Mental Health of Cambodian Refugees 2 Decades After Resettlement in the United States
CONTEXT Little is known about the long-term mental health of trauma-exposed refugees years after permanent resettlement in host countries. OBJECTIVE To assess the prevalence, comorbidity, and correlates of psychiatric disorders in the US Cambodian refugee community. DESIGN, SETTING, AND PARTICIPANTS...
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| creator | Marshall, Grant N Schell, Terry L Elliott, Marc N Berthold, S. Megan Chun, Chi-Ah |
| description | CONTEXT Little is known about the long-term mental health of trauma-exposed
refugees years after permanent resettlement in host countries. OBJECTIVE To assess the prevalence, comorbidity, and correlates of psychiatric
disorders in the US Cambodian refugee community. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional, face-to-face interview conducted in Khmer language
on a random sample of households from the Cambodian community in Long Beach,
Calif, the largest such community in the United States, between October 2003
and February 2005. A total of 586 adults aged 35 to 75 years who lived in
Cambodia during the Khmer Rouge reign and immigrated to the United States
prior to 1993 were selected. One eligible individual was randomly sampled
from each household, with an overall response rate (eligibility screening
and interview) of 87% (n = 490). MAIN OUTCOME MEASURES Exposure to trauma and violence before and after immigration (using
the Harvard Trauma Questionnaire and Survey of Exposure to Community Violence);
weighted past-year prevalence rates of posttraumatic stress disorder (PTSD)
and major depression (using the Composite International Diagnostic Interview
version 2.1); and alcohol use disorder (by the Alcohol Use Disorders Identification
Test). RESULTS All participants had been exposed to trauma before immigration. Ninety-nine
percent (n = 483) experienced near-death due to starvation and 90%
(n = 437) had a family member or friend murdered. Seventy percent
(n = 338) reported exposure to violence after settlement in the
United States. High rates of PTSD (62%, weighted), major depression (51%,
weighted), and low rates of alcohol use disorder were found (4%, weighted).
PTSD and major depression were highly comorbid in this population (n = 209;
42%, weighted) and each showed a strong dose-response relationship with measures
of traumatic exposure. In bivariate analyses, older age, having poor English-speaking
proficiency, unemployment, being retired or disabled, and living in poverty
were also associated with higher rates of PTSD and major depression. Following
multivariate analyses, premigration trauma remained associated with PTSD (odds
ratio [OR], 2.08; 95% CI, 1.37-3.16) and major depression (OR, 1.56; 95% CI,
1.24-1.97); postmigration trauma with PTSD (OR, 1.65; 95% CI, 1.21-2.26) and
major depression (OR, 1.45; 95% CI, 1.12-1.86); and older age with PTSD (OR,
1.76; 95% CI, 1.46-2.13) and major depression (OR, 1.47; 95% CI, 1.15-1.89). CONCLUSION More |
