Rheumatological Disorders and Somatization in U.S. Mien and Lao Refugees with Depression and Post-Traumatic Stress Disorder: A Cross-Cultural Comparison

Abstract

We report a study comparing presenting symptoms and medical diagnoses of Mien and Lao refugees seen at a specialized psychiatric referral programme in Oregon. Rheumatological assessment in Mien and Lao refugees suffering from depression and post-traumatic stress disorder revealed similar prevalence rates of pain, rheumatologic disorders and somatization despite different initial clinical presentations. Of 89 patients seen in out-patient clinics, 95% had chronic pain, 88% had rheumatological diagnoses and 53% had medically unexplained pain. Although this was a selected sample, our results support the notion that physical pain complaints in psychiatric patients contribute to psychopathology and deserve careful evaluation. Culture strongly affected presentation and this study supports the identification of a Mien Somatic Complaint Syndrome.