TITLE:
Somato-Psychic Interplay and Academic Distress in an Expatriation Context: Case Report of a Depressive Episode in a Patient with Ankylosing Spondylitis
AUTHORS:
Hugo Hermann Bohongwe Divahe, Christian Eyoum, Massale Doucouré Tandjigora, Mane Diop, Cecile Elsa Pende, Keren Atseng, Babacar Diop, Abou Sy, Sokhna Seck
KEYWORDS:
Reactive Depression, Academic Failure, Ankylosing Spondylitis, Migration, Moussa Diop Clinic
JOURNAL NAME:
Open Journal of Depression,
Vol.15 No.4,
November
3,
2026
ABSTRACT: Introduction: In healthcare students, depressive decompensation frequently results from a complex interaction between individual vulnerability, academic stressors, and somatic comorbidity. We report the case of a female student experiencing a major depressive episode after being notified of her failure in the medical internship competitive examination. Methods: This is a qualitative case study with a clinical follow-up conducted over a 3-month period post-discharge at the Moussa Diop Psychiatric Clinic of the Fann National University Hospital (Dakar). Data were collected through weekly and then monthly semi-structured interviews during inpatient care and outpatient follow-up. Results: Ms. RK, a 24-year-old Cameroonian medical student with a history of ankylosing spondylitis (AS), presented with a moderate depressive episode (ICD-10) reactive to her failure in the internship examination. Clinical features included sadness, irritability, feelings of guilt, and temporary discontinuation of her somatic treatment. Integrative management (7-day hospitalization, short-term mexazolam treatment, supportive psychotherapy, techniques borrowed from behavioral activation, psychoeducation, and rheumatology referral) achieved full clinical remission and resumption of AS care within three months. Discussion: Academic failure acted as a major narcissistic injury. Inflammatory comorbidity and expatriation-related isolation exacerbated psychological vulnerability. Psychoeducation and selected cognitive-behavioral techniques were helpful in restoring coping mechanisms. Conclusion: This case highlights the necessity of an early biopsychosocial approach in international students.