Adaptational problems of Vietnamese refugees. I. Health and mental health status.

The forced migratory influx of Vietnamese to the United States has raised questions regarding the resettlement process, the effect of culture shock, the refugees' coping behavior and adaptabilities, and their health and mental health status. We report the two-year results of ongoing research on the Vietnamese refugees based on the use of the Cornell Medical Index (CMI). The responses on the CMI on the first (1975) and second (1976) administrations indicate a high and continuing level of physical and mental dysfunction. The second administration also revealed significant shifts in dysfunctions as well as exposing factors that related to these dysfunctions, ie, age/sex interactions, marital status, family groupings, and public assistance. The follow-up CMI also showed an increase in anger and hostility with concomitant reductions in feelings of inadequacy.

Adaptation problems of Vietnamese refugees. II. Life changes and perception of life events.

The Vietnamese refugees have encountered a multitude of acute psychological, social, cultural, economic, and political upheavals. This study documents the Vietnamese perceptions of the life events that have swirled about them as well as the occurrences of these life events. Questionnaires were administered in 1975 and 1976 as part of an ongoing study. The expected high amount of life change in the year of the evacuation and resettlement (1975) continued into the following year (1976). Financial, life-style, work, spouse, and schooling problems continued to plague them and were increased in the second year. There was a positive correlation between life change and health status. The Vietnamese rank ordered the impact of life events in a fashion similar to the Americans, but there were differences in mean magnitude estimations. Substantial reductions in magnitude estimations at second administration of the Social Readjustment Rating Questionnaire indicated a change in the situational perception set with time.

Depression among Vietnamese refugees in a primary care clinic.

Refugees are at high risk for mental disorders and manifest cultural influences in their health behavior. The Vietnamese Depression Scale was administered to Vietnamese patients at a community clinic to assess the underlying prevalence of depression. The rate of accurate diagnosis and the manifestations of depression were also examined. A high prevalence of depression (52 percent) and a high level of underdiagnosis (56 percent) by primary care physicians were found. Ninety-five percent of these patients presented with physical symptoms. Compared with patients who had negative depression scores, those who had positive depression scores were more likely to be older and sought care at the clinic more frequently. These findings underscore the importance of depression as an urgent health problem among Vietnamese refugees in primary care. Accuracy in diagnosis can be improved by using the Vietnamese Depression Scale and constitutes the first step toward effective treatment.