Peritraumatic tonic immobility predicts a poor response to pharmacological treatment in victims of urban violence with PTSD.
BACKGROUND
Tonic immobility is the last defense against predation in animals and is characterized by paralysis and analgesia. In humans, it has only been reported in women victims of sexual abuse.


OBJECTIVE
This study evaluated the prevalence of peritraumatic tonic immobility (PTI) in patients with PTSD and investigated its association with response to treatment.


METHODS
Victims of urban violence with PTSD diagnosed through the SCID-IV (n=23) underwent a naturalistic pharmacological treatment according to the recommended guidelines for PTSD. The Post-Traumatic Stress Disorder Checklist--Civilian Version (PCL-C) and the Clinical Global Impressions (CGI) Severity scores were applied at baseline and endpoint. PTI was assessed using the Tonic Immobility Scale.


RESULTS
PTI was reported by both genders in 43% of the sample. Patients with PTI responded significantly poorly to treatment than those without it, either considering the PCL-C or the CGI scores.


CONCLUSIONS
This study probed PTI retrospectively and was based on a small sample recruited in a tertiary clinic.


CONCLUSIONS
We have expanded the scope of the two previous investigations on PTI by showing its occurrence also in men and during non-sexual violence. In addition, the finding of a significant relationship between PTI and poor response to treatment of PTSD indicates that PTI may carry a prognostic value in this disorder and suggests that PTI should be routinely assessed in traumatized patients.
Fiszman
Adriana
A
Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-FRJ), Brazil. adrianafiszman@terra.com.br
Mendlowicz
Mauro V
MV
Marques-Portella
Carla
C
Volchan
Eliane
E
Coutinho
Evandro S
ES
Souza
Wanderson F
WF
Rocha
Vanessa
V
Lima
Alessandra A
AA
Salomão
Fernanda P
FP
Mari
Jair J
JJ
Figueira
Ivan
I
D000328:Adult; D019548:Crime Victims / Q000523:psychology*; D005260:Female; D006801:Humans; D046353:Immobility Response, Tonic / Q000502:physiology*; D008297:Male; D014179:Neurotransmitter Uptake Inhibitors / Q000627:therapeutic use; D010555:Personality Inventory; D011379:Prognosis; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012720:Severity of Illness Index; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D016896:Treatment Outcome; D014505:Urban Population / Q000706:statistics & numerical data*; D014754:Violence / Q000523:psychology* / Q000706:statistics & numerical data
D014179:Neurotransmitter Uptake Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors