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Brain structural abnormalities and mental health sequelae in South Vietnamese ex-political detainees who survived traumatic head injury and torture.
Arch Gen Psychiatry. 2009 Nov; 66(11):1221-32.AG

Abstract

CONTEXT

A pilot study of South Vietnamese ex-political detainees who had been incarcerated in Vietnamese reeducation camps and resettled in the United States disclosed significant mental health problems associated with torture and traumatic head injury (THI).

OBJECTIVES

To identify structural brain alterations associated with THI and to investigate whether these deficits are associated with posttraumatic stress disorder and depression.

DESIGN

Cross-sectional neuroimaging study.

SETTING

Massachusetts General Hospital and McLean Hospital.

PARTICIPANTS

A subsample of Vietnamese ex-political detainees (n = 42) and comparison subjects (n = 16) selected from a community study of 337 ex-political detainees and 82 comparison subjects.

MAIN OUTCOME MEASURES

Scores on the Vietnamese versions of the Hopkins Symptom Checklist-25 (HSCL) and Harvard Trauma Questionnaire for depression and posttraumatic stress disorder, respectively; cerebral regional cortical thickness; and manual volumetric morphometry of the amygdala, hippocampus, and thalamus.

RESULTS

Ex-political detainees exposed to THI (n = 16) showed a higher rate of depression (odds ratio, 10.2; 95% confidence interval, 1.2-90.0) than those without THI exposure (n = 26). Ex-political detainees with THI had thinner prefrontotemporal cortices than those without THI exposure (P < .001 by the statistical difference brain map) in the left dorsolateral prefrontal and bilateral superior temporal cortices, controlling for age, handedness, and number of trauma/torture events (left superior frontal cortex [SFC], P = .006; left middle frontal cortex, P = .01; left superior temporal cortex [STC], P = .007; right STC, P = .01). Trauma/torture events were associated with bilateral amygdala volume loss (left, P = .045; right, P = .003). Cortical thinning associated with THI in the left SFC and bilateral STC was related to HSCL depression scores in THI-exposed (vs non-THI-exposed) ex-political detainees (left SFC, P for interaction = .007; left STC, P for interaction = .03; right STC, P for interaction = .02).

CONCLUSIONS

Structural deficits in prefrontotemporal brain regions are linked to THI exposures. These brain lesions are associated with the symptom severity of depression in Vietnamese ex-political detainees.

Authors+Show Affiliations

Harvard Program in Refugee Trauma, 22 Putnam Ave, Cambridge, MA 02139, USA. rmollica@partners.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19884610

Citation

Mollica, Richard F., et al. "Brain Structural Abnormalities and Mental Health Sequelae in South Vietnamese Ex-political Detainees Who Survived Traumatic Head Injury and Torture." Archives of General Psychiatry, vol. 66, no. 11, 2009, pp. 1221-32.
Mollica RF, Lyoo IK, Chernoff MC, et al. Brain structural abnormalities and mental health sequelae in South Vietnamese ex-political detainees who survived traumatic head injury and torture. Arch Gen Psychiatry. 2009;66(11):1221-32.
Mollica, R. F., Lyoo, I. K., Chernoff, M. C., Bui, H. X., Lavelle, J., Yoon, S. J., Kim, J. E., & Renshaw, P. F. (2009). Brain structural abnormalities and mental health sequelae in South Vietnamese ex-political detainees who survived traumatic head injury and torture. Archives of General Psychiatry, 66(11), 1221-32. https://doi.org/10.1001/archgenpsychiatry.2009.127
Mollica RF, et al. Brain Structural Abnormalities and Mental Health Sequelae in South Vietnamese Ex-political Detainees Who Survived Traumatic Head Injury and Torture. Arch Gen Psychiatry. 2009;66(11):1221-32. PubMed PMID: 19884610.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Brain structural abnormalities and mental health sequelae in South Vietnamese ex-political detainees who survived traumatic head injury and torture. AU - Mollica,Richard F, AU - Lyoo,In Kyoon, AU - Chernoff,Miriam C, AU - Bui,Hoan X, AU - Lavelle,James, AU - Yoon,Sujung J, AU - Kim,Jieun E, AU - Renshaw,Perry F, PY - 2009/11/4/entrez PY - 2009/11/4/pubmed PY - 2009/11/13/medline SP - 1221 EP - 32 JF - Archives of general psychiatry JO - Arch Gen Psychiatry VL - 66 IS - 11 N2 - CONTEXT: A pilot study of South Vietnamese ex-political detainees who had been incarcerated in Vietnamese reeducation camps and resettled in the United States disclosed significant mental health problems associated with torture and traumatic head injury (THI). OBJECTIVES: To identify structural brain alterations associated with THI and to investigate whether these deficits are associated with posttraumatic stress disorder and depression. DESIGN: Cross-sectional neuroimaging study. SETTING: Massachusetts General Hospital and McLean Hospital. PARTICIPANTS: A subsample of Vietnamese ex-political detainees (n = 42) and comparison subjects (n = 16) selected from a community study of 337 ex-political detainees and 82 comparison subjects. MAIN OUTCOME MEASURES: Scores on the Vietnamese versions of the Hopkins Symptom Checklist-25 (HSCL) and Harvard Trauma Questionnaire for depression and posttraumatic stress disorder, respectively; cerebral regional cortical thickness; and manual volumetric morphometry of the amygdala, hippocampus, and thalamus. RESULTS: Ex-political detainees exposed to THI (n = 16) showed a higher rate of depression (odds ratio, 10.2; 95% confidence interval, 1.2-90.0) than those without THI exposure (n = 26). Ex-political detainees with THI had thinner prefrontotemporal cortices than those without THI exposure (P < .001 by the statistical difference brain map) in the left dorsolateral prefrontal and bilateral superior temporal cortices, controlling for age, handedness, and number of trauma/torture events (left superior frontal cortex [SFC], P = .006; left middle frontal cortex, P = .01; left superior temporal cortex [STC], P = .007; right STC, P = .01). Trauma/torture events were associated with bilateral amygdala volume loss (left, P = .045; right, P = .003). Cortical thinning associated with THI in the left SFC and bilateral STC was related to HSCL depression scores in THI-exposed (vs non-THI-exposed) ex-political detainees (left SFC, P for interaction = .007; left STC, P for interaction = .03; right STC, P for interaction = .02). CONCLUSIONS: Structural deficits in prefrontotemporal brain regions are linked to THI exposures. These brain lesions are associated with the symptom severity of depression in Vietnamese ex-political detainees. SN - 1538-3636 UR - https://www.unboundmedicine.com/medline/citation/19884610/Brain_structural_abnormalities_and_mental_health_sequelae_in_South_Vietnamese_ex_political_detainees_who_survived_traumatic_head_injury_and_torture_ L2 - https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/archgenpsychiatry.2009.127 DB - PRIME DP - Unbound Medicine ER -