Baxter Cynthia L, White William D
University of Calgary, Alberta, Canada.
Int J Psychiatry Med. 2003;33(3):317-22. doi: 10.2190/YVP4-3GTC-0EWK-42E8.
Coma is present when the patient appears asleep, is unrousable, and unresponsive. Where no underlying medical condition is found, the role of the psychiatrist may become prominent. We present a clinical case and review the literature on psychogenic coma. According to DSM-IV-TR, psychogenic coma is a dissociative disorder not otherwise specified. Management is largely supportive. Principles include speaking in a reassuring manner and avoiding repeated painful stimuli. Education of family and other professionals that symptoms are real and not consciously feigned may be important. There may be a short-term role for anxiolytic and/or antipsychotic medication to assist return to consciousness.
