A/59/324 for the rest of their lives. It will constantly remind them of the torture experience, which has considerable psychological effects. 48. The lack of medical treatment for torture survivors in custody may not only be considered as a prolongation of the torture,18 it may also have far-reaching consequences in terms of their rehabilitation. Indeed, victims with serious physical injuries who are left medically unattended because of lack of will or means may see their condition worsen to the point that medicine may not be of any help once they are referred to the medical profession. A number of cases have been transmitted to the Special Rapporteur regarding pre-trial detainees who, after having been tortured upon arrest or during interrogation sessions, have been refused medical attention. 49. The most common diagnosis of psychiatric symptoms among torture survivors is said to be post-traumatic stress disorder. Torture victims may suffer from aftereffects such as sleep disturbance, irritability, anxiety, impaired memory, concentration deficiencies and depression. The Special Rapporteur nevertheless would like to emphasize that each individual responds in his own way to the experience of having been tortured, depending on various factors, such as age, gender, family status, socio-economic status, cultural background, etc. Another factor is the so-called “psychological preparedness for trauma”, which includes a strong belief system (political, religious or other), the ability to give meaning to the traumatic experience, predictability or controllability of traumatic stressors or prior immunization to traumatic stressors in the context of political activity.19 50. In addition to the physical and psychological damage, torture may also have a serious impact on the survivor’s family and social life. Physical and psychological impediments caused by torture may create difficulties in resuming satisfactory relationships with the family, in particular with spouses and children. After-effects of torture, such as irritability, resentment and depression, may also impair interpersonal relationships. Feelings of fear and insecurity, as well as lack of selfconfidence or confidence in the authorities that were supposed to guarantee a secure environment, may also make difficult a smooth readaptation into society. Permanent physical wounds, psychological problems and cognitive impairment may also reduce the survivor’s working capacity. Social disabilities and loss of employment may lead to social and economic exclusion, which would have an impact on the whole family, especially when the torture survivor was the principal earner.20 Some torture victims may also decide to leave their home place for fear of continued persecution, because of the social stigma or in an attempt to forget the experience. They, and often their relatives, would have thus to start a new life with all the socioeconomic and other consequences this involves. 51. The torture of one individual affects the entire family and community of the victim. When the conditions in which a person is detained or the treatment to which she or he is subjected are made known to her or his relatives — sometimes intentionally, with a view to putting pressure on them or to punishing them — the impact thereof may also amount to a form of ill-treatment. The anguish is heightened when the family is not informed of the fate and whereabouts of the victim. In this respect, the Special Rapporteur would like to remind the General Assembly that the Human Rights Committee has held that the practice of disappearance may be considered a form of torture both for the victim and for the relatives.21 Furthermore, once the victim is released from custody, the family may be faced with a different person, with physical and mental handicaps and who needs 14