High Commissioner for Refugees, Statistics. Available at: http://www.unhcr.org/.Accessed March 18, 2005.

  6. Rasmussen OV. Medical aspects of torture. Dan Med Bull. 1990;37, 1–88(Suppl 1):1–88.

    PubMed  Google Scholar 

  7. Basoglu M, Paker M, Ozmen E, Tasdemir O, Sahin D. Factors related to long-term traumatic stress responses in survivors of torture in Turkey. JAMA. 1994;272:357–63.

    Article  PubMed  CAS  Google Scholar 

  8. Goldfeld AE, Mollica RF, Pesavento BH, Faraone SV. The physical and psychological sequelae of torture. Symptomatology and diagnosis. JAMA. 1988;259:2725–9.

    Article  PubMed  CAS  Google Scholar 

  9. Moisander PA, Edston E. Torture and its sequel—a comparison between victims from six countries. Forensic Sci Int. 2003;137:133–40.

    Article  PubMed  Google Scholar 

  10. Moreno A, Grodin MA. Torture and its neurological sequelae. Spinal Cord. 2002;40:213–23.

    Article  PubMed  CAS  Google Scholar 

  11. Nice DS, Garland CF, Hilton SM, Baggett JC, Mitchell RE. Long-term health outcomes and medical effects of torture among US Navy prisoners of war in Vietnam. JAMA. 1996;276:375–81.

    Article  PubMed  CAS  Google Scholar 

  12. Norredam M, Crosby S, Munarriz R, Piwowarczyk L, Grodin M. Urologic complications of sexual trauma among male survivors of torture. Urology. 2005;65:28–32.

    Article  PubMed  Google Scholar 

  13. Marshall GN, Schell TL, Elliott MN, Berthold SM, Chun CA. Mental health of Cambodian refugees 2 decades after resettlement in the United States. JAMA. 2005;294:571–9.

    Article  PubMed  CAS  Google Scholar 

  14. Jaranson JM, Butcher J, Halcon L, et al. Somali and Oromo refugees: correlates of torture and trauma history. Am J Public Health. 2004;94:591–8.

    Article  PubMed  Google Scholar 

  15. Eisenman DP, Keller AS, Kim G. Survivors of torture in a general medical setting: how often have patients been tortured, and how often is it missed? West J Med. 2000;172:301–4.

    Article  PubMed  CAS  Google Scholar 

  16. Eisenman DP, Gelberg L, Liu H, Shapiro MF. Mental health and health-related quality of life among adult Latino primary care patients living in the United States with previous exposure to political violence. JAMA. 2003;290:627–34.

    Article  PubMed  Google Scholar 

  17. Eisenman DP, Tracy K, Keller AS. Development of a screening questionnaire for detecting victims of torture in medical settings. J Gen Intern Med. 1988;13:126.

    Google Scholar 

  18. Montgomery E, Foldspang A. Criterion-related validity of screening for exposure to torture. Dan Med Bull. 1994;41:588–91.

    PubMed  CAS  Google Scholar 

  19. StataCorp. Stata Statistical Software: Release 7.0. College Station, TX: Stata Corporation; 2001.

    Google Scholar 

  20. Ulrich YC, Cain KC, Sugg NK, Rivara FP, Rubanowice DM, Thompson RS. Medical care utilization patterns in women with diagnosed domestic violence. Am J Prev Med. 2003;24:9–15.

    Article  PubMed  Google Scholar 

  21. Hougen HP, Kelstrup J, Petersen HD, Rasmussen OV. Sequelae to torture. A controlled study of torture victims living in exile. Forensic Sci Int. 1988;36:153–60.

    Article  PubMed  CAS  Google Scholar 

  22. Rasmussen OV, Lunde I. Evaluation of investigation of 200 torture victims. Dan Med Bull. 1980;27:241–3.

    PubMed  CAS  Google Scholar 

  23. Weinstein HM, Dansky L, Iacopino V. Torture and war trauma survivors in primary care practice. West J Med. 1996;165:112–8.

    PubMed  CAS  Google Scholar 

  24. Goldfeld AE, Mollica RF, Pesavento BH, Faraone SV. The physical and psychological sequelae of torture. Symptomatology and diagnosis. JAMA. 1988;259:2725–9.

    Article  PubMed  CAS  Google Scholar 

  25. Holtan N, Antolak K, Johnson DR, Ide L, Jaranson J, Ta K. Unrecognized torture affects the health of refugees. Minn Med. 2002;85:35–9.

    PubMed  Google Scholar 

  26. National Consortium of Torture Treatment Programs. Available at: http://ncttp.westside.com/default.view. Accessed March 29, 2005.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sondra S. Crosby MD.

Additional information

None of the authors have any conflicts of interest to declare.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Crosby, S.S., Norredam, M., Paasche-Orlow, M.K. et al. Prevalence of torture survivors among foreign-born patients presenting to an urban ambulatory care practice. J Gen Intern Med 21, 764–768 (2006). https://doi.org/10.1111/j.1525-1497.2006.00488.x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1111/j.1525-1497.2006.00488.x

Key words

Navigation