%0 Journal Article
%T A diagnostic dilemma between psychosis and post-traumatic stress disorder: a case report and review of the literature
%A Ricardo Coentre
%A Paddy Power
%J Journal of Medical Case Reports
%D 2011
%I BioMed Central
%R 10.1186/1752-1947-5-97
%X We report the case of a 32-year-old black African woman with a history of both post-traumatic stress disorder and psychosis. Two years ago she presented to mental health services with auditory and visual hallucinations, persecutory delusions, suicidal ideation, recurring nightmares, hyper-arousal, and initial and middle insomnia. She was prescribed trifluoperazine (5 mg/day) and began cognitive-behavioral therapy for psychosis. Her psychotic symptoms gradually resolved over a period of three weeks; however, she continues to experience ongoing symptoms of post-traumatic stress disorder. In our case report, we review both the diagnostic and treatment issues regarding post-traumatic stress disorder with psychotic symptoms.There are many factors responsible for the symptoms that occur in response to a traumatic event, including cognitive, affective and environmental factors. These factors may predispose both to the development of post-traumatic stress disorder and/or psychotic disorders. The independent diagnosis of post-traumatic stress disorder with psychotic features remains an open issue. A psychological formulation is essential regarding the appropriate treatment in a clinical setting.Post-traumatic stress disorder (PTSD) is defined as a mental disorder that arises from the experience of traumatic life events. Documented symptoms include re-experiencing the traumatic event, hyper-arousal and avoidance of stimuli associated with the trauma [1]. None of the Diagnostic and Statistical Manual of Mental Disorders Text Revision (DSM-IV-TR) diagnostic criteria refers to psychotic phenomena such as delusions or hallucinations. Research has shown a high incidence of co-morbidity between PTSD and psychosis; for example, psychosis with PTSD and vice versa [2]. The emergence of psychosis in PTSD raises important nosological questions about the disorder. In our case report, we describe the case of a patient with PTSD who later developed psychotic features. We will also discuss
%U http://www.jmedicalcasereports.com/content/5/1/97