Psychiatric aspects of detention: illustrative case studies.

Psychiatric aspects of detention: illustrative case studies.
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拘留的精神病学方面:说明性案例研究。

DOI:
10.1111/j.1440-1614.2004.01402.x
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发表时间:
2004
期刊:
The Australian and New Zealand journal of psychiatry
影响因子:
--
通讯作者:
Sotoodeh Abhary
Sotoodeh Abhary
中科院分区:
--
文献类型:
--
作者:
L. Koopowitz;Sotoodeh Abhary

文献摘要

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目的 虽然这两种政治制度不能等同,但根据澳大利亚现政府的移民条例被拘留的人和根据南非上届种族隔离政府的安全立法被拘留的人所引起的精神和心理问题在许多方面是相似的。 方法 我们提出了两种情况下的累积临床经验的作者在他们的工作(作为他们的日常临床实践和医学院的经验的一部分)与寻求庇护者和政治拘留者在南非和澳大利亚的急性精神科单位的代表。 结果 提出的类似问题包括对这些患者进行精神病诊断的有效性,以及这一难题在多学科团队中引发的辩论。政治家在住院被拘留者的临床管理方面对临床医生施加的压力在两国引起了类似的伦理问题。抑郁症和创伤后应激障碍的临床症状相似。“临时保护签证”赋予难民的“非人”地位的效果,可以等同于对阿巴查政权反对者实施的“禁止令”的效果。 结论 在南非,政治犯参加了斗争,期望在当时的政府手中面临困难和酷刑。寻求庇护者逃往澳大利亚,期望得到民主制度的支持,一般没有为进一步的监禁和另一场政治斗争做好准备。尽管存在这种看似根本的差异,但两种截然不同的政治制度下的被拘留者的经历却非常相似。
OBJECTIVE Although the two political systems cannot be equated, the psychiatric and psychosocial issues raised by people detained under the migration regulations of the present Australian government, and those detained under the security legislation of the last apartheid government in South Africa, are similar in many aspects. METHOD We present two case scenarios representative of the cumulative clinical experience of the authors in their work (as part of their routine clinical practice and medical school experience) with asylum seekers and political detainees in acute psychiatric units in both South Africa and Australia. RESULTS Similar issues raised included the validity of a psychiatric diagnosis in these patients and the debate this conundrum provoked among the multidisciplinary teams. The pressures placed on clinicians by politicians in terms of clinical management of hospitalized detainees raised similar ethical questions across both countries. The clinical syndromes of depression and posttraumatic stress disorder were similar. The effect of the 'non-person' status conferred upon refugees by the 'temporary protection visa' could be equated with the effect of 'banning orders' imposed on opponents of the Apartheid regime. CONCLUSIONS In South Africa, political detainees entered into the struggle expecting to face hardship and torture at the hands of the government of the time. Asylum seekers flee to Australia expecting support from a democratic system and generally had not prepared themselves for further incarceration and yet another political struggle. Despite this seemingly fundamental difference, the experiences of detainees across two very different political systems are remarkably similar.