1.Combined psychopharmacological and psychosocial approaches and the relevance of therapeutic jurisprudence and religion in the successful management of battered woman's syndrome: A case report.
The Philippine Journal of Psychiatry 2016;38(2):22-32
INTRODUCTION: Although Battered Woman Syndrome is not listed in the DSM 5 and the ICD 10 as an official diagnosis, it is undeniable that women suffering Intimate Partner Violence (IPV) experience the same cycle of violence, suffer from a common range of symptoms, and have a predictable prognosis. While psychosocial guidelines and support are available, like in our Women and Child Protection Units (WCPU), there is also a gap in the clinical guidelines in treating and managing these cases, which might present with a combination of posttraumatic and depressive symptomatology. In this report, we discuss the case of a 32 year old woman who was subjected to severe physical and emotional abuse by her longtime romantic partner. She consulted at our center seeking help for a psychiatric evaluation for the case she was going to pursue in court but it was apparent she was suffering from posttraumatic, somatic, and depressive symptoms. Supportive therapy was initially done and she was started on Escitalopram and low dose Quetiapine for sleep problems. As her case started gathering steam, issues about the court process, possible setback with her church and possible retaliation from her partner weighed heavily on her. Possible issues were discussed beforehand and successfully faced up to her partner in a church related tribunal and in the fiscal's office. Using an Eye Movement Desensitization and Reprocessing(EMDR) variant, Unfinished Trauma Episode Protocol (U-TEP), her posttraumatic symptoms were eventually addressed. As she started having faith in the legal system and her church, she had restored self-esteem, was active in her social circle and become an advocate in helping other women get proper treatment and to fight for their rights. Besides the clinician advocated treatment along with the services delivered via the WCPU network, the perception of getting justice from social institutions like the judiciary and the church helped in the recovery of this patient. Clinicians dealing with Battered Woman Syndrome should be aware of issues the patient might go through the stages of her fight and that the process of seeking for justice is also a process of mental healing.
Human ; Female ; Adult ; Depressive Disorder, Major ; Jurisprudence ; Battered Women ; Wounds And Injuries ; Violence ; Dependent Personality Disorder
2.One year readmission rates of acute and transient psychotic disorders & diagnosis of patients admitted at the National Center for Mental Health from Jan-Dec 2012.
Paccial Rodelen C. ; Andrada-Domingo Grace P. ; Cruzada Joeffrey L.
The Philippine Journal of Psychiatry 2016;38(2):3-9
OBJECTIVES:The aim of this study was to determine the readmission rates of Acute and Transient Psychotic Disorders (ATPD) who were admitted for the first time in the National Center of Mental Health from January to December 2012.
METHODOLOGY: This study used the retrospective cohort method. Patients included in the study were admitted for the first time with a diagnosis of Acute and Transient Psychotic Disorders (ATPD) during the period of January to December 2012. The source of data involved the chart review during the first admission and the subsequent admission. Patients who were readmitted beyond one year from time of admission were excluded.
RESULTS:Results showed that 25 out of 204 (12.26%) patients diagnosed with an ATPD were readmitted within one year. The most common diagnosis of ATPD upon admission were: Acute Schizophrenia-Like Psychotic Disorder (n=95), Other Schizophrenia (n=90) and Acute Polymorphic Psychotic Disorder (n=19). ATPD's with the highest 1 year readmission rates were Acute Polymorphic Psychotic Disorder (3/19),Other Schizophrenia (13/90) and Acute Schizophrenia-Like Psychotic Disorder(9/95).Those that were readmitted had a different discharge diagnosis in their second admission.The three most common diagnosis upon readmission were Undifferentiated Schizophrenia (36%), Bipolar Affective Disorder, current episode manic, with psychotic symptoms (24%) and Other Schizophrenia (12%). Acute Schizophrenia-Like Psychotic Disorder were mostly readmitted as Bipolar Affective Disorder in 44% of patients; Acute Polymorphic Psychotic Disorder (APPD) were readmitted as another ATPD (66.6%); and Other Schizophrenia was diagnosed as Undifferentiated Schizophrenia (54%).
CONCLUSION:Only a small percentage of patients with ATPD were readmitted one year from admission and those who were readmitted revealed that they may have actually been suffering from or developed another more chronic psychotic disorder.
