Prevalence of torture and trauma history among immigrants in primary care in Denmark: do general practitioners ask?

Author:

Ostergaard Liv Stubbe1ORCID,Wallach-Kildemoes Helle2,Thøgersen Marie H3,Dragsted Ulrik B4,Oxholm Annemette4,Hartling Ole4,Norredam Marie1

Affiliation:

1. Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Danish Research Center on Migration, Ethnicity and Health, Section of Health Services Research, Copenhagen, Denmark

2. Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Section for Social and Clinical Pharmacy, Copenhagen, Denmark

3. Department of Rehabilitation, Dignity – Danish Institute Against Torture, København, Denmark

4. Amnesty Internationals Danish Medical Group, Amnesty International Denmark, The Medical Group, Copenhagen, Denmark

Abstract

Abstract Background Torture survivors typically present with varied and complex symptoms, which may challenge assessment by general practitioners (GPs). This study explored the prevalence of torture and trauma history among immigrants born in non-Western countries presenting to GPs in Denmark and the extent to which GPs ask this population about torture or trauma history. Methods Based on a self-reported questionnaire among non-western immigrant patients, we used bivariate analyses to determine the prevalence of torture and trauma history and the proportion of patients being asked by their GP about this. Data were analysed using multivariate logistic regression. Results From 46 GP clinics, 300 questionnaires were finalized by immigrant patients. Twenty-eight percent of the patients had a history of torture. Of these, significantly more were men (70%) than women (29%). About half of the torture survivors (55%) had been asked by their GP about torture history. The odds ratio (OR, 95% confidence interval) for being asked about torture history by the GP was 1.28 (0.46–3.53) among women compared with men. Compared with Southeast Europe, OR for being a torture survivor among male immigrants from Middle East-North African region and South and East Asia was 1.83 (0.81–4.15) and 0.25 (0.08–0.82), respectively. Conclusions Our results suggest that torture and trauma are widespread among immigrants presenting to GPs. In our study, the GPs had managed to detect half of the torture survivors. A more systematic approach to detection in General Practice is advisable, and more knowledge on how and when to ask is needed.

Funder

Amnesty International’s Medical Group

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health

Reference23 articles.

1. Health care of torture survivors;Piwowarczyk;Jama,2000

2. Asylum seekers in Denmark—a study of health status and grade of traumatization of newly arrived asylum seekers;Masmas;Torture,2008

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