2^nd Global Experts Meeting on
Psychiatry and Mental Health

Aims and hypothesis

The aim of this study is to report a case in which somatisation was the initial presenting symptom in a child who developed PTSD following witnessing the Manchester Arena bombing on 22nd May 2017.

Background

Post-traumatic stress disorder (PTSD) is a psychiatric condition that occurs after experiencing, or bearing witness to a traumatic event. The typical presentation involves the individual reliving the traumatic event through flashbacks or nightmares and avoiding reminders of the trauma to avoid painful emotions. On 22nd May 2017, a lone bomber carried out a suicide attack in the Manchester Arena. The bomber detonated a shrapnel-laden bomb killing 22 people and injuring over 800. Our study examines the case of a previously well 12-year-old girl, who 4 months after falling witness to the Manchester attack, present with symptoms of lower limb weakness, visual loss, vomiting and headaches. Following rigorous medical investigation no organic cause was found and it was only after the development of the typical aforementioned PTSD symptoms, that she was diagnosed with PTSD and received treatment.

Methods

A series of interviews were carried out with the child and her mother. The first wasdone face to face at the initial presentation of the child’s symptoms in the hospital setting. The remaining were done via telephone consultation, occurring at monthly intervals for a duration of 6 months. The interview chelate details on the child’s symptom variety and severity as well has her progress in receiving a diagnosis and treatment.

Results

Interviews with the patient detailed how her physical symptoms persisted in isolation for 3 months following initial presentation. During this time she was unable to attend school, peer relationships broke down and her self care deteriorated. At three months, she developed the more typical PTSD symptoms of flashbacks and nightmares and it was only at this point that she was referred for specialist trauma based therapy and began to improve. The patients mother experienced low mood and developed anxiety and was commenced on an SSRI after seeking help from her GP.

Conclusions

This case demonstrates how a failure to recognise somatisation as an initial presentation / predictor of PTSD can lead to delayed diagnosis and treatment, which effects not only the patients quality of life, but that of those close to them too.