Clinical Pitfalls in the Diagnosis of Ataque de Nervios: A Case Study

Abstract

Ataque de nervios (attack of nerves) is an idiom of distress generally thought of in relation to Caribbean Hispanics. The following case study discusses the presentation of ataque de nervios in a Colombian female. This case study provides insight into a different presentation of ataque de nervios in a new population that clinicians should be aware of in order to ensure accurate diagnosis. Ataque de nervios is a distinct syndrome that does not fully correspond with any single DSM-IV diagnosis. However, there is overlap between symptoms in this condition and those in conventional clinical diagnoses. Common problems in deriving an accurate differential diagnosis are discussed. Implications for treatment are also reviewed, with an emphasis on a comprehensive approach to treatment that supports the client's norms and values.

Somatização na América Latina: uma revisão sobre a classificação de transtornos somatoformes, síndromes funcionais e sintomas sem explicação médica

“…2,4,5,13 The presence of somatization among Latin American individuals does no seem to impede or replace the manifestation of evident symptoms of anxiety and depression, 13,14 and an important international multicenter study has shown an increased tendency to somatization in its two participating South American centers. 2,4 It is also important to examine the evidence describing the presence and characteristics of functional somatic syndromes in South American patients, including fibromyalgia (FM) and chronic fatigue syndrome -all placed by literature alongside somatization phenomena 6,7,15,16 31 Other articles also found support from case reports to discuss the difficulties in the approach, diagnosis, and care of patients lying in the frontier between the somatic and psychological realms. 25,28 However, Bombana referred to the existence of severe conditions located in one extreme of this continuum that required treatment at a specialized outpatient unit in Brazil.…”

Integrative Psychodynamic Treatment of Ataque de Nervios

“…The majority of published research regarding ataque de nervios has focused primarily on Caribbean-origin Latinos, with few exceptions (Lizardi et al, 2009). Ana's description of her ataques was similar to those reported by Caribbean-origin Latinos.…”

“…However, clinicians should be careful not to assume a history of traumatic experiences given the uncertain relationship between trauma and ataque de nervios. Careful diagnosis and assessment should be undertaken to consider and rule out possible comorbid conditions, such as panic disorder, posttraumatic stress disorder, the effects of complex trauma (DESNOS), traumatic brain injuries, borderline personality, borderline decompensation, seizures, or other organic conditions (Lizardi et al, 2009). Clients' ego functioning and developmental history should be considered before engaging in more expressive or uncovering work for clients experiencing ataques de nervios.…”

“…Much of the current case study literature of ataques de nervios is focused on the syndrome among Caribbean or Central American Latinas (Lizardi, Oquendo, & Graver, 2009). The following case study is with a woman of Mexican origin.…”