Human ; Female ; Middle Aged ; Adult ; Schizophrenia ; Bipolar Disorder ; Psychotic Disorders
3.Posttraumatic symptomatology of a rural Filipino population in Merida, Leyte in the wake of Super Typhoon Yolanda (Haiyan)
Rodelen C. Paccial ; Mark Philip R. Rivera ; Bernard B. Argamosa
The Philippine Journal of Psychiatry 2019;41(2):3-9
Objectives:
The goal of the research was to provide local
data on the varieties of posttraumatic symptomatology among
survivors of Super typhoon Haiyan in a rural community in
Merida, Leyte.
Methodology:
This is a single point
non-invasive study of Filipino survivors of typhoon Yolanda
who came from Merida, Leyte, involving administration
of a symptom checklist i.e. Post Traumatic Stress Disorder
Checklist- Civilian version (PCL-C) to assess the occurrence
of posttraumatic symptoms in the selected group of
volunteers with no history of psychiatric illness. The PCL-C
was given as part of a community screening for symptoms of
PTSD conducted three months after the typhoon. There were
two ways of scoring the PTSD Checklist- Civilian version
(PCL-C) - either by computing for the total severity score or
by scoring each response category just like one would in the
Diagnostic and Statistical Manual (DSM IV TR) criteria. The
sum of all PCL-C item scores indicated the severity of Post
Traumatic Stress Disorder (PTSD). A score of 30 and above
represented the occurrence of PTSD. T-test was used to
determine differences in the severity scores of those who met
the criteria for PTSD using the total "severity scoring method"
and those who did not.
Results:
A total of 29 respondents
took part in the study where the majority were female (28/29
or 96.55%). The results showed that Filipinos suffered more
re-experiencing symptoms but less avoidance symptoms
compared to the DSM IV-TR criteria. Nine of 29 (31.03%)
respondents were assessed as having Post Traumatic Stress
Disorder (PTSD) based on the total "severity score method':
However, none fulfilled the PTSD DSM IV TR criteria when
the response "category scoring method" was used. Those who
met the severity criteria had significantly higher scores in
items 1 (Repeated, disturbing memories, thoughts, or images
of a stressful experience from the past?), 3 (Suddenly acting
or feeling as if a stressful experience were happening again?),
5 (Having physical reactions when something reminded you
of a stressful experience from the past?), 6 (Avoid thinking
about or talking about a stressful experience from the past or
avoid having feelings related to it?) and 13 (Trouble falling
or staying asleep?).
Conclusion
There seems to be a
difference in how the Filipinos experience trauma compared to Western models such as described in the Diagnostic
Symptom Manual (DSM IV TR) criteria though caution is
warranted in interpreting the results due to the small sample
size and the predominance of female respondents.
Stress Disorders, Post-Traumatic
;
Natural Disasters
;
Cyclonic Storms
4.A trauma perspective on a case of Mayer-Rokitansky-Kuster-Hauser Syndrome presenting with major depression with psychosis
Maria Theresa Sarah C. Rivera ; Jhun Robbie U. Galicia ; Rodelen C. Paccial
The Philippine Journal of Psychiatry 2022;3(1-2):60-66
The psychological impact of the diagnosis of congenital anomalies is an area with limited
research; and more limited still when such congenital anomalies are not very obvious. MayerRokitansky-Kuster-Hauser (MRKH) syndrome can be one of those less apparent congenital
anomalies. Owing to their inability to bear children, women confronted with the diagnosis of
MRKH can be left stressed, or worse, traumatized by the fact that they can no longer function
in their traditional gender roles. This may leave any individual wanting to deny the diagnosis or
even withhold such information. And the experience is a fertile ground for the development of
any mental illness. MRKH occurs in every 1 out of 4000-5000 females. Although the
psychological impact of stress is a well –established fact, there are fewer literature on the
possible genetic link of MRKH and mental illness, the psychodynamic underpinnings and the
similarities to trauma of the diagnosis of MRKH, in particular.
We present here a case of MRKH syndrome with an initial presentation of major depression
and psychosis; with the diagnosis of MRKH initially withheld from the resident psychiatrist. We
would also want to highlight a trauma perspective of the case presented as well as to
emphasize the need for more research congenital anomalies are accompanied by co-morbid
psychiatric illnesses.
Depression
;
Psychotic Disorders
;
Psychological Distress