Psychiatric disability among tortured Bhutanese refugees in Nepal

Am J Psychiatry. 2003 Nov;160(11):2032-7. doi: 10.1176/appi.ajp.160.11.2032.


Objective: Most refugees live in low-income countries. There is a lack of data on psychiatric disability among such refugees. The authors compared psychiatric disability in tortured and nontortured Bhutanese refugees living in Nepal and examined factors associated with psychiatric disability among the tortured refugees.

Method: A cross-sectional survey was conducted among 418 tortured and 392 nontortured Bhutanese refugees, matched for age and gender. The Composite International Diagnostic Interview, version 2.1, and the World Health Organization Short Disability Assessment Schedule were used to measure ICD-10 psychiatric disorders and disability, respectively.

Results: Approximately one in five tortured and nontortured Bhutanese refugees were found to be disabled. Posttraumatic stress disorder, specific phobia, and present physical disease were identified as factors associated with disability among the tortured refugees. On the other hand, present physical disease, greater age, and generalized anxiety disorder were associated with disability among the nontortured group.

Conclusions: These findings show that the tortured and nontortured refugees were equally likely to be disabled. Different sets of predictors were identified among tortured and nontortured refugees, indicating the need for comprehensive psychiatric assessment of both tortured and nontortured refugees in clinical practice.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Bhutan / ethnology
  • Cross-Sectional Studies
  • Disability Evaluation
  • Disabled Persons / psychology
  • Disabled Persons / statistics & numerical data
  • Ethnicity / psychology*
  • Ethnicity / statistics & numerical data
  • Female
  • Humans
  • Life Change Events
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology*
  • Mental Disorders / psychology
  • Middle Aged
  • Nepal / epidemiology
  • Odds Ratio
  • Psychiatric Status Rating Scales
  • Refugees / psychology*
  • Refugees / statistics & numerical data
  • Survivors / psychology
  • Survivors / statistics & numerical data
  • Torture / psychology*
  • Torture / statistics & numerical data