Refugees: Stress in trauma

Armed conflicts throughout the world have created millions of refugees who in their tragic lives may have experienced death of family members, starvation, torture, and long periods in refugee camps. In the country of resettlement, many refugees will have major psychiatric problems including post-traumatic stress disorder, depression, traumatic brain injury, and psychosis. The evaluation of refugees is difficult because of language, culture, and the effect of trauma itself. Many forms of technical treatment have been suggested, but probably the personal characteristics of the therapist and providing safety and continuity over time is the most helpful. Much symptomatic relief can be given with medicine targeting insomnia, nightmares, and irritability. More research is needed to understand why some traumatized refugees get symptoms and others do not what treatments are effective for patients from different cultures, and how to treat the high rate of cardiovascular disease among refugees.