Torture; mental sequelae and treatment approaches are these applicable in low-income countries?

Abstract

1 ABSTRACT 1.1 Background: According to recent statistics torture is still practiced in many countries and is most prevalent in low- and middle income countries. In these countries, the availablity of and funding for psychiatric health aid is scarce and the living conditions are usually unstable and insecure. This literary review investigate what mental sequelae result from torture, which therapeutic opportunities are available to address them and which of these are applicable in low- and middle-income countries. 1.2 Method: Several databases were searched for articles concerning torture trauma, its mental sequelae and treatment approaches producing 30 articles on the psychiatric and psychological sequelae of torture trauma and its treatment approaches, which were reviewed. 1.3 Results: The literary review showed that the most common mental sequelae of torture are PTSD, depression and anxiety as well as other symptoms that are not covered by these spesific diagnoses. Limited research on treatment approaches show that narrative exposure therapy, cognitive behavioural therapy and interpersonal therapy have the most effect on reducing torture trauma symptoms. 1.4 Conclusion: Torture does lead to psychiatric and psychological sequelae. Several treatment approaches are recommended, but none are specifically designed to address torture trauma. Although some show promising effect, it is questionnable how applicable these approaches are considering the cultural, linguistic, religious and financial barriers that have to be overcome in unstable situations in low- and midddle-income countries in order to implement them. None are at this time ideal. There is suggestion of producing a model where the treatment encompasses all aspects of torture trauma, including both those on the individual as well as the community as a whole, but further research is needed.