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PTSD Case Study of Iraqi Male

AR is a 24-year-old Iraqi man who witnessed his brother being shot dead in Iraq in 2008. Since then, he has suffered from poor sleep, flashbacks, hearing voices telling him to kill Americans, and a belief that others are conspiring to kill him. He has been diagnosed with PTSD and has a history of panic attacks dating back to 2003. He is currently being treated with medications including olanzapine and diazepam, which have helped reduce his symptoms.

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481 views21 pages

PTSD Case Study of Iraqi Male

AR is a 24-year-old Iraqi man who witnessed his brother being shot dead in Iraq in 2008. Since then, he has suffered from poor sleep, flashbacks, hearing voices telling him to kill Americans, and a belief that others are conspiring to kill him. He has been diagnosed with PTSD and has a history of panic attacks dating back to 2003. He is currently being treated with medications including olanzapine and diazepam, which have helped reduce his symptoms.

Uploaded by

ayhamsalim
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
  • Case Presentation: PTSD: Introduction to the case presentation focusing on PTSD by Dr. Hadeel Jawad.
  • Demographic Details: Provides personal background including age, gender, and country of origin.
  • Presenting Complaints: Details the patient's main psychological and physical symptoms upon presentation.
  • History of Presenting Complaints: Discusses the context and events leading to current complaints, focusing on traumatic experiences and psychological impact.
  • Past Psychiatric History: Outlines previous psychiatric diagnoses and treatments received by the patient.
  • Medical History: Provides information on the patient's past medical conditions, focusing on diabetes management.
  • Medications: Lists medications prescribed over different periods and their adjustments.
  • Family History: Details the patient’s family background, including information about siblings and parents.
  • Personal History: Narrates significant life events impacting the patient's personal development, such as education and early family life.
  • Social History: Covers the patient’s social interactions and support systems, including relocation details.
  • Personality: Explores the patient’s self-perception and traits noted prior to traumatic experiences.
  • MSE on 11/11: Presents findings from the mental status examination to assess the current psychological state.
  • Investigations: Lists medical tests conducted to support diagnosis and explore health conditions.
  • Differential Diagnosis: Discusses possible conditions that might account for the patient’s symptoms.
  • Formulation: Provides a comprehensive understanding of the case with factors contributing to the patient's current state.
  • PTSD: Elaborates on PTSD criteria, symptoms, and its impact on the patient.
  • PTSD Additional Criteria: Details additional diagnostic criteria for PTSD under ICD-10 guidelines.
  • PTSD Epidemiology and Aetiology: Discusses the prevalence and causes of PTSD.
  • PTSD Risk Factors: Identifies social and personal characteristics increasing PTSD risk.
  • PTSD Management: Covers therapeutic approaches to managing PTSD, including psychological and pharmacological interventions.
  • Conclusion: Final slide marking the end of the presentation.

Case Presentation: PTSD

Dr. Hadeel Jawad 23rd November 2011

NAME:AR
Age:24 Gender: Male

Country of origin: Iraq

Demographic Details

Poor sleep Flashbacks Hearing voices of Iraqi terrorist telling him to kill Americans He believes that T.V and newspapers talk about him He thinks that there is a conspiracy to kill him in Ireland. Garda and Iraq terrorist are part of this conspiracy Panic attacks

Presenting complaints

In February 2008 AR witnessed his brother being shot dead in front of him .Since then ,things have never anyway normal for him . He is always tense ,very sensitive to noise ,flashbacks .He is trying to avoid reminders of the event. He is also suffering from low mood.
He has been attending the Millmount OP clinic since May 2011

History of presenting complaints

He admitted having panic attacks since 2003 ,and he was getting treatment from Iraq(sleeping tablets??)
He was treated by a doctor in Iraq for PTSD in 2008. He claimed that he was treated by a psychiatrist in Waterford and Rathmines.

Past psychiatric history

Type 1 DM

His blood sugar is poorly controlled .

Medical history

In May he was on: Diazepam 5 mg BD, zopiclone 7.5 mg OD, Amisulpride 200mg mane-400 mg nocte. In July Amisulpride was switched to Olanzapine 2.5mg B.D-7.5 mg nocte. He benefited significantly from Olanzapine with a reduction in symptoms. In August :olanzapine 5 mg b.d,10 mg nocte ,zopiclone 7.5 mg nocte,diazepam 5 mg mane and 3 mg evening,citalopram 20 mg o.d

medications

He is the eldest of 4 boys. One of his brothers shot dead in Iraq in 2008. His parents and 2 siblings are still living in Iraq. He has 1 cousin living in Dublin. His mother is suffering from chronic depression

Family history

He was born in Iraq .Reportedly, his birth and early developmental milestones were normal.
He did a course at a college in Whitehall , but he didnt finish and dropped out because he couldnt cope. He believed that his classmates may be out to kill him.

Personal history

He arrived in Ireland 2 months after the attack.


He doesnt smoke or drink alcohol. Social isolation. He has an Irish girlfriend , they are doing well He receives social welfare benefit.

Social History

He described himself as fun-loving, outgoing person prior to the incident.

Personality

Appearance and behaviour: He was casually dressed, poor eye contact, reasonable rapport. Speech: was reduced in rate and amount. Mood: Objectively he appeared depressed. I couldnt complete the assessment as he started to hear voices so he became agitated and hyperventilated.

MSE on /11/11

FBC , TFT ,B.S ,Coagulation profile.


ECG,ECHO. U+Es, LFT, Creatinine.

investigations

PTSD.
Acute psychotic episode.

Mood disorder with psychotic symptoms.


Anxiety disorder. Malingering. Enduring personality change after a catastrophic event [duration at least 2 yrs.

Differential Diagnosis

[Link] factors: personality,previous traumatic events.


[Link] factors: He witnessed his brother being shot dead in front of him in 2008 and his family house was burnt down. [Link] factors: Away from the family, social isolation due to cultural and language barriers.

Formulation

Severe psychological disturbance following a traumatic event


Both ICD-10 and DSM-IV criteria include: 2 or more of the following [not present before exposure to stressor]

[Link] falling or staying a sleep


2. Irritability or outbursts of anger 3. Difficulty in concentrating 4. Hypervigillance [Link] startle response

PTSD

Other ICD-10 criteria : Persistent remembering or reliving of stressor in intrusive flashbacks , vivid memories. Actual or preferred avoidance of circumstances resembling or associated with the stressors. Inability to recall either partially or completely.

Epidemiology: Risk of developing PTSD 8-13% for men,20-30% for women. cultural differences exist.
Aetiology: [Link]/Biological. [Link]. [Link]

PTSD

Risk factors:

Low education , low social class , female gender , low self-esteem, neurotic traits, previous or family history of psychiatric problems , previous traumatic events.

PTSD

Management:

[Link]

-CBT
- EMDR -Psychodynamic therapy.

[Link]. Out-Come:~50% will recover within 1 yr. chronic course. ~30% will run a

PTSD

Thank

You

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