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Lund T, Bernier E, Roman-Juan J, Kopala-Sibley D, Soltani S, Noyek S, Nania C, Beveridge J, Hoppe T, O'Connor R, O'Connor C, Clemens J, Mychasiuk R, Asmundson G, Stinson J, Noel M. Pain and Post-traumatic Stress Disorder Symptoms: Dyadic Relationships Between Canadian Armed Forces Members/Veterans with Chronic Pain and their Offspring. J Pain 2024:S1526-5900(24)00436-X. [PMID: 38580101 DOI: 10.1016/j.jpain.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 02/29/2024] [Accepted: 03/24/2024] [Indexed: 04/07/2024]
Abstract
Chronic pain and mental health issues occur at higher rates in Veterans than the general population. One widely recognized mental health issue faced by Veterans is post-traumatic stress disorder (PTSD). Trauma symptoms and pain frequently co-occur and are mutually maintained due to shared mechanisms. Many Veterans are also parents. Parental physical and mental health issues significantly predict children's chronic pain and related functioning, which can continue into adulthood. Only one US-based study has examined pain in the offspring of Veterans, suggesting heightened risk for pain. Research to date has not examined the associations between trauma and pain, and the dyadic influences of these symptoms, among Veterans and their children. The current study aimed to describe pain characteristics in Canadian Armed Forces (CAF) Members/Veterans with chronic pain and their offspring (youth and adult children aged 9-38). Cross-lagged Panel Models (CLPM) were conducted to examine dyadic relationships between pain interference and trauma symptoms of CAF Members/Veterans and their offspring. Over half of adult offspring and over one quarter of youth offspring reported chronic pain. Results revealed effects between one's own symptoms of PTSD and pain interference. No significant effects of parents on offspring or offspring on parents were found. The findings highlight the interconnection between pain and PTSD consistent with mutual maintenance models, and a lack of significant interpersonal findings suggestive of resiliency in this unique population. PERSPECTIVE: We characterized chronic pain in offspring of Canadian Armed Forces Members/Veterans with chronic pain and examined dyadic relationships between PTSD symptoms and chronic pain interference. Findings revealed that PTSD symptoms and pain interference were related within Veterans and offspring, but no dyadic relationships were found, which could reflect resiliency.
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Affiliation(s)
- Tatiana Lund
- Department of Psychology, University of Calgary, Canada.
| | - Emily Bernier
- Department of Psychology, University of Calgary, Canada
| | - Josep Roman-Juan
- Universitat Rovira i Virgili, Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | | | | | | | - Cara Nania
- Department of Psychology, University of Calgary, Canada
| | | | - Tom Hoppe
- The Chronic Pain Centre of Excellence for Canadian Veterans.
| | - Robert O'Connor
- Department of Psychology, University of Calgary, Canada; Universitat Rovira i Virgili, Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain; Department of Psychiatry, University of Calgary, Canada; The Chronic Pain Centre of Excellence for Canadian Veterans; Department of Neuroscience, Monash University, Australia; Department of Psychology, University of Regina, Canada; The Hospital for Sick Children, Canada
| | - Christine O'Connor
- Department of Psychology, University of Calgary, Canada; Universitat Rovira i Virgili, Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain; Department of Psychiatry, University of Calgary, Canada; The Chronic Pain Centre of Excellence for Canadian Veterans; Department of Neuroscience, Monash University, Australia; Department of Psychology, University of Regina, Canada; The Hospital for Sick Children, Canada
| | - Jessica Clemens
- Department of Psychology, University of Calgary, Canada; Universitat Rovira i Virgili, Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain; Department of Psychiatry, University of Calgary, Canada; The Chronic Pain Centre of Excellence for Canadian Veterans; Department of Neuroscience, Monash University, Australia; Department of Psychology, University of Regina, Canada; The Hospital for Sick Children, Canada
| | | | | | | | - Melanie Noel
- Department of Psychology, University of Calgary, Canada
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Fung HW, Tse HWY, Chau AKC, Lam SKK. Psychometric properties of the Chinese version of the Post-traumatic Maladaptive Beliefs Scale: A brief report. Asian J Psychiatr 2024; 93:103912. [PMID: 38237534 DOI: 10.1016/j.ajp.2024.103912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 12/31/2023] [Indexed: 03/08/2024]
Affiliation(s)
- Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong.
| | - Helen Wing Yuk Tse
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands.
| | - Anson Kai Chun Chau
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Stanley Kam Ki Lam
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
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Shang J, Hackett ML, Harris K, Woodward M, Roberts LM, Zhang P, Henry A. Mental health in the two years following hypertensive and normotensive pregnancy: The Postpartum, Physiology, Psychology and Paediatric follow-up (P4) cohort study. Pregnancy Hypertens 2024; 35:43-50. [PMID: 38171140 DOI: 10.1016/j.preghy.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/18/2023] [Accepted: 12/25/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Postpartum mental illnesses and hypertensive disorders of pregnancