Psychogenic Coma: Case Report

Abstract

Coma is present when the patient appears asleep, is unrousable, and unresponsive. Where no underlying medical condition is found, the role of the psychiatrist may become prominent. We present a clinical case and review the literature on psychogenic coma. According to DSM-IV-TR, psychogenic coma is a dissociative disorder not otherwise specified. Management is largely supportive. Principles include speaking in a reassuring manner and avoiding repeated painful stimuli. Education of family and other professionals that symptoms are real and not consciously feigned may be important. There may be a short-term role for anxiolytic and/or antipsychotic medication to assist return to consciousness.