Posttraumatic stress disorder following recent-onset psychosis: an unrecognized postpsychotic syndrome

Article Abstract:

Post-traumatic stress disorder (PTSD) is a condition in which a set of physiologic responses (e.g., startle responses, sweating) combined with conscious and unconscious emotions and behavior (e.g., flashbacks, intrusive thoughts, withdrawal, nightmares, and intense anxiety) are associated with memories of a catastrophe, severe trauma, or stressor. A study was performed to find out if PTSD is associated with recovery from psychotic illness. Acute psychosis can be highly stressful and traumatic due to anxiety resulting from persecutory or frightening delusions and hallucinations, or a sense of disintegration of the self. Treatment, which can include coercion, forced sedation, restraints and seclusion, may also contribute to the development of PTSD. Thirty-six male and female mental hospital inpatients (with an average age of 25 years) who were in the early phase of recovery from an acute psychotic episode were assessed while in the hospital and then at 4- and 11-months after discharge. They were given tests to measure PTSD symptoms, the impact of hospitalization, depression, and the negative symptoms (NS) of schizophrenic psychosis (blunted mood and emotions, poverty of speech, slow movements, and loss of drive). At the four-month follow-up, 46 percent of the patients were diagnosed with PTSD. Thirty-five percent were diagnosed with PTSD at the 11-month follow-up. A significant relationship was found between intensity of depression and intensity and number of PTSD symptoms at both follow-up periods. No relationships were found between NS and PTSD symptoms. The most common PTSD symptoms were recurrent nightmares involving forced sedation and isolation, suggesting that psychosis-related PTSD is influenced more by traumatic hospitalization experiences than the psychosis itself. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Stress (Psychology), Post-traumatic stress disorder, Psychoses, Psychotic disorders

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Hidden severe psychiatric morbidity in sentenced prisoners: an Australian study

Article Abstract:

In order to evaluate the type and prevalence of severe mental disorders among sentenced prisoners, a random sample of 158 male and 31 female prisoners in three Australian prisons were studied. Severe mental disorders were those defined by criteria set by the Diagnostic and Statistical Manual of Mental Disorders (third edition, revised) for major mood disorders, schizophrenia, various other psychotic disorders, substance abuse or dependence, and organic mental disorder. The prisoners' ages ranged from 15 to 34 years. Seventy-eight percent of the men and 87 percent of the women were repeat offenders who had served previous sentences for crimes that were classified as violent, drug-related or sexual. A diagnosis of at least one severe mental disorder was made for 82 percent of the prisoners, while 26 percent were shown to have more than one chronic diagnosis. Lifetime mood disorders, including major depression, mania and dysthymia, were diagnosed in 34 percent of the prisoners. Six percent were diagnosed with psychotic disorder, and 69 percent were found to be alcoholics or drug-dependent. No significant relationships were found between sentence length, age and psychiatric diagnosis. If they can be replicated, results of this study could influence future rehabilitation practices, since inmates with active alcoholism, drug dependence and untreated chronic major depressive disorder seem to dominate the prison population and compose a large percentage of recidivists. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Australia, Statistics, Prisoners, Psychology, Forensic, Forensic psychology, Psychiatric disability evaluation

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Prevalence of severe mental disorders in disaffiliated and homeless people in inner Melbourne

Article Abstract:

Previous British and American studies of the incidence of chronic mental disorder among the homeless have indicated that between one quarter and one half of adult homeless are mentally disturbed. The prevalence of mental illness was determined among 382 homeless or disaffiliated people in the inner city of Melbourne, Australia. A standardized interview was administered to diagnose a number of disorders, including psychotic, affective (emotional), and drug- or alcohol-related disorders. Half of the people interviewed had current mental problems, and 70 percent had some mental illness in the course of their lifetime. Alcohol and drug dependence, schizophrenia, and major depression were most common; about one fifth were considered psychotic. Comorbidity, the coexistence of two or more disorders, was common; the authors suggest that comorbidity may be an important factor in how people with severe mental problems end up homeless or disaffiliated. It is probable that a number of additional factors should also be considered, including childhood experiences, poverty, education, social support and personality. The problem of mental illness among the homeless may be seen as a steadily increasing one, requiring a flexible response in providing a range of services.

Social aspects, Mental illness, Mental disorders, Affective disorders, Mood disorders, Drug abuse, Homeless persons, Alcoholics, Schizophrenics, Melbourne, Australia, Melbourne

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