scholarly journals Discharge against Medical Advice in Surgical Patients with Posttraumatic Stress Disorder: A Case Report Series Illustrating Unique Challenges

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Marek Brzezinski ◽  
Maren Gregersen ◽  
Luiz Gustavo Schuch ◽  
Ricarda Sawatzki ◽  
Joy W. Chen ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Case Report ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Medical Advice ◽  
Surgical Patients ◽  
Missed Appointments ◽  
Against Medical Advice ◽  
First Case ◽  
Discharge Against Medical Advice

Discharge against medical advice (DAMA) can have detrimental effects on patient outcomes. Recently, the diagnosis of posttraumatic stress disorder (PTSD) has been linked with DAMA in the mental health setting. However, PTSD as a risk factor for DAMA in surgical patients has not received much consideration, although such patients may be at risk for triggering or amplification of PTSD symptoms perioperatively. We present the first case report series of three surgical patients with PTSD who left the hospital AMA. These cases differ markedly from DAMA in non-PTSD patients. In all three subjects, the stress of feeling misunderstood by clinicians and the distress of public detainment by hospital security in the setting of chronic PTSD led to aggressive and risky behavior. All three subjects represented a risk to themselves and to others at the time of DAMA. Finally, all three subjects were difficult to contact for follow-up or medical care and missed appointments.

Quetiapine Therapy for Posttraumatic Stress Disorder

2002 ◽  
Vol 36 (12) ◽  
pp. 1875-1878 ◽  
Author(s):  
S Pirzada Sattar ◽  
Bernadette Ucci ◽  
Kathleen Grant ◽  
Subhash C Bhatia ◽  
Frederick Petty
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
English Language ◽  
Rating Scale ◽  
Stress Disorder ◽  
Traumatic Event ◽  
Treatment Options ◽  
Clinical Signs ◽  
Ptsd Symptoms ◽  
First Case

OBJECTIVE: To report a case of improvement in posttraumatic stress disorder (PTSD) after adjunctive therapy with quetiapine. CASE SUMMARY: A 49-year-old white man witnessed a traumatic event and experienced severe PTSD. He was started on paroxetine, with increases in dosage and no significant improvement. Quetiapine was added to his regimen, with increased doses resulting in improvement of PTSD symptoms, both clinically and as measured on the Hamilton-D rating scale for depression and the clinician-administered PTSD screen. DISCUSSION: This is the first case published in the English language literature describing improvement in PTSD symptoms after treatment with quetiapine. There are several treatment options for PTSD, but some severe cases may require treatment with antipsychotic medications. Because of the lower risks of serious adverse effects, the newer atypical antipsychotics are much safer than the older antipsychotics. Although use of risperidone and olanzapine in the successful treatment of PTSD has been reported in the literature, there are no reports of quetiapine use in this clinical condition. CONCLUSIONS: Quetiapine appeared to improve clinical signs and symptoms of PTSD in this patient. It may be a treatment option in other severe cases of PTSD.

scholarly journals Posttraumatic Stress Disorder Postpartum of a Woman Recovered from Drug Addiction: A Case Report

Reports ◽  
2020 ◽  
Vol 3 (2) ◽  
pp. 14
Author(s):  
Evangelia Antoniou ◽  
Eirini Orovou ◽  
Vasileios Stavropoulos ◽  
Ermioni Palaska ◽  
Angeliki Sarella ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Case Report ◽  
Cesarean Section ◽  
Posttraumatic Stress ◽  
Life Events ◽  
Drug Addiction ◽  
Stress Disorder ◽  
Traumatic Life Events ◽  
Postpartum Ptsd ◽  
The Impact

There is high degree of prevalence and variety of risk factors of postpartum Posttraumatic Stress Disorder (PTSD). However, some postpartum women seem to struggle with their past traumatic life events and previous PTSD can result in them sinking deeper into a new PTSD, a postpartum PTSD. The person who has undergone detoxification has endured a very painful process and there is a strong association between drug addiction and mortality. The aim of this case report study is to raise the understanding of health professionals regarding the impact that these two factors might have on ex-drug addicted women. Data were collected from the Maternity unit of the University Hospital of Larisa in Greece. A mother on day 2 after elective cesarean section confirmed her participation and filled in a Life Events Checklist (LEC-5), Posttraumatic Checklist (PCL-5), Criteria A, and a socio-demographic questionnaire. After the sixth postpartum week, the woman answered via telephone, adapted for postpartum PCL-5. This case study describes vividly and painfully the impact of past drug addiction not only on her cesarean section but also how it affected her postpartum period. Eight past traumatic life events led to the creation of a chronic PTSD, i.e., trauma re-experiencing, avoidance, negative thoughts and feelings, agitation, and reactivity. Unfortunately, in cases of traumatic childbirth, especially cesarean section, when there are past traumatic experiences, such as addiction or sexual abuse, postpartum PTSD is an unbearable experience.

Discharge against Medical Advice

2002 ◽  
Vol 32 (3) ◽  
pp. 149-151 ◽  
Author(s):  
E C Ohanaka
Keyword(s):  
Clinical Condition ◽  
Medical Advice ◽  
Surgical Patients ◽  
Long Bones ◽  
Age Group ◽  
Common Condition ◽  
Against Medical Advice ◽  
Discharge Against Medical Advice ◽  
The University ◽  
Age Range

An audit of surgical patients who requested discharge against medical advice over a 5 year period (July 1996–July 2001) at the University of Benin Teaching Hospital showed that 78 patients (66 males and 12 females) were involved. The age range was 3 days to 85 years (mean 37.86 years). The 21–40 age group was the most involved. Trauma in general accounted for the most common clinical condition that caused a patient to discharge against medical advice (64 or 82%), while fracture involving the long bones was the most common condition (37 or 47.4%). The plausible reasons for this practice have been outlined including measures that may help to reduce discharge against medical advice in a developing country.

scholarly journals COMPLETE SYMPTOM’S REMISSION OF ACUTE NON-COMBAT PTSD AFTER ONE EMDR SESSION

2008 ◽  
Vol 37 (2) ◽  
pp. 147-150
Author(s):  
Rusmir Softic
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Case Report ◽  
Posttraumatic Stress ◽  
Eye Movement ◽  
Psychosocial Functioning ◽  
Stress Disorder ◽  
Severe Stress

Background: Recent studies pointed to Eye Movement Desensitization and Reprocessing as an efficient psychoterapeutic approach in the treatment of states caused by severe stress. Until now in Bosnia and Hercegovina were no published studies regarding to EMDR. Case report: Patient with acute posttraumatic stress disorder developed after he survived the mining accident was presented. After one session of EMDR simptoms were solved, and patient returns at premorbid level of psychosocial functioning. Conclusion: Patients treated with EMDR has a lot of benefits from this approach, especialy in cases of Posttraumatic stress disorder caused by simple trauma that is not incorporated into patients personality.

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