Treatment change of somatic symptoms and cultural syndromes among Cambodian refugees with PTSD

Depress Anxiety. 2012 Feb;29(2):147-54. doi: 10.1002/da.20905. Epub 2011 Nov 7.

Abstract

Background: There is only one previously published study of treatment change across initial pharmacological treatment for a minority or refugee group with posttraumatic stress disorder (PTSD). That study found that certain somatic symptoms among Southeast Asian populations did not improve across treatment. This article assesses in a culturally sensitive way symptom change through time of Cambodian patients presenting for pharmacotherapy treatment of PTSD.

Methods: Fifty-six Cambodian refugees with PTSD and no previous psychiatric treatment were assessed at baseline and then at 3 and 6 months after initiating pharmacotherapy. The measures included the PTSD Checklist; the Cambodian Somatic Symptom and Syndrome Inventory (SSI) to assess culturally salient somatic symptoms and cultural syndromes; and the Short Form-12 Health Survey to assess self-perceived functioning.

Results: Across treatment, large effect sizes were seen on all measures (Cohen's d = 1.1-1.4). The SF-12 change score was more highly correlated to the SSI change score (r = .82) than to the PTSD change score (r = .61). Significant change only occurred from baseline to 3 months.

Conclusions: Pharmacological treatment for traumatized Cambodian refugees with PTSD seems to lead to improvement not only in PTSD symptoms, but also in culturally salient somatic symptoms and cultural syndromes. Culturally sensitive assessment and treatment should ideally include the assessment of culturally salient somatic symptoms and cultural syndromes.

MeSH terms

  • Adult
  • Cambodia / ethnology
  • Cultural Characteristics
  • Female
  • Humans
  • Male
  • Massachusetts
  • Middle Aged
  • Refugees / psychology*
  • Severity of Illness Index
  • Stress Disorders, Post-Traumatic / drug therapy*
  • Stress Disorders, Post-Traumatic / ethnology*
  • Stress Disorders, Post-Traumatic / physiopathology