Psychiatric admission as a risk factor for posttraumatic stress disorder.

Psychiatric hospitalization poses a risk for Posttraumatic Stress Disorder (PTSD), partly because of coercion. However, the role of legal status is less clear, while factors like insight, exposure to violence and affective disorders have not been addressed adequately. The present study aims at assessing PTSD rates after hospitalization and evaluating the potential role of these factors. 98 inpatients were assessed for PTSD, insight, main diagnosis, adverse events during hospitalization and legal status. Assessment took place at discharge (T1) and three months later (T2). Three months after discharge, 74.2% of patients with affective disorders met symptom-criteria for PTSD. Voluntarily hospitalized patients had more severe PTSD-symptoms. This relation vanished after controlling for affective disorders. The latter, as well as exposure to violence were the most significant risk factors at T2. Female gender, marital status (not married) and employment status (not employed), were additional risk factors at T1, while involuntary medication had a negative effect on PTSD-symptoms. Voluntarily hospitalized patients are more vulnerable to PTSD, due to higher rates of affective disorders. Females suffering from affective disorders who are not married and not employed should be monitored for PTSD symptoms during and after hospitalization, especially if exposed to violence.

Spontaneously Healed Pathologic Fracture over a Critical-Size Calcaneal Cyst.

Simple bone cysts are nonsymptomatic lesions. They typically involve the medullary cavity, but they can also be found in nonlong bones such as the calcaneum. Their treatment remains controversial varying from observation and conservative healing to irritating injections or bone grafting. In the case of a pathologic fracture, surgical treatment seems most appropriate especially when the cyst is situated on a weight-bearing bone. We present herein the rare case of a spontaneously healed pathological fracture over a critical-size calcaneal cyst of a patient reluctant to undergo surgical treatment. An interpretation of the healing procedure as well as a review of the literature is presented.