Measuring generalized anxiety disorder (GAS) using the DSM-V severity measure assessment among resettled Bhutanese-Nepali refugees

Public Health Relevance: Mental illness affects refugees who settle all over the world; however, Bhutanese refugees who settle in western societies are at higher risk. These high rates affect local communities, health systems, and economies, while highlighting the importance of refugee health services. Objective: The aim of this study was to measure generalized anxiety disorder (GAD) in a sample of Bhutanese-Nepali refugees experiencing mental health symptoms in Pittsburgh, Pennsylvania, and explore their attitudes about mental health and treatment options. Methods: Six participants volunteered for in-home interviews where GAD status was assessed using the mean DSM-V Severity Measure for Generalized Anxiety Disorder questionnaires. A review of literature, in-home interviews and a single focus group with four participants were conducted to gain information on attitudes about mental health, culturally specific events or experiences related to mental health, and treatments available and utilized by this community. Results: A moderate level of GAD was found in the sample. Traditional medicine (meditation, yoga, dhamis) and clinical medicine (pharmaceuticals) were reportedly used to treat anxiety in this sample, with a combination of both reportedly working best. Stress associated with relocation and resettlement has been suggested as a cause of GAD among the sample. Conclusion: In a small sample of Bhutanese-Nepali refugees in Pittsburgh, Pennsylvania; moderate levels of GAD were reported; however, due to a small sample size an alternative diagnosis such as a culture-bound syndrome should not be excluded. Future evaluations should be done to expand treatment regimens for mental health in the international refugee population, as well as evaluate diagnostic measuring tools