This presentation focuses on certain forms of abuses in these settings that may cross the threshold of acceptable standards of ethical medical treatment and cross over to what is globally defined as torture or cruel, inhuman or degrading treatment and punishment (CIDT). It examines a number of abusive practices commonly reported to be happening in psychiatric care settings and describes how the human rights framework applies in this context. This presentation will also attempt to elucidate this concerns both in the specific context of vulnerable populations of the mentally disabled or ill. It will also raise policy implications and recommendations for reflection.

Torture is an extreme life stressor which increases the risk of serious psychological and physical sequelae of victims. Despite Geneva declaration, Amnesty International reports that torture remains as human rights issue in many sites of the world. Even in Korean peninsula, torture is a serions human rights issue. This paper is a critical review on torture; to describe its methods and effects, the assessment of psychological and physical sequelae, and its treatment. Torture also affects survivor's family. The more prolonged, repeated, and unpredictable the experience of torture is, the more serious psychiatric consequences are likely. Psychological responses and sequelae include not only symptoms of Posttraumatic Stress Disorder (PTSD), but also depression, personality changes, somatoform disorders and others. Diagnositic terms such as complex PTSD or torture syndrome have been used to denote the complexity of torture trauma. Treatment is a combination of pharmacotherapy, cognitive-behavioural therapy, guidance for of socialre readaptation. Ensuring safety and trust between survivors and medical staffs is important. Torture prevention is to expose the facts particularly health data to the public, and collaborate with international organizations fighting against torture. Preventive interventions is linked to a change in the underlying socio-political causes and to the creation of necessary conditions for human rights and development at the level of society.
Depression ; Drug Therapy ; Human Rights ; Humans ; Medical Staff ; Somatoform Disorders ; Stress Disorders, Post-Traumatic ; Survivors ; Torture*

OBJECTIVES: This study was to investigate the psychiatric diagnoses of survivors of traumatic stress, i.e. torture, as a part of a large research project of a human rights survey of torture survivors. METHODS: Participants were 24 torture survivors who consented to participate, who had experienced torture during the period of 1970 through the 2000's. Participants were recruited from human rights support groups and government agencies using the snowballing technique. Data was collected by a psychiatrist and two psychologists using the MINI-International Neuropsychiatric Interview PLUS. RESULTS: The prevalence of past psychiatric diagnoses which occurred during a post-victimization period included post-traumatic stress disorder (PTSD, 37.5%), depressive disorders (45.8%), panic disorder (16.6%), substance related disorders (24.9%), psychotic disorder (4.1%), and adjustment disorder (16.6%). The prevalence of current diagnoses at interview period included PTSD (33.3%), depressive disorders (41.6%), panic disorder (8.2%), generalized anxiety disorder (4.1%), substance related disorders (20.8%), psychotic disorder (4.1%), adjustment disorder (12.5%), and suicidal tendency of above mid-level (16.6%). The co-morbidity rate was 37.5% in the past, and 33.3% at present. CONCLUSION: It was revealed that torture survivors were suffering from high rates of chronic psychiatric disorders. Appropriate psychiatric treatment may be in need to support the sufferings of the survivors.
Adjustment Disorders ; Anxiety Disorders ; Depressive Disorder ; Government Agencies ; Human Rights ; Humans ; Mental Disorders ; Panic Disorder ; Prevalence ; Psychiatry ; Psychotic Disorders ; Self-Help Groups ; Stress Disorders, Post-Traumatic ; Stress, Psychological ; Survivors ; Torture

“Comfort women” are survivors of sexual slavery by the Imperial Japanese Army during World War II, who endured extensive trauma including massive rape and physical torture. While previous studies have been focused on the trauma of the survivors themselves, the effects of the trauma on the offspring has never been evaluated before. In this article, we reviewed the first study on the offspring of former “comfort women” and aimed to detect the evidence of transgenerational transmission of trauma. In-depth psychiatric interviews and the Structured Clinical Interview for DSM-5 Axis I Disorders were conducted with six offspring of former “comfort women.” Among the six participants, five suffered from at least one psychiatric disorder including major depressive disorder, panic disorder, posttraumatic stress disorder, adjustment disorder, insomnia disorder, somatic symptom disorder, and alcohol use disorder. Participants showed similar shame and hyperarousal symptoms as their mothers regarding stimuli related to the “comfort woman” issue. Increased irritability, problems with aggression control, negative worldview, and low self-esteem were evident in the children of mothers with posttraumatic stress disorder. Finding evidence of transgenerational transmission of trauma in offspring of “comfort women” is important. Future studies should include more samples and adopt a more objective method.
Adjustment Disorders ; Aggression ; Asian Continental Ancestry Group ; Child ; Depressive Disorder, Major ; Humans ; Methods ; Military Personnel ; Mothers ; Panic Disorder ; Rape ; Shame ; Slavery ; Sleep Initiation and Maintenance Disorders ; Stress Disorders, Post-Traumatic ; Survivors ; Torture ; World War II

“Comfort women” refers to young women and girls who were forced into sexual slavery by the Imperial Japanese military during World War II. They were abducted from their homes in countries under Imperial Japanese rule, mostly from Korea, and the rest from China, Philippines, Malaysia, Taiwan, Indonesia, the Netherlands, etc. “Comfort women” endured extreme trauma involving rape, sexual torture, physical abuse, starvation, threats of death, and witnessed many others being tortured and killed. This article reviews all the studies that have investigated the psychiatric or psychosocial sequelae of the survivors of the Japanese military sexual slavery. Most importantly, a recent study which conducted a psychiatric evaluation on the former “comfort women” currently alive in South Korea is introduced. The participants’ unmarried rate was relatively high and their total fertility rate was relatively low. Majority of the participants reported having no education and being the low economic status. They showed high current and lifetime prevalence of posttraumatic disorder, major depressive disorder, somatic symptom disorder, social anxiety disorder, panic disorder, and alcohol use disorder. Participants showed high suicidality and majority of the participants still reported being ashamed of being former “comfort women” after all these years. This article high-lights the fact that the trauma has affected the mental health and social functioning of former “comfort women” throughout their lives, and even to the present day.
Anxiety Disorders ; Asian Continental Ancestry Group* ; Birth Rate ; China ; Depressive Disorder, Major ; Education ; Female ; Humans ; Indonesia ; Korea ; Malaysia ; Mental Health ; Military Personnel* ; Netherlands ; Panic Disorder ; Philippines ; Physical Abuse ; Prevalence ; Rape ; Single Person ; Slavery* ; Starvation ; Stress Disorders, Post-Traumatic ; Survivors* ; Taiwan ; Torture ; World War II*