1/7. sleep paralysis among Cambodian refugees: association with PTSD diagnosis and severity.Among Cambodian refugees attending a psychiatric clinic (n=100), 49% (49/100) had at least one episode of sleep paralysis (SP) in the previous 12 months. The annual and monthly SP prevalences were much higher in posttraumatic stress disorder (PTSD) than in non-PTSD patients. Among the PTSD patients, 65% (30/46) had monthly episodes of SP versus 14.85% (8/54) among non-PTSD patients (chi2[2, n=100]=26.78, P<.001). Moreover, patients with SP in the last month (n=30) versus those without SP had much higher PTSD severity scores. In the entire sample (n=100), the PTSD severity scores correlated significantly with the rate of SP in the last month. During SP, Cambodian refugees usually hallucinated an approaching figure (90%, 44/49). The rate of SP-associated and post-SP panic attacks was high, indicating the great distress caused by the phenomenon. SP seems to be a core aspect of the Cambodian refugee's response to trauma. When treating Cambodian refugees, and traumatized refugees in general, clinicians should assess for its presence.- - - - - - - - - - ranking = 1keywords = stress disorder (Clic here for more details about this article) |
2/7. Psychological implications of admission to critical care.Admission to critical care can have far-reaching psychological effects because of the distinct environment. critical care services are being re-shaped to address long-term sequelae, including post-traumatic stress disorder, anxiety and depression. The long-term consequences of critical illness not only cost the individual, but also have implications for society, such as diminished areas of health-related quality-of-life in sleep, reduced ability to return to work and enjoy recreational activities (Audit Commission, 1999; Hayes et al, 2000). The debate around the phenomenon of intensive care unit (ICU) syndrome is discussed with reference to current thinking. After critical care, patients may experience amnesia, continued hallucinations or flashbacks, anxiety, depression, and dreams and nightmares. nursing care for patients while in the critical care environment can have a positive effect on psychological well-being. Facilitating communication, explaining care and rationalizing interventions, ensuring patients are oriented as to time and place, reassuring patients about transfer, providing patients,where possible, with information about critical care before admission and considering anxiolytic use, are all practices that have a beneficial effect on patient care. Follow-up services can help patients come to terms with their experiences of critical illness and provide the opportunity for them to access further intervention if desired. Working towards providing optimal psychological care will have a positive effect on patients' psychological recovery and may also help physical recuperation after critical care.- - - - - - - - - - ranking = 1keywords = stress disorder (Clic here for more details about this article) |
3/7. Persisting hallucinations following childhood sexual abuse.hallucinations can persist for many years after childhood sexual abuse. If we recognise this, we will not mis-diagnose psychosis and we may treat with psychotherapy (talk). The hallucinations are distinct from hallucinations in schizophrenia though patients have frequently been given that diagnosis. They would generally be classified as pseudo-hallucinations. They are generally self-referential. They can involve all sensory modalities. Three case reports illustrate this link. methods for interviewing and providing ongoing help are discussed. Issues in phenomenology and diagnosis are considered. Post-traumatic stress disorder is the best diagnostic fit, though psychotic depression may explain some cases. Freud's case of Frau P (1896) was an early report of this link.- - - - - - - - - - ranking = 1keywords = stress disorder (Clic here for more details about this article) |
4/7. Auditory hallucinations in combat-related chronic posttraumatic stress disorder.Intrusive images have been reported to occur in a broad range of people with posttraumatic stress disorder, but the frequency of intrusive auditory perceptions has rarely been addressed. This study compared five posttraumatic stress disorder veterans experiencing auditory hallucinations with 31 nonhallucinating veterans on demographic, military, postmilitary, and symptom variables. veterans who reported auditory hallucinations had higher combat exposure and more intense posttraumatic stress disorder symptoms than the other veterans. These veterans also tended to be more refractory to treatment than veterans with no hallucinations. Clinical vignettes of the veterans with auditory hallucinations are given, and the implications of the results for a subgroup of chronic posttraumatic stress disorder veterans are discussed.- - - - - - - - - - ranking = 8keywords = stress disorder (Clic here for more details about this article) |
5/7. Case study: trauma-related hallucinations.Proper differential diagnosis of psychiatric disorders with psychotic symptoms is imperative, as the treatment implications of the various conditions are quite different. A case study of a 5-year-old abused child with posttraumatic stress disorder is presented to illustrate some of the characteristic features of psychotic symptoms in traumatized children. literature reviewed suggests that trauma-related hallucinations frequently contain content which is related to children's life experiences, are exacerbated by "triggers" and safety concerns, resolve with psychotherapy or psychosocial interventions, and are resistant to standard neuroleptic treatments. They are also associated with unique clinical, familial, developmental, and psychobiological correlates, and they require multifaceted treatment interventions.- - - - - - - - - - ranking = 1keywords = stress disorder (Clic here for more details about this article) |
6/7. Dangerous misidentification of people due to flashback phenomena in posttraumatic stress disorder.Misidentification of people may occur in a number of psychiatric disorders associated with delusional thinking. Misidentification of people may also occur in the context of visual flashback phenomena associated with post-traumatic stress disorder. People who misidentify someone during a flashback associated with previous war combat experience may perceive and conceptualize the misidentified object as an enemy who may be both feared and disliked. This might make the misidentified objects become the targets of violent attacks by the affected person. In this article we present five cases of flashback-induced misidentification of people who were subsequently attacked within the context of the flashback experience. The nature of the misidentification of persons due to flashback experiences is discussed. The association between the type of misidentification and aggression is also discussed.- - - - - - - - - - ranking = 5keywords = stress disorder (Clic here for more details about this article) |
7/7. Psychotic symptoms in post-traumatic stress disorder.Although many coexisting disorders have been reported with post-traumatic stress disorder (PTSD), little reference has been made to the presence of psychotic symptoms. Psychotic symptoms are not included in the diagnostic and statistical manual of mental disorders IV or international classification of diseases 10 diagnoses of PTSD. The hallucinations and delusions described here in two cases of PTSD were accompanied by psychotic symptoms. These symptoms clearly differ from flashbacks but have a strong symbolic relationship to the trauma, and they do not respond to antipsychotic drugs. The question is whether there are two separate diagnoses or if psychotic symptoms are an integral part of PTSD. More systematic studies are required to explore the possibility of changing the current classifications of PTSD to include a diagnosis of PTSD with psychotic features.- - - - - - - - - - ranking = 4keywords = stress disorder (Clic here for more details about this article) |