| doi_str_mv | 10.1001/jama.294.5.571 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_68443453</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ama_id>201332</ama_id><sourcerecordid>877749251</sourcerecordid><originalsourceid>FETCH-LOGICAL-a329t-638c18d5070741f52f02709161e69784e10ce6b66f62ef580b1481dff46635e13</originalsourceid><addsrcrecordid>eNpd0UtLxDAQAOAgiq6Pq-BFgqC3rpm8e5T1CSuCuueSbSfapQ9t0oP_3sCuIuYygflmGGYIOQY2BcbgcuVaN-W5nKqpMrBFJqCEzYTK7TaZMJbbzEgr98h-CCuWHgizS_ZAM2OYgglZPGIXXUPv0TXxnfaezly77KvadfQZ_fiGGCin11i6Kv2ufMQhJQLG2GCbamnd0fiOdNHVESv6El3EcEh2vGsCHm3iAVnc3rzO7rP5093D7GqeOcHzmGlhS7CVYoYZCV5xz7hhOWhAnRsrEViJeqm11xy9smwJ0kLlvdRaKARxQC7WfT-G_nPEEIu2DiU2jeuwH0OhrZRCKpHg2T-46sehS7MVHEBoaYxM6HSDxmWLVfEx1K0bvoqfbSVwvgEulK7xg-vKOvxxuZWK2-RO1i4d5zfL0-4FF98pIn4G</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211364774</pqid></control><display><type>article</type><title>Mental Health of Cambodian Refugees 2 Decades After Resettlement in the United States</title><source>MEDLINE</source><source>American Medical Association Journals</source><creator>Marshall, Grant N ; Schell, Terry L ; Elliott, Marc N ; Berthold, S. Megan ; Chun, Chi-Ah</creator><creatorcontrib>Marshall, Grant N ; Schell, Terry L ; Elliott, Marc N ; Berthold, S. Megan ; Chun, Chi-Ah</creatorcontrib><description>CONTEXT Little is known about the long-term mental health of trauma-exposed
refugees years after permanent resettlement in host countries. OBJECTIVE To assess the prevalence, comorbidity, and correlates of psychiatric
disorders in the US Cambodian refugee community. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional, face-to-face interview conducted in Khmer language
on a random sample of households from the Cambodian community in Long Beach,
Calif, the largest such community in the United States, between October 2003
and February 2005. A total of 586 adults aged 35 to 75 years who lived in
Cambodia during the Khmer Rouge reign and immigrated to the United States
prior to 1993 were selected. One eligible individual was randomly sampled
from each household, with an overall response rate (eligibility screening
and interview) of 87% (n = 490). MAIN OUTCOME MEASURES Exposure to trauma and violence before and after immigration (using
the Harvard Trauma Questionnaire and Survey of Exposure to Community Violence);
weighted past-year prevalence rates of posttraumatic stress disorder (PTSD)
and major depression (using the Composite International Diagnostic Interview
version 2.1); and alcohol use disorder (by the Alcohol Use Disorders Identification
Test). RESULTS All participants had been exposed to trauma before immigration. Ninety-nine
percent (n = 483) experienced near-death due to starvation and 90%
(n = 437) had a family member or friend murdered. Seventy percent
(n = 338) reported exposure to violence after settlement in the
United States. High rates of PTSD (62%, weighted), major depression (51%,
weighted), and low rates of alcohol use disorder were found (4%, weighted).
PTSD and major depression were highly comorbid in this population (n = 209;
42%, weighted) and each showed a strong dose-response relationship with measures
of traumatic exposure. In bivariate analyses, older age, having poor English-speaking
proficiency, unemployment, being retired or disabled, and living in poverty
were also associated with higher rates of PTSD and major depression. Following
multivariate analyses, premigration trauma remained associated with PTSD (odds
ratio [OR], 2.08; 95% CI, 1.37-3.16) and major depression (OR, 1.56; 95% CI,
1.24-1.97); postmigration trauma with PTSD (OR, 1.65; 95% CI, 1.21-2.26) and
major depression (OR, 1.45; 95% CI, 1.12-1.86); and older age with PTSD (OR,
1.76; 95% CI, 1.46-2.13) and major depression (OR, 1.47; 95% CI, 1.15-1.89). CONCLUSION More than 2 decades have passed since the end of the Cambodian civil
war and the subsequent resettlement of refugees in the United States; however,
this population continues to have high rates of psychiatric disorders associated
