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Cambodians experienced genocide from 1975 to 1979 and ensuing civil war until 1993. Purpose: Are Khmer with a history of trauma who present to a general medical clinic with unexplained physical symptoms more likely than the general population to harbor psychiatric symptoms? Methods: Subjects were drawn from a Phnom Penh clinic and the surrounding neighborhood. All subjects completed the Stressful Life Events Screening Questionnaire (SLESQ) and the PRIME MD. Clinic patients with unexplained physical complaints were compared with neighborhood nonpatients. All individuals reporting trauma during the Pol Pot regime were compared to those reporting no such trauma; and those reporting exposure to domestic violence were compared to those without such exposure. Findings: There is an increased incidence of traumatic events, depressive symptoms, general anxiety symptoms, and panic symptoms
The authors thank the following individuals for their assistance with this project: In the United States: Douglas Waldrep, COL, MC, USA, Chief, National Capital Area Military Psychiatry Residency, for his assistance with Graduate Medical Education requirements, and Susan Fracisco, LTC, MC, USA, Assistant Chief, Department of Clinical Investigation, Walter Reed Army Medical Center, for her assistance with ensuring legal and ethical review.
In Cambodia: Tim Benadum, M.D., and Modich Chap, M.D., who graciously provided access to their clinic and patients, Vichetra Prok, Rathmony Heng, and Pisey Uk, each of whom had multiple hours of patient contact to collect the data from the clinic participants, Chheng Theavy, Srene Chanroth, Him Chorvan, Mok Sony, Hoy Vanthy, Thai Nha, ChhengDavy, UnSorasmei, who volunteered to collect datafrom studyparticipantsin the control group.
This article was presented at the American Academy of Psychoanalysis and Dynamic Psychiatry in Toronto, Ontario, Canada, May 21, 2006.
Disclaimer: The opinions or assertions contained in this article are the private views of the authorsandare not to be construed as official or as reflecting the views or policies of the Uniformed Services University, Walter Reed Army Medical Center, the Department of the Army, the Department of Defense, the United States Government, the Royal Government of Cambodia, or the Cambodian Ministry of Health.
in the clinical group as compared to the control group. Survivors of genocide-associated trauma reported more somatic complaints and panic symptoms, while survivors of domestic violence had an increased incidence of depressive symptoms, general anxiety symptoms, and panic symptoms. Conclusion: Clinicians should consider the possibility of trauma-related psychological distress in patients who present with undiagnosable physical complaints.