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Biomedical subjects

J Westermeyer

Publications and source records attributed to J Westermeyer.

At least 55 records · Page 3Linked to original sources
PubMed1990

Welfare status and psychosocial adjustment among 100 Hmong refugees.

Although the mental health of recently employed persons has been well studied, the mental health of welfare recipients is not well understood. Among our increasing refugee population, many receive welfare benefits at some point. The Hmong are among those who are highly represented among welfare recipients in several areas of the United States. Do psychiatrists have anything to contribute toward the resolution of high welfare rates? This question is especially relevant in refugee populations who are at increased risk for several psychiatric disorders, including depression, paranoia, and adjustment disorders. This study was undertaken among 100 Hmong refugees who had been in the United States for 8 years. Indices of mental health included two rating scales (the Zung Depression Scale and the SCL-90), five-axis DSM-III diagnoses, Hamilton Anxiety and Depression Scales, Global Assessment Scale, Brief Psychiatric Rating Scale, Inpatient Multidimensional Scale, and Mini-Mental State Exam. These indices were compared with current welfare status and the duration of time on welfare. Other comparisons with welfare included demographic characteristics, material possessions, acculturation characteristics, health and social problems, and nonoccupation avocations. Results indicate that welfare recipients show lower acculturation and elevated psychiatric symptom levels. Suggestions for ameliorating this situation are extrapolated from studies in the literature on chronically unemployed persons.

Acculturation↗
PubMed1990

Working with an interpreter in psychiatric assessment and treatment.

Cross-cultural assessment and care frequently involve cross-language communication via a translator, interpreter, or bilingual worker. A resurgence of immigration, legalization of former illegal migrants, and refugee flight to the United States has increased the need for such special means of communication. Psychiatrists and other mental health professionals should develop conceptual models, skills, and experience for conducting cross-language interviews. This article provides information, terminology, and models for one aspect of this special clinical task, i.e., working with translators.

Adult↗
PubMed1990

Treatment for psychoactive substance use disorder in special populations: issues in strategic planning.

During their recovery, special populations of alcoholics and addicts have need for both (1) involvement with their own special social identity groups and (2) involvement with others broadly representative of the communities in which they will live and function. Self-help groups and treatment institutions in the societal mainstream have often neglected special populations and their special needs. Family education, support and therapy is especially important to many patients from these special populations. Obstacles to treatment for these special groups are described, along with strategies for overcoming these obstacles.

Alcoholism↗
PubMed1990

Methodological issues in the epidemiological study of alcohol-drug problems: sources of confusion and misunderstanding.

Epidemiological research on psychoactive substance use disorders can and sometimes does lead to conclusions that are mutually conflicting. A current example is the apparent drop in substance use among adolescents in schools, with continuing high levels of substance-associated adolescent suicide, hospitalization, and crime. In an effort to clarify such differences, the author underscores the importance of understanding the three most common epidemiological methods. Each has different histories, advantages, liabilities, inherent value sets, and disparate-but-overlapping purposes.

Adolescent↗
PubMed1989

Delusions of fatal contagion among refugee patients.

Delusions of fatal contagion were encountered in about 10% of refugee psychiatric patients from Southeast Asia belonging to one ethnic group, the Hmong. Psychotic depression was the most common diagnosis among the Hmong patients with delusions of contagion, whereas paranoid and schizophrenic diagnoses predominate in patients with similar delusions from other refugee groups. Some cases also occurred as a shared delusional disorder. Associated findings included isolation from the community, intrafamilial conflict, failure to acculturate, and sexual frustration or conflict. Most patients responded to tricyclic medication, later supplemented in about half of the cases with a neuroleptic. This syndrome, which does not appear to have been described previously, should be considered in cases of somatizing refugees who present repeatedly to medical facilities.

Adolescent↗
PubMed1989

Somatization among refugees: an epidemiologic study.

Somatization has been widely reported among refugee psychiatric patients since World War II, and some psychological theorists have viewed somatization as an alternative to depression. These and other theories were tested in a population survey of 97 Hmong refugees who had lived in the U.S. for several years. Four different measures of somatization were employed, including a 12-item self-rating scale, a single-item global rating based on the total interview, and somatic subscales of the two Hamilton interview-rating scales. These data demonstrate that somatization accompanies certain demographic characteristics that are associated with failure to acculturate. Somatization in this non-patient, refugee population was associated with treatment seeking and self-identified "medical problems" and with psychiatric symptoms and disorders, but not with objective evidence of medical disorder.

Acculturation↗
PubMed1989

Psychosocial adjustment of Hmong refugees during their first decade in the United States. A longitudinal study.

