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Trauma‑related Hallucination in an 8‑year‑old Child with Dissociative Symptoms
Journal
Malaysian Journal of Psychiatry
Date Issued
2023
Author(s)
Nathratul Ayeshah Zulkifli
Universiti Sains Islam Malaysia
Aliyyah Mohammad Khuzaini
Universiti Sains Islam Malaysia
Abdul Rasyid Abdul Aziz
Universiti Sains Islam Malaysia
Hamidin Awang
Universiti Sains Islam Malaysia
DOI
10.4103/mjp.mjp_10_23
Abstract
The clinical presentation symptoms among psychiatric pediatric patients often illustrate the characteristic psychotic features of traumatized children. Cases may go underdiagnosed, misdirected, or commonly treated inappropriately. Clinical studies have conclusively shown an obvious link between childhood trauma and the emergence of symptoms. Transient dissociative episodes are common and normative phenomena during childhood. We reported a case of an 8-year-old boy, who presented with a 5-day history of hallucinatory behavior. He was causing significant nuisances, sudden onset of shouting aggressively, and behavioral changes, associated with neuropsychiatric presentation such as repetitive irregular movement involving his head, neck, and upper limb. There was an asynchrony of symptoms exhibited which were unexplained by clinical semiology or patterns. He was screaming in fear, talking irrelevantly, and acting suspiciously. This was his first presentation to the hospital and no features to suggest organicity. There was no family history of mental illness. No substances, or alcohol and drug usage Serial investigation turned out to be normal and unremarkable. The episodes get frequent whenever parents or hospital staff give more attention toward him. He was given a low dose of antipsychotics, but no obvious rapid changes were observed afterward. Further exploration noted, his parents reported that the patient had been very worked up with past related trauma at school and constantly talking about it. He was afraid, distressed, and anxious as he felt something bad would happen to him. There were significant issues related to attachment figures in this boy, possibly the absent parenting style. He spent most of time playing online games and was preoccupied with them on a daily basis.
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