Combined psychopharmacological and psychosocial approaches and the relevance of therapeutic jurisprudence and religion in the successful management of battered woman's syndrome: A case report

INTRODUCTION: Although Battered Woman Syndrome is not listed in the DSM 5 and the ICD 10 as an official diagnosis, it is undeniable that women suffering Intimate Partner Violence (IPV) experience the same cycle of violence, suffer from a common range of symptoms, and have a predictable prognosis. While psychosocial guidelines and support are available, like in our Women and Child Protection Units (WCPU), there is also a gap in the clinical guidelines in treating and managing these cases, which might present with a combination of posttraumatic and depressive symptomatology. In this report, we discuss the case of a 32 year old woman who was subjected to severe physical and emotional abuse by her longtime romantic partner. She consulted at our center seeking help for a psychiatric evaluation for the case she was going to pursue in court but it was apparent she was suffering from posttraumatic, somatic, and depressive symptoms. Supportive therapy was initially done and she was started on Escitalopram and low dose Quetiapine for sleep problems. As her case started gathering steam, issues about the court process, possible setback with her church and possible retaliation from her partner weighed heavily on her. Possible issues were discussed beforehand and successfully faced up to her partner in a church related tribunal and in the fiscal's office. Using an Eye Movement Desensitization and Reprocessing(EMDR) variant, Unfinished Trauma Episode Protocol (U-TEP), her posttraumatic symptoms were eventually addressed. As she started having faith in the legal system and her church, she had restored self-esteem, was active in her social circle and become an advocate in helping other women get proper treatment and to fight for their rights. Besides the clinician advocated treatment along with the services delivered via the WCPU network, the perception of getting justice from social institutions like the judiciary and the church helped in the recovery of this patient. Clinicians dealing with Battered Woman Syndrome should be aware of issues the patient might go through the stages of her fight and that the process of seeking for justice is also a process of mental healing.

One year readmission rates of acute and transient psychotic disorders & diagnosis of patients admitted at the National Center for Mental Health from Jan-Dec 2012

OBJECTIVES:The aim of this study was to determine the readmission rates of Acute and Transient Psychotic Disorders (ATPD) who were admitted for the first time in the National Center of Mental Health from January to December 2012.METHODOLOGY: This study used the retrospective cohort method. Patients included in the study were admitted for the first time with a diagnosis of Acute and Transient Psychotic Disorders (ATPD) during the period of January to December 2012. The source of data involved the chart review during the first admission and the subsequent admission. Patients who were readmitted beyond one year from time of admission were excluded.RESULTS:Results showed that 25 out of 204 (12.26%) patients diagnosed with an ATPD were readmitted within one year. The most common diagnosis of ATPD upon admission were: Acute Schizophrenia-Like Psychotic Disorder (n=95), Other Schizophrenia (n=90) and Acute Polymorphic Psychotic Disorder (n=19). ATPD's with the highest 1 year readmission rates were Acute Polymorphic Psychotic Disorder (3/19),Other Schizophrenia (13/90) and Acute Schizophrenia-Like Psychotic Disorder(9/95).Those that were readmitted had a different discharge diagnosis in their second admission.The three most common diagnosis upon readmission were Undifferentiated Schizophrenia (36%), Bipolar Affective Disorder, current episode manic, with psychotic symptoms (24%) and Other Schizophrenia (12%). Acute Schizophrenia-Like Psychotic Disorder were mostly readmitted as Bipolar Affective Disorder in 44% of patients; Acute Polymorphic Psychotic Disorder (APPD) were readmitted as another ATPD (66.6%); and Other Schizophrenia was diagnosed as Undifferentiated Schizophrenia (54%).CONCLUSION:Only a small percentage of patients with ATPD were readmitted one year from admission and those who were readmitted revealed that they may have actually been suffering from or developed another more chronic psychotic disorder.