Over their first decade in the United States, 100 Hmong refugees were studied on three occasions. Data included demographic characteristics, acculturation skills, traditional affiliations and pastimes, material acquisitions, psychosocial problems, and self-rating scales. In addition to a description of the data changes, a multiple regression analysis was performed. Changes demonstrated considerable evidence of acculturation, psychiatric care seeking, and greatly reduced symptom levels for several symptom complexes. However, a large minority of subjects remain illiterate, unable to speak English, generally involved with other Hmong but not with the majority society, and/or have high symptom levels on self-rating scales. Regarding symptom changes, depression, somatization, phobia, and self-esteem symptoms improved the most with time and acculturation. On the contrary, anxiety, hostility, and paranoid symptoms changed little. Multiple regression analyses indicated that strong traditional ties (e.g., large household size, being an herbal healer), older age, marital problems, and medical complaints were most associated with high symptom levels.

Acculturation↗
PubMed1989

An epidemic of opium dependence among Asian refugees in Minnesota: characteristics and causes.

After several decades absence, opium smoking has reappeared in the U.S. Introduced by Indochinese refugees in the early 1980's, it has spread to several regions of the country. In this report the characteristics of refugee opium addicts is described. In addition, the factors contributing to a fertile situation for opium addiction are presented. Finally, implications of these findings and remedial recommendations are suggested.

Adult↗
PubMed1989

Paranoid symptoms and disorders among 100 Hmong refugees: a longitudinal study.

Paranoid disorder has been recognized as a special problem among migrants in general, and refugees in particular. Controversy exists about whether vulnerability to paranoia is a pre-emigration or postmigration phenomenon, and whether paranoia is caused by genetic or organic factors, victimization, or the stress of acculturation. Information is limited on the distribution of paranoid symptoms among refugees. The course of paranoid symptoms in refugees is unknown. Findings reveal that: most refugees have no or mild paranoid symptoms (suspiciousness or mistrust); a small number have severe symptoms (ideas of reference, paranoid delusions or paranoid hallucinations); paranoid symptoms (unlike depressive symptoms) tend to remain at about the same level over several years; and the prevalence and incidence of paranoid disorders among refugees are high compared with other groups.

Acculturation↗
PubMed1989

Assessing the victimized psychiatric patient.

Psychiatric patients who have experienced violence or victimization usually do not report these traumatic events to clinicians spontaneously, although they may be relevant to the patients' current problems. Therefore, inquiry about such experiences should be part of the clinical assessment of patients who are refugees, crime victims, or military veterans or patients whose histories suggest traumatic events. The authors present a series of questions designed to facilitate discussion of traumatic events and to elicit clinical information that is relevant from both somatic and psychosocial perspectives.

Adult↗
PubMed1989

National and international strategies to control drug abuse.

Since drug problems continue to produce health problems in our society, it is important to understand world-wide issues favoring the continued existence of drug abuse. National decisions to attack the problem at the production end outside the U.S. have been viewed as being more efficient, more effective, less disruptive and less expensive than approaches to reduce consumption within our own boundaries. This review aims at clarifying the issues involved in national versus international strategies against drugs.

Drug and Narcotic Control↗
PubMed1989

AIDS-related illness and AIDS risk in male homo/bisexual substance abusers: case reports and clinical issues.

Little has been written about the treatment of substance use disorders among seropositive HIV patients or high-risk seronegative substance abusers. Demographic and clinical characteristics, along with treatment issues, were examined based on experience with 18 patients in a substance abuse program in a university medical center (3 AID, 3 ARC, 9 seropositive only, and 3 seronegative high risk). Scores on a substance abuse rating scale were extremely high. Most of them abused three or more different substances, had used drugs parenterally, had more than 50 sex partners, and/or had received previous substance abuse treatment. Affective disorder, suicide attempt, and antisocial personality were frequent in this group. About half of the patients complied with treatment and showed improvement in their substance disorder. Several common themes in the management of these patients are described.

AIDS-Related Complex↗
PubMed1989

Addiction to tranylcypromine (Parnate): a case report.

The monoamine oxidase inhibitors are increasingly prescribed for several disorders today, after a hiatus of nonuse lasting a decade. One case of excessive MAOI use and two cases of MAOI withdrawal are reported in the literature. This case report adds a fourth instance and suggests patient characteristics which should alert the clinician to the risk of MAOI abuse or addiction.

Adult↗
PubMed1989

A case of koro in a refugee family: association with depression and folie à deux.

Koro, a folk syndrome involving fear of genital retraction, is known to occur in epidemic fashion and is usually associated with anxiety symptoms. The author describes a sporadic case of koro accompanied by psychotic depression in a refugee. The refugee's wife, who was also suffering a major depression, also believed that the patient was undergoing genital retraction with a potentially fatal outcome. The cultural, familial, and acculturative stresses associated with the syndrome are described. Resolution of the koro syndrome and its associated psychopathology required interventions on biomedical, psychological, familial, and sociocultural levels.

Acculturation↗