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KMID : 0377819950150080866
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Diagnosis and Treatment
1995 Volume.15 No. 8 p.866 ~ p.871
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THE PSYCHIATRIC SHOCK AND ITS COMPLICATION
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Abstract
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For hundreds of years, the human response to shock has´ been recognized. The shock is a sudden physical or mental disturbance which follows catastrophic traumatic experience. We re-viewed the psychiatric perspectives of shock.
The clinincal symptoms are recurrent and intrusive distressing recollections of the event, re-current distressing dreams of the shock, intense psychological distress, persistent avoidance of stimuli associated with the shock, and persistent increased arousal. Limitations in the cross-cultural sensitivity of much of the existing ethnocultural research constrain our knowledge about culture-specific aspects of shock. In addition, ethnocultural factors may be important determinants of vulnerability to shock. For example, it is widely known that many non-Western ethnic group present symptoms somatically rather than psychologically or existentially.
Not every individual develop psychiatric symptoms after catastrophic experiences. There are several important and reasonably well-established premorbid vulnerability risk factors. It is likely that interactive effects occur between the shock and the host.
A variety of conceptual models, including a psychodynamic formulation and neurobiological model, have been developed to explain the formation and resultant symptomatic picture after shock.
The past decade has seen advances in the understanding of the psychodynamic, cognitive-behavior, and neurobiological factors contributing to the development of psychiatric distress after shock. Exposure to trauma results in the parallel activation of brain norepinephrine and the CRF-HPA axis system.
The best treatment is an integrated approach for the shock.
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KEYWORD
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