Childhood trauma, abuse disrupt early brain development and immune system

Institute of Psychiatry organises CPC on trauma in children & adolescents

Rawalpindi

Childhood trauma and abuse cause disruption in early brain development and immune system and the phenomena increases risk of mental health problems. Even infants can have Post Traumatic Stress Disorder and PTSD has been called as the “rheumatic fever” of child psychiatry.

A senior mental health expert expressed this while talking to audience in a Clinico-Pathological Conference (CPC) organised by the Institute of Psychiatry and World Health Organization Collaborating Centre for Mental Health Training and Research at Benazir Bhutto Hospital on the theme of Trauma in Children & Adolescents.

The CPC organized at the New Teaching Block of Rawalpindi Medical College sought to apprise the medical students, psychologists, and various physicians and surgeons in attendance, about the profound implications of traumatic experiences in childhood and adolescence.

The proceedings ensued with reciting from the holy Qur’an by Post-Graduate Resident Dr. Yousaf Raza after which Senior Resident at the Institute Dr. Hania Amin presented the first case history giving a detailed history of a young girl who developed psychiatric complications in the form of psychogenic seizures and depressive symptoms as a consequence of sexual abuse at the hands of her stepbrother.

Assistant Professor of Psychiatry and Head of the Child Psychiatry Unit at the Institute Dr. Ayesha Minhas then took the stage to discuss and elaborate upon the case presented by Dr. Hania. Childhood trauma causes disruption in early brain development and immune system, limbic irritability, deficient development of the cerebral cortex and the hippocampus, she said.

She quoted Henry Maudsley “The sorrow which has no vent in tears may make other organs weep” and commented that this is stress that makes children present with different psychological and somatic complaints.

Talking of Child Maltreatment, she said it includes all types of physical and/or emotional ill-treatment, sexual abuse, neglect and commercial exploitation of children below 18 years of age, which results in actual or potential harm to the child’s health, survival, development or dignity. Any type of childhood trauma increases risk of mental health problems. Even infants can have Post Traumatic Stress Disorder and PTSD has been called as the “rheumatic fever” of child psychiatry.

She ended her discussion alluding to a common comment by adults about children in general, “They are too young to understand”. However, young children, she said, are significantly affected by traumatic events.

Head of the Institute Professor of Psychiatry Dr. Fareed A. Minhas then introduced the audience to the much awaited screening of the docudrama prepared by the Institute of Psychiatry to highlight the issue of Child Sexual Abuse.

The docudrama already uploaded on the facebook page of the institute of psychiatry depicted the story of a young man engaging in acts of repeated self-harm, impulsivity, and mood dysregulation. In conversation with a psychiatrist he opens up about his childhood experience of sexual abuse. The docudrama ended with Dr. Ayesha Minhas providing information about child sexual abuse; its extent, its impact on child’s psychology, and what needs to be done to ensure protection of children.

Professor Fareed then opened the floor for questions. Dr. Azeem inquired about how to approach patients of child abuse and disclose this information to the family. Professor Fareed answered to this query by highlighting the significance of asking open ended questions in accessing “the heart and mind of patient”. He also shared his own approach while talking to a patient that “I have made your diagnosis and now I want to know if there is anything in your childhood that needs to be addressed or any bad memory”.

Professor Jahangir Sarwar commended the video and asked whether early age marriages are considered as part of sexual abuse. In reply to this Professor Fareed said that early marriages cause a range of emotional and physical problems which also hinder positive and genuine parenting of their offspring.

Professor Shagufta Sial asked about identification clues in children of abuse which was answered by Professor Fareed as noticing any change in child’s behavior like social withdrawal, lack of interest and excessive anger. Any subtle behavioral change should urge parents to look for cause and investigate it properly, he said.

Head of Paediatrics Department at RMC Professor Rai Asghar then shared his experience of seeing children who present with bed wetting and other physical symptoms, where the underlying pathology is history of abuse.

Rawalpindi Medical College Principal Professor Muhammad Umar appreciated the efforts of the institute and showed his willingness to participate in such future activities of the Institute of Psychiatry.

At the end, Professor Fareed informed the audience of another of his efforts to increase awareness of psychiatry; a short documentary entitled, “Mental Health Matters”, which has been uploaded on the facebook page of the institute of psychiatry. He invited the audience to share in the cause by helping to spread the messages communicated in these videos.