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Trauma for the vulnerable: Real or imagined?

The Philippine Journal of Psychiatry.2022;3(1-2):3-15.

Linn is a twenty-year-old female who grew up silently competitive while feeling inferior, and still excelling academically in the background of bullying and social exclusion. This report proposes that the vulnerability to trauma or to the perception of being traumatized can be related to the individual’s level of narcissism. Trauma-associated narcissistic symptoms (TANS) are a result of experiencing a stressor as an affront to the grandiose self. A traumatic disequilibrium occurs in a narcissistically vulnerable self. In both TANS and posttraumatic stress disorder (PTSD), secondary symptoms of anxiety and depression can significantly color the patient’s clinical presentation. Individuals can develop both TANS and PTSD, displaying a mixed clinical presentation. Psychotherapy with the primary goal to restore narcissistic equilibrium is recommended.
Wounds and Injuries ; Stress Disorders, Post-Traumatic ; Narcissism

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Triple ripples: The Neuropsychiatric aftermath of COVID-19 infection

Maria Carmela M. Alipio ; Anna Aurelia Noel-Cortes

The Philippine Journal of Psychiatry.2022;3(1-2):16-25.

This case illustrates the myriad neuropsychiatric symptoms associated with the direct and indirect exposure to COVID-19 infection. The disruption in our daily routines, the uncertainty brought on by the then novel and unknown condition, the specter of death and the “horror” stories that spread through the grapevine during the lockdown shook the foundations of our existence. To make matters even worse, the government protocols required those infected to move away from the comfort of the familiar and the emotional support of family and friends.
COVID-19

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A case report on complex Post-Traumatic Stress Disorder and Comorbid Bipolar II Disorder

Andrea Nichole D. Bautista ; Encarnita Raya-Ampil

The Philippine Journal of Psychiatry.2022;3(1-2):26-34.

This is a case of a 22-year-old female who presented with labile mood, impulsivity and persistent suicidality. Despite numerous pharmacologic and psychotherapeutic regimens, she only had minimal improvement. Subsequently, she revealed traumatic events in younger years.She has been experiencing recurrent intrusive thoughts, low self-worth, guilt and avoidance behavior. Pharmacotherapeutic management was revised as well as her psychotherapy, which resulted in a positive outcome. However, recurrence occurred after she encountered negative life events. Electroconvulsive therapy and revision of pharmacologic treatment eventually led to significant improvement. This case highlights the importance of underlying psychological trauma that caused persistent symptoms. The intensity of impact and the chronic recurrent negative effect of the trauma on the patient influenced the treatment outcome. It is important to optimize therapeutic management with the use of pharmacologic agents, psychotherapy and somatic therapies.
Stress Disorders, Post-Traumatic ; Bipolar Disorder

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Upon that which binds me

Peter B. Santos ; Agnes B. Padilla

The Philippine Journal of Psychiatry.2022;3(1-2):35-49.

The patient is a 36-year-old- male who was bullied by peers and was emotionally abused by his father for being effeminate and preferring to play with dolls. These adverse childhood experiences made him vulnerable to depression. He told himself that he could no longer rely on anyone else but himself and took pride in his independence. He gave his best with his endeavors and did not settle for mediocrity, frequently reviewing his work. During the pandemic, he experienced several hardships such as disruption of activities, inability to meet the financial needs of his family and unemployment. He found himself struggling but surviving. While in a work-from-home arrangement, he was so frustrated about his internet connection that he complained on social media. The internet company then threatened him of possible legal charges and felt stuck in a hopeless situation. This affected his day-to-day activities until he felt so overwhelmed that he attempted suicide by ingesting multiple medications. He was then brought to the emergency room and was admitted. He was diagnosed to have Major Depressive Disorder and was started on antidepressants. Psychotherapy focused on identifying stressors and strengthening adaptive coping mechanisms while he was admitted at an isolation facility. He then followed up at the outpatient department of a tertiary government hospital in Mindanao with noted improvement in mood and functionality overtime. During admission, he was also diagnosed to have Diabetes Mellitus and COVID-19, which added to his burden as these were the biologic factors that were correlated to his depression. The case highlighted the interplay between the effects of multiple traumatic experiences in a vulnerable individual and thus necessitating a holistic management.
Depressive Disorder, Major ; Psychiatry ; Suicide

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Silent screams: A case report on a Muslim medical student with borderline personality and major depressive disorder

Ana Socorro Rita Pago Beroin ; Kristine Elaine Q. Abary

The Philippine Journal of Psychiatry.2022;3(1-2):50-59.

This is a case of a Muslim medical student who sought psychiatric consultation because of suicidal behaviors and declining academic performance, diagnosed with Borderline Personality and Major Depressive Disorder. It was later discovered that she had gone through various instances of physical, emotional and sexual trauma since she was a child. These histories of transgenerational trauma were explored throughout the course of evaluation, including how these experiences had affected her current condition.
Depressive Disorder ; Suicidal Ideation ; Islam ; Students ; Referral and Consultation

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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

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Pagdahun hin kalinaw (Hope for peace and tranquility)

Mary Bernadette V. Egloso ; Bernardo Jorge G. Conde ; Edwin A. Menguito

The Philippine Journal of Psychiatry.2022;3(1-2):67-87.

Words cannot fully describe the grotesque experiences of rape survivors. as psychiatry residents, we are faced with the formidable task of trying to understand their inner experiences, so we can journey with them towards healing.

