Complex Post Traumatic Stress Disorder (PTSD) in Defilement: Case Report

Abstract

We report a case of the debilitating and lifelong complex post traumatic stress disorder. Data on rape/defilement-related complex post traumatic stress disorder (PTSD) is rare due to low reporting rates and misdiagnosis in Kenya. Childhood complex PTSD is compounded by its symptomatic overlap with rape trauma syndrome (RTS) and attention deficit hyperactivity disorder (ADHD). This case demonstrated the difficulties involved in making the correct diagnosis while at the same time it brought to the fore clearly the features of complex PTSD as opposed to ordinary PTSD. Strengths in management depended on making appropriate diagnosis based on concerted efforts by clinicians, comprehensive care, team work, sensitivity to age and sex, winning trust of the child and the care taker among others and bearing in mind the in-ward handling of the trauma by the rape/defilement victims. This case shared a lot with other cases of complex PTSD in its presentation, course of illness, diagnosis and response to management protocol instituted yielding positive results. Using the lessons learnt from this case, her response was satisfactory based on her improved social and occupational functioning. The patient continues to respond well to treatment to date, bearing in mind that her presentation and age within a dysfunctional family background did not offer good prognosis, especially if the management and social support system will not be steadfast and innovative.