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Trauma and loss as determinants of medically unexplained epidemic illness in a Bhutanese refugee camp

Published online by Cambridge University Press:  01 October 2001

M. VAN OMMEREN ,
B. SHARMA ,
I. KOMPROE ,
B. N. POUDYAL ,
G. K. SHARMA ,
E. CARDEÑA  and
J. T. V. M. DE JONG
M. VAN OMMEREN
Affiliation:
From the Center for Victims of Torture Nepal in Kathmandu, Nepal; the Transcultural Psychosocial Organization, Vrije Universiteit, Amsterdam, The Netherlands; and the University of Texas, Pan American, TX, USA
B. SHARMA
Affiliation:
From the Center for Victims of Torture Nepal in Kathmandu, Nepal; the Transcultural Psychosocial Organization, Vrije Universiteit, Amsterdam, The Netherlands; and the University of Texas, Pan American, TX, USA
I. KOMPROE
Affiliation:
From the Center for Victims of Torture Nepal in Kathmandu, Nepal; the Transcultural Psychosocial Organization, Vrije Universiteit, Amsterdam, The Netherlands; and the University of Texas, Pan American, TX, USA
B. N. POUDYAL
Affiliation:
From the Center for Victims of Torture Nepal in Kathmandu, Nepal; the Transcultural Psychosocial Organization, Vrije Universiteit, Amsterdam, The Netherlands; and the University of Texas, Pan American, TX, USA
G. K. SHARMA
Affiliation:
From the Center for Victims of Torture Nepal in Kathmandu, Nepal; the Transcultural Psychosocial Organization, Vrije Universiteit, Amsterdam, The Netherlands; and the University of Texas, Pan American, TX, USA
E. CARDEÑA
Affiliation:
From the Center for Victims of Torture Nepal in Kathmandu, Nepal; the Transcultural Psychosocial Organization, Vrije Universiteit, Amsterdam, The Netherlands; and the University of Texas, Pan American, TX, USA
J. T. V. M. DE JONG
Affiliation:
From the Center for Victims of Torture Nepal in Kathmandu, Nepal; the Transcultural Psychosocial Organization, Vrije Universiteit, Amsterdam, The Netherlands; and the University of Texas, Pan American, TX, USA
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Abstract

Background. We sought to identify personal factors that placed people at risk during an epidemic of medically unexplained illness in a Bhutanese refugee camp in southeastern Nepal.

Methods. We conducted a case–control study, involving 68 cases and 66 controls. Caseness was defined as experiencing at least one attack of medically unexplained fainting or dizziness during the time of the epidemic. We performed hierarchical logistic regression analysis to identify significant predictors of case status.

Results. In terms of Western psychiatric constructs, the illness involved somatoform symptoms of both acute anxiety and dissociation. Sixty per cent reported visual and 28% reported auditory hallucinatory experiences. Cases and controls were similar on all demographic variables, school performance, number of attacks witnessed and psychopathology before the onset of the epidemic. Recent loss, early loss, childhood trauma and pulse-rate were predictors of case status.

Conclusion. We identified trauma, early loss and, especially, recent loss as predictors of attacks during medically unexplained epidemic illness in a Bhutanese refugee community.

Type
Original Article
Information
Psychological Medicine , Volume 31 , Issue 7 , October 2001 , pp. 1259 - 1267
Copyright
© 2001 Cambridge University Press

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