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The silenced victim: Into the neurological intricacies of complex trauma (Borderline Personality Disorder & Complex Post-Traumatic Stress Disorder)

Maria Lourdes Rosanna E. de Guzman ; Tyrone Paul Cammayo

The Philippine Journal of Psychiatry.2022;3(1-2):88-99.

This case is noteworthy and the problem that it addresses will definitely be of interest to all, given that this is frequently encountered not only in the clinics, but in social media, on-line platforms, in community and disaster work, and within the confines of the homes given the stigma of borderline personality disorder (BPD) and the lack of understanding of PostTraumatic Stress Disorder (PTSD) and Complex Post-Traumatic Stress Disorder (cPTSD). The objective of this case presentation is to look into the challenges that a mental health professional has to face when presented with a case of a patient with a chronic of history of sexual abuse, BPD and PTSD/cPTSD. First of all, given the case presentation, there is a need to determine the diagnosis and to work through the intricacies of symptomatology to be able to distinguish BPD, PTSD or CPTSD with a thorough discussion. Secondly, to present the neurobiology of early trauma and its impact on the developing brain, which often lead to adult symptomatology. Finally, to provide recommendations for treatment, both medical and psychological treatments, in order to find out what best fits the patient.
tress Disorders, Traumatic

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Prevalence of psychosocial distress among flood victims in selected urban barangays in Manila.

Bernadette Joy Q. ALMIROL ; Czarina Charmaine S. DIWA ; Diana Francesca G. GEPTE ; Ofelia P. SANIEL

The Philippine Journal of Psychiatry.2017;39(1):3-13.

OBJECTIVES: This study was conducted to estimate the prevalence of psychosocial problems among residents of four flood-prone barangays in Manila located along the Maricaban-Malibay creek in Pasay City and were reported to have experienced 10-15 feet-deep flood waters simultaneously caused by Typhoon Maring and the southwest monsoon in August 2013.
METHODOLOGY: A stratified two-stage random cluster sampling method, adapted from the Community Assessment for Public Health Emergency Response (CASPER) Toolkit, was employed in the syudy. The first stage of sampling used street clusters, with more or less of the same size, as the primary sampling unites (PSU) and households as secondary sampling units (SSU) to select the households that will be included in the survey. Since the clusters were more or less of the same size, they ahd equal chances of being selected in the study if the probability of selection is proportionate to size (PPS). Seven houses were then randomly chosen from the 30 selected clusters. All of the househol heads from the 210 selected households were given several copies of the self-administered questionnairescalled the Self-Reporting Questionnaire-20 (SRQ-20), a screening tool developed by WHO, to determine the psychosocial condition of the household members 12-65 years.
RESULTS: The prevalence of psychosocial distress in this population was estimated at 17% (95%CI=13.7-20.3%). The residents of the study barangays were in their rehabilitation phase i.e., three months post disaster when data was collected for this study. The study also characterized the households in the sample according to socio-economic status, presence of members with special needs, and presence of children 0-5 years ol. In the aftermath of the disaster, 46.84% of the respondents had positive answer on the group of questions about decreased energy, 49.8% on somatic symptoms,25.89% on depressive thoughts and 40.91% on depressive moods.There was a higher prevalence of these 4 factors among females, those separated, with low socioeconomic status and low educational attainment.
CONCLUSION: The estimated prevalence of psychosocial distress was 17% (95%CI=13.7%-20.3%), In the aftermath of the disaster, 46.8% of the respondents had positive answer on the group of questions about decreased energy, 49.8% on somatic symptoms, 25.9% on depressive thoughts and 40.9% on depressive moods.

Human ; Male ; Female ; Depression ; Anxiety ; Stress Disorders, Post-traumatic ; Cyclonic Storms ; Floods

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Prevalence of depression and anxiety symptoms and their correlation with posttraumatic growth among HIV-positive patients enrolled in an HIV/AIDS clinic at a tertiary hospital from July 2015 to October 2015.

Kenneth Ross P JAVATE

The Philippine Journal of Psychiatry.2017;39(1):14-22.

OBJECTIVES: This study evaluated the prevalence of anxiety, depression, and posttraumatic growth (positive psychological change as a result of the struggle with highly challenging life circumstances) among patients with HIV/AIDS as well as determine the correlation between these variables alongside select sociodemographic variables.
METHODOLOGY: Fifty eight patients enrolled in an HIV/AIDS clinic at a tertiary hospital were selected via convenience sampling and asked to complete a sociodemographic questionnaire, the Posttraumatic Growth Inventory (PTGI) and the Hospital Anxiety and Depression Scale (HADS) from July to October 2015.
RESULTS: Ninety three percent of the participants reported moderate to high levels of posttraumatic growth, with a mean score of 4.70 (SD = 0.86). 20.7% (11.2 - 33.4, CL=95%) of patients screened positive for depression while 55.2% (41.5 - 68.3, CL=95%) of patients screened positive for anxiety. A statistically significant negative corellation was demonstrated between posttraumatic growth and depression (r=-0.29, p-value= 0.027) but not for anxiety (r=.027, p-value= 0.118).
CONCLUSION: There is a high prevalence of patients in the sample that exhibit depression and anxiety symptoms. Despite this, most patients report a capacity to experience positive changes in the aftermath of a life-threatening, chronic, and stigmatizing illness, correlating with a decrease in depressive symptomatology. As such, initiatives promoting posttraumatic growth are valuable in the comprehensive care for patients afflicted with HIV/AIDS.

Human ; Male ; Female ; Depression ; Anxiety ; Hiv ; Prevalence ; Posttraumatic Growth, Psychological ; Depressive Disorder ; Anxiety Disorders ; Tertiary Healthcare

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