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couldn't clean himself.

He slipped and fell in the toilet twice, waiting for some hours before someone found him. The lack of a social support system that should have provided him the necessary care following a serious surgery that bound him to bed worsened his feelings of helplessness and hopelessness vis-a-vis his life in Turkey. The operation has been a total failure which totally incapacitated him. He is in constant pain, has tremendous difficulty sitting, moving, and walking. Currently, no organization assumes responsibility for his healthcare. Psychological health During his initial assessment in October 2011 Mr. Moazzen did not show any sign of cognitive, perceptual, and affective disorder. He frequently re-experienced his trauma events in the form of unwanted memories, images, and nightmares. He made an effort to suppress memories with failure. He reported psychological distress and physical reactivity upon reminders of torture and made effort to avoid them. He was constantly hypervigilant due to perceived threat to his safety and anticipatory fear of retaliation by the smugglers / Iranian agents. He reported depressed mood, loss of interest, insomnia, loss of appetite, jumpiness, detachment, and thoughts of death. He stated that he constantly ruminated about issues regarding the ongoing trial of his torturers in Turkey, his unfavorable living conditions, his deteriorated physical and mental health, and the uncertainty about his fate. His concerns made him feel extremely anxious and depressed. He developed a sense of foreshortened future. Mr. Moazzen met diagnostic criteria for Posttraumatic Stress Disorder (PTSD) (assessment based on the Clinician-Administered PTSD Scale - CAPS)). His PTSD was extremely severe according to score interpretation criteria2 set out for CAPS (scored 97 out of a possible score of 136). He also met diagnostic criteria for current Major Depressive Episode (assessment based on the Structured Clinical Interview for DSM-IV Major Depressive Episode Module SCID-MDE3). He had been diagnosed with the same disorders before and hospitalized twice (February and September 2011) by psychiatrists at the Bakirkoy Prof. Dr. Mazhar Osman Ruh Sagltgt ve Sinir Hastaliklari Egiim ve Ara,tirma Hastanesi. He received medical treatment with no benefit. He also received treatment with psychotropic medication from the Human Rights Foundation of Turkey with no benefit. Trauma specific psychotherapy was attempted at our center with limited benefit. Blake DD, Weathers FW, Nagy LM, Kaloupek DG, Charney DS, Keane TM. Clinician-Administered PTSD Scale (CAPS) - Current and Lifetime Diagnostic Version. Boston: National Center for Posttraumatic Stress Disorder, Behavioral Science Division; 1990. 2 Weathers FW, Keane TM, Davidson JRT. Clinician-administered PTSD scale: A review of the first ten years of
research. Depression and Anxiety. 2001;13(3):

First MB, Spitzer RL, Gibbon M, Williams JBW. Structured Clinical Interview for D.SM-lV Axis I Disorders -Non-patient Edition (SCID-i/NP, Version 2). New York: Biometrics Research Department, New York State Psychiatric Institute; 1996. 3

132-156.

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