The Body Remembers: Somatic Symptoms in Traumatized Khmer

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 PRIMEMD. 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 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.