ABSTRACT
@#The psychological impact of the diagnosis of congenital anomalies is an area with limited research; and more limited still when such congenital anomalies are not very obvious. MayerRokitansky-Kuster-Hauser (MRKH) syndrome can be one of those less apparent congenital anomalies. Owing to their inability to bear children, women confronted with the diagnosis of MRKH can be left stressed, or worse, traumatized by the fact that they can no longer function in their traditional gender roles. This may leave any individual wanting to deny the diagnosis or even withhold such information. And the experience is a fertile ground for the development of any mental illness. MRKH occurs in every 1 out of 4000-5000 females. Although the psychological impact of stress is a well –established fact, there are fewer literature on the possible genetic link of MRKH and mental illness, the psychodynamic underpinnings and the similarities to trauma of the diagnosis of MRKH, in particular. We present here a case of MRKH syndrome with an initial presentation of major depression and psychosis; with the diagnosis of MRKH initially withheld from the resident psychiatrist. We would also want to highlight a trauma perspective of the case presented as well as to emphasize the need for more research congenital anomalies are accompanied by co-morbid psychiatric illnesses.
Subject(s)
Depression , Psychotic Disorders , Psychological DistressABSTRACT
Objectives@#The goal of the research was to provide local data on the varieties of posttraumatic symptomatology among survivors of Super typhoon Haiyan in a rural community in Merida, Leyte.@*Methodology@#This is a single point non-invasive study of Filipino survivors of typhoon Yolanda who came from Merida, Leyte, involving administration of a symptom checklist i.e. Post Traumatic Stress Disorder Checklist- Civilian version (PCL-C) to assess the occurrence of posttraumatic symptoms in the selected group of volunteers with no history of psychiatric illness. The PCL-C was given as part of a community screening for symptoms of PTSD conducted three months after the typhoon. There were two ways of scoring the PTSD Checklist- Civilian version (PCL-C) - either by computing for the total severity score or by scoring each response category just like one would in the Diagnostic and Statistical Manual (DSM IV TR) criteria. The sum of all PCL-C item scores indicated the severity of Post Traumatic Stress Disorder (PTSD). A score of 30 and above represented the occurrence of PTSD. T-test was used to determine differences in the severity scores of those who met the criteria for PTSD using the total "severity scoring method" and those who did not.@*Results@#A total of 29 respondents took part in the study where the majority were female (28/29 or 96.55%). The results showed that Filipinos suffered more re-experiencing symptoms but less avoidance symptoms compared to the DSM IV-TR criteria. Nine of 29 (31.03%) respondents were assessed as having Post Traumatic Stress Disorder (PTSD) based on the total "severity score method': However, none fulfilled the PTSD DSM IV TR criteria when the response "category scoring method" was used. Those who met the severity criteria had significantly higher scores in items 1 (Repeated, disturbing memories, thoughts, or images of a stressful experience from the past?), 3 (Suddenly acting or feeling as if a stressful experience were happening again?), 5 (Having physical reactions when something reminded you of a stressful experience from the past?), 6 (Avoid thinking about or talking about a stressful experience from the past or avoid having feelings related to it?) and 13 (Trouble falling or staying asleep?).@*Conclusion@#There seems to be a difference in how the Filipinos experience trauma compared to Western models such as described in the Diagnostic Symptom Manual (DSM IV TR) criteria though caution is warranted in interpreting the results due to the small sample size and the predominance of female respondents.