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Background: Refugees are likely to suffer from complex medical conditions due to persecution and exile. The symptoms may persist several years after the individual has fled his or her homeland. Knowledge of refugees' health condition in their receptive countries is insufficient., Material and Method: Qualitative interviews with 12 general practitioners (GPs) in and around Oslo. A narrative approach was chosen for the analysis., Results: The GPs' consultations with refugee patients seem to be characterised by uncertainty on the relevance of their refugee experience to their health condition. The GPs were reluctant to invite the patient to talk about traumatic experiences connected to their homelands, the escape and the exile. Rather, they express that unfamiliar culture and foreign language act as barriers to good communication between doctor and patient. Specialised health services seem neither to be accessible to the patients nor to be providers of clinical supervision for the GPs., Interpretation: Cultural status seems to cover up experiences related to escape and exile. A lack of specialised health services seems to place the GP as a single actor in the medical service to refugee patients. The interviews revealed a need for instruction material adapted to the GPs' situation.

Background: The purpose of this article is to describe the prevalence of chronic pain in traumatized refugees. Further, we sought to identify the possible associations between pain and psychosocial factors, reported traumatic events, and posttraumatic stress disorder., Materials and Methods: Seventy-two patients (40%) were followed up 3 to 8 years after contact with a psychiatric outpatient clinic at the Psychosocial Centre for Refugees in the University of Oslo. Of the men, 83 % had been imprisoned before flight, of the women, 44%. In this study data was collected at onset of treatment and at follow up by a semi-structured interview. We included data on pain, previously experienced traumatic events, socio-demographic information, social support and psychiatric symptoms using the Hopkins symptom check list-25, the symptom scale of Harvard trauma questionnaire, and a screening for a diagnosis of posttraumatic stress disorder according to the DSM-IV. Additionally, general assessment of functioning was estimated. Chronic pain was defined as suffering continuously from serious pain over the last 6 months., Results and Interpretation: Forty-seven (65%) patients reported they had problems with chronic pain; out of these, 34 (72%) reported they experienced severe pain. No significant association was found between type or number of traumatic event and chronic pain. Significant association was found between severe chronic pain, posttraumatic stress disorder, anxiety and depression scores, general assessment of functioning, and medium/low social support. A significant association was found between severe chronic pain and the frequency of consultations with a general practitioner. Inquiry about and treatment for chronic severe pain should be included in the rehabilitation of traumatized refugees.