with trauma.</description><identifier>ISSN: 0098-7484</identifier><identifier>EISSN: 1538-3598</identifier><identifier>DOI: 10.1001/jama.294.5.571</identifier><identifier>PMID: 16077051</identifier><identifier>CODEN: JAMAAP</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Cambodia - ethnology ; Comorbidity ; Depressive Disorder, Major - epidemiology ; Emigration and Immigration - statistics & numerical data ; Female ; General aspects ; Humans ; Immigration ; Male ; Medical sciences ; Mental disorders ; Mental Disorders - epidemiology ; Mental Health ; Middle Aged ; Prevalence ; Psychiatry ; Refugees ; Refugees - psychology ; Relocation ; Stress Disorders, Post-Traumatic - epidemiology ; Time Factors ; United States - epidemiology ; Violence - statistics & numerical data ; Warfare</subject><ispartof>JAMA : the journal of the American Medical Association, 2005-08, Vol.294 (5), p.571-579</ispartof><rights>2005 INIST-CNRS</rights><rights>Copyright American Medical Association Aug 3, 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a329t-638c18d5070741f52f02709161e69784e10ce6b66f62ef580b1481dff46635e13</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jama/articlepdf/10.1001/jama.294.5.571$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.294.5.571$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,314,776,780,3327,27901,27902,76231,76234</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16984528$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16077051$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marshall, Grant N</creatorcontrib><creatorcontrib>Schell, Terry L</creatorcontrib><creatorcontrib>Elliott, Marc N</creatorcontrib><creatorcontrib>Berthold, S. Megan</creatorcontrib><creatorcontrib>Chun, Chi-Ah</creatorcontrib><title>Mental Health of Cambodian Refugees 2 Decades After Resettlement in the United States</title><title>JAMA : the journal of the American Medical Association</title><addtitle>JAMA</addtitle><description>CONTEXT Little is known about the long-term mental health of trauma-exposed
refugees years after permanent resettlement in host countries. OBJECTIVE To assess the prevalence, comorbidity, and correlates of psychiatric
disorders in the US Cambodian refugee community. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional, face-to-face interview conducted in Khmer language
on a random sample of households from the Cambodian community in Long Beach,
Calif, the largest such community in the United States, between October 2003
and February 2005. A total of 586 adults aged 35 to 75 years who lived in
Cambodia during the Khmer Rouge reign and immigrated to the United States
prior to 1993 were selected. One eligible individual was randomly sampled
from each household, with an overall response rate (eligibility screening
and interview) of 87% (n = 490). MAIN OUTCOME MEASURES Exposure to trauma and violence before and after immigration (using
the Harvard Trauma Questionnaire and Survey of Exposure to Community Violence);
weighted past-year prevalence rates of posttraumatic stress disorder (PTSD)
and major depression (using the Composite International Diagnostic Interview
version 2.1); and alcohol use disorder (by the Alcohol Use Disorders Identification
Test). RESULTS All participants had been exposed to trauma before immigration. Ninety-nine
percent (n = 483) experienced near-death due to starvation and 90%
(n = 437) had a family member or friend murdered. Seventy percent
(n = 338) reported exposure to violence after settlement in the
United States. High rates of PTSD (62%, weighted), major depression (51%,
weighted), and low rates of alcohol use disorder were found (4%, weighted).
