Rashid Mishalle F, Leggett Richard, Grzybowska Aleksandra, Gentry Bryce, Linder Ellis
Medicine, Edward Via College of Osteopathic Medicine, Blacksburg, USA.
Psychiatry, LewisGale Medical Center, Salem, USA.
Cureus. 2025 Mar 18;17(3):e80779. doi: 10.7759/cureus.80779. eCollection 2025 Mar.
This case report reviews the psychiatric difficulties of a 27-year-old female patient from Botswana with symptoms fitting for posttraumatic stress disorder (PTSD), cluster B personality traits, and attention-deficit/hyperactivity disorder (ADHD). Her case illustrates how corporal punishment, an accepted practice in Botswana, remains in stark contrast to the standards of American society and the psychological consequences that may emerge from such practices. The patient presented with mood instability, anxiety, and recurrent depressive episodes, which were worsened by poor coping mechanisms including binge drinking and emotional dissociation. The patient's interviews confirmed the presence of PTSD, ADHD, and personality disorder per diagnostic criteria in the DSM-5. She was treated with lamotrigine and Adderall XR, with trauma-informed group therapy and psychoeducation about cultural perceptions of abuse. The patient showed improvement in emotional regulation and investment in the treatment; however, she continued to have difficulties with sleep hygiene and alcohol consumption. This case underlines the importance of culturally sensitive psychiatric care and emphasizes that osteopathic practitioners should further work within the framework of the trauma-informed approach with consideration of cultural influence when managing patients, especially those of migrant backgrounds.
本病例报告回顾了一名来自博茨瓦纳的27岁女性患者的精神问题,其症状符合创伤后应激障碍(PTSD)、B类人格特质和注意力缺陷多动障碍(ADHD)。她的病例说明了体罚这一在博茨瓦纳被认可的做法,与美国社会的标准形成了鲜明对比,以及这种做法可能产生的心理后果。患者表现出情绪不稳定、焦虑和反复出现的抑郁发作,包括酗酒和情绪解离在内的不良应对机制使这些症状更加严重。根据《精神疾病诊断与统计手册》第5版(DSM - 5)的诊断标准,对患者的访谈证实了PTSD、ADHD和人格障碍的存在。她接受了拉莫三嗪和安非他命长效释放制剂治疗,并接受了创伤知情团体治疗以及关于虐待文化认知的心理教育。患者在情绪调节和对治疗的投入方面有所改善;然而,她在睡眠卫生和饮酒方面仍有困难。本病例强调了具有文化敏感性的精神科护理的重要性,并强调整骨疗法从业者在管理患者,尤其是那些有移民背景的患者时,应在创伤知情方法的框架内进一步开展工作,并考虑文化影响。