ABSTRACT
Research has demonstrated an association between direct exposure to traumatic events and the exacerbation of mental illness. This report describes the case of a man who had a preexisting mental illness with psychotic symptoms and no history of psychiatric hospitalization who was evacuated from the World Trade Center area after the terrorist attack of September 11, 2001. He did not receive any intensive, specialized treatment during the ensuing months as his mental state deteriorated, and he eventually required psychiatric hospitalization for a full-blown psychotic episode. Given the continuing threat of terrorist attacks, recognition of preexisting psychiatric conditions and early, specialized interventions for those at risk are essential in providing effective treatment and preventing decompensation.