PTSD and major depression were highly comorbid in this population (n = 209;
42%, weighted) and each showed a strong dose-response relationship with measures
of traumatic exposure. In bivariate analyses, older age, having poor English-speaking
proficiency, unemployment, being retired or disabled, and living in poverty
were also associated with higher rates of PTSD and major depression. Following
multivariate analyses, premigration trauma remained associated with PTSD (odds
ratio [OR], 2.08; 95% CI, 1.37-3.16) and major depression (OR, 1.56; 95% CI,
1.24-1.97); postmigration trauma with PTSD (OR, 1.65; 95% CI, 1.21-2.26) and
major depression (OR, 1.45; 95% CI, 1.12-1.86); and older age with PTSD (OR,
1.76; 95% CI, 1.46-2.13) and major depression (OR, 1.47; 95% CI, 1.15-1.89). CONCLUSION More than 2 decades have passed since the end of the Cambodian civil
war and the subsequent resettlement of refugees in the United States; however,
this population continues to have high rates of psychiatric disorders associated
with trauma.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cambodia - ethnology</subject><subject>Comorbidity</subject><subject>Depressive Disorder, Major - epidemiology</subject><subject>Emigration and Immigration - statistics & numerical data</subject><subject>Female</subject><subject>General aspects</subject><subject>Humans</subject><subject>Immigration</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mental disorders</subject><subject>Mental Disorders - epidemiology</subject><subject>Mental Health</subject><subject>Middle Aged</subject><subject>Prevalence</subject><subject>Psychiatry</subject><subject>Refugees</subject><subject>Refugees - psychology</subject><subject>Relocation</subject><subject>Stress Disorders, Post-Traumatic - epidemiology</subject><subject>Time Factors</subject><subject>United States - epidemiology</subject><subject>Violence - statistics & numerical data</subject><subject>Warfare</subject><issn>0098-7484</issn><issn>1538-3598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0UtLxDAQAOAgiq6Pq-BFgqC3rpm8e5T1CSuCuueSbSfapQ9t0oP_3sCuIuYygflmGGYIOQY2BcbgcuVaN-W5nKqpMrBFJqCEzYTK7TaZMJbbzEgr98h-CCuWHgizS_ZAM2OYgglZPGIXXUPv0TXxnfaezly77KvadfQZ_fiGGCin11i6Kv2ufMQhJQLG2GCbamnd0fiOdNHVESv6El3EcEh2vGsCHm3iAVnc3rzO7rP5093D7GqeOcHzmGlhS7CVYoYZCV5xz7hhOWhAnRsrEViJeqm11xy9smwJ0kLlvdRaKARxQC7WfT-G_nPEEIu2DiU2jeuwH0OhrZRCKpHg2T-46sehS7MVHEBoaYxM6HSDxmWLVfEx1K0bvoqfbSVwvgEulK7xg-vKOvxxuZWK2-RO1i4d5zfL0-4FF98pIn4G</recordid><startdate>20050803</startdate><enddate>20050803</enddate><creator>Marshall, Grant N</creator><creator>Schell, Terry L</creator><creator>Elliott, Marc N</creator><creator>Berthold, S. Megan</creator><creator>Chun, Chi-Ah</creator><general>American Medical Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QL</scope><scope>7QP</scope><scope>7TK</scope><scope>7TS</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20050803</creationdate><title>Mental Health of Cambodian Refugees 2 Decades After Resettlement in the United States</title><author>Marshall, Grant N ; Schell, Terry L ; Elliott, Marc N ; Berthold, S. Megan ; Chun, Chi-Ah</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a329t-638c18d5070741f52f02709161e69784e10ce6b66f62ef580b1481dff46635e13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cambodia - ethnology</topic><topic>Comorbidity</topic><topic>Depressive Disorder, Major - epidemiology</topic><topic>Emigration and Immigration - statistics & numerical data</topic><topic>Female</topic><topic>General aspects</topic><topic>Humans</topic><topic>Immigration</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mental disorders</topic><topic>Mental Disorders - epidemiology</topic><topic>Mental Health</topic><topic>Middle Aged</topic><topic>Prevalence</topic><topic>Psychiatry</topic><topic>Refugees</topic><topic>Refugees - psychology</topic><topic>Relocation</topic><topic>Stress Disorders, Post-Traumatic - epidemiology</topic><topic>Time Factors</topic><topic>United States - epidemiology</topic><topic>Violence - statistics & numerical data</topic><topic>Warfare</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marshall, Grant N</creatorcontrib><creatorcontrib>Schell, Terry L</creatorcontrib><creatorcontrib>Elliott, Marc N</creatorcontrib><creatorcontrib>Berthold, S. Megan</creatorcontrib><creatorcontrib>Chun, Chi-Ah</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>JAMA : the journal of the American Medical Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marshall, Grant N</au><au>Schell, Terry L</au><au>Elliott, Marc N</au><au>Berthold, S. Megan</au><au>Chun, Chi-Ah</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mental Health of Cambodian Refugees 2 Decades After Resettlement in the United States</atitle><jtitle>JAMA : the journal of the American Medical Association</jtitle><addtitle>JAMA</addtitle><date>2005-08-03</date><risdate>2005</risdate><volume>294</volume><issue>5</issue><spage>571</spage><epage>579</epage><pages>571-579</pages><issn>0098-7484</issn><eissn>1538-3598</eissn><coden>JAMAAP</coden><abstract>CONTEXT Little is known about the long-term mental health of trauma-exposed
refugees years after permanent resettlement in host countries. OBJECTIVE To assess the prevalence, comorbidity, and correlates of psychiatric
disorders in the US Cambodian refugee community. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional, face-to-face interview conducted in Khmer language
on a random sample of households from the Cambodian community in Long Beach,
Calif, the largest such community in the United States, between October 2003
and February 2005. A total of 586 adults aged 35 to 75 years who lived in
Cambodia during the Khmer Rouge reign and immigrated to the United States
prior to 1993 were selected. One eligible individual was randomly sampled
from each household, with an overall response rate (eligibility screening
and interview) of 87% (n = 490). MAIN OUTCOME MEASURES Exposure to trauma and violence before and after immigration (using
the Harvard Trauma Questionnaire and Survey of Exposure to Community Violence);
weighted past-year prevalence rates of posttraumatic stress disorder (PTSD)
and major depression (using the Composite International Diagnostic Interview
version 2.1); and alcohol use disorder (by the Alcohol Use Disorders Identification
Test). RESULTS All participants had been exposed to trauma before immigration. Ninety-nine
percent (n = 483) experienced near-death due to starvation and 90%
(n = 437) had a family member or friend murdered. Seventy percent
(n = 338) reported exposure to violence after settlement in the
United States. High rates of PTSD (62%, weighted), major depression (51%,
weighted), and low rates of alcohol use disorder were found (4%, weighted).
PTSD and major depression were highly comorbid in this population (n = 209;
42%, weighted) and each showed a strong dose-response relationship with measures
of traumatic exposure. In bivariate analyses, older age, having poor English-speaking
proficiency, unemployment, being retired or disabled, and living in poverty
were also associated with higher rates of PTSD and major depression. Following
multivariate analyses, premigration trauma remained associated with PTSD (odds
ratio [OR], 2.08; 95% CI, 1.37-3.16) and major depression (OR, 1.56; 95% CI,
1.24-1.97); postmigration trauma with PTSD (OR, 1.65; 95% CI, 1.21-2.26) and
major depression (OR, 1.45; 95% CI, 1.12-1.86); and older age with PTSD (OR,
1.76; 95% CI, 1.46-2.13) and major depression (OR, 1.47; 95% CI, 1.15-1.89). CONCLUSION More than 2 decades have passed since the end of the Cambodian civil
war and the subsequent resettlement of refugees in the United States; however,
this population continues to have high rates of psychiatric disorders associated
with trauma.</abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>16077051</pmid><doi>10.1001/jama.294.5.571</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0098-7484 |
| ispartof | JAMA : the journal of the American Medical Association, 2005-08, Vol.294 (5), p.571-579 |
| issn | 0098-7484 1538-3598 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_68443453 |
| source | MEDLINE; American Medical Association Journals |
| subjects | Adult Aged Biological and medical sciences Cambodia - ethnology Comorbidity Depressive Disorder, Major - epidemiology Emigration and Immigration - statistics & numerical data Female General aspects Humans Immigration Male Medical sciences Mental disorders Mental Disorders - epidemiology Mental Health Middle Aged Prevalence Psychiatry Refugees Refugees - psychology Relocation Stress Disorders, Post-Traumatic - epidemiology Time Factors United States - epidemiology Violence - statistics & numerical data Warfare |
| title | Mental Health of Cambodian Refugees 2 Decades After Resettlement in the United States |
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