Citation

McIntosh I, Story GW. BMJ Case Rep. 2021; 14(1): e235384.

Copyright

(Copyright © 2021, BMJ Publishing Group)

DOI

10.1136/bcr-2020-235384

PMID

unavailable

Abstract

Early theories of schizophrenia considered the illness as a fragmentation of mental content in response to psychological trauma. Here we present a case of very late onset schizophrenia in a previously high-functioning man in his mid-60s, precipitated by having lost his family in a terrorist attack, while he was living in Africa. He presented with symptoms consistent with post-traumatic stress disorder, however also exhibited visual and auditory hallucinations and marked deterioration in daily functioning. He showed mild impairment on cognitive testing, however brain imaging and screening for reversible causes of cognitive impairment were normal. The case highlights the need for a formulation-based approach to understanding and managing responses to severe trauma, from resolution through to psychotic disintegration.

Language: en

Keywords

schizophrenia; anxiety disorders (including OCD and PTSD); global health; memory disorders (psychiatry)