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Post-traumatic stress disorder and psychosis: the role of empowerment

Articles

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Disciplines
KeywordsTriple Keywords
Context (Linguistics)
Grammar, Comparative and general--Context
Situation (Linguistics)
Identity
Identity (Philosophical concept)
Human emotions
Feelings
Passions
Emotions
Experience
Autonomy
Self-government
Independence
Tension (Psychology)
Psychological stress
Stress (Psychology)
Emotional stress
Mental stress

Abstract

PTSD and psychosis is now a recognized and adequately documented comorbidity. Its incidence is not well determined, but according to some studies, it can vary between 11% and 67% after an acute psychotic episode. Post-traumatic anxiety symptoms are not well researched by the practitioner and, therefore, it is poorly recognized and often confused with the manifestations of a psychotic type. However, PTSD syndrome presents, even in a clinical context of comorbidity with a sufficient typicality (DSM-IV) for three-quarters of patients and infraclinical appearance for the two-thirds of patients. The stress factor, in these circumstances, is less directly associated with psychotic symptomatology itself (acute auditory hallucinations, persecution threats, delusions) than the subjective perception of the patient regarding the impact of psychosis on their life and identity. The status of “mentally ill” is a subjective perception upsetting the balance of patient’s identity and giving rise to feelings of shame and stress. This survey highlights that the triggering factor of this anxious symptomatology is the experience of hospitalization in a specialized environment (often under duress). According to C. Rodwell [25], the notion of autonomy and subjective involvement (empowerment) in people experiencing illness and care experiences has become increasingly important. The patient who has suffered an acute psychotic episode, and in addition their first, lives through a deep sense of loss of autonomy (lack of empowerment) linked to this psychotic breakdown. Chemotherapeutic and psychotherapeutic resources to be developed specifically to meet this evolutionary situation are discussed here, including a care strategy taking into account the need for preservation and recovery of the sense of subjective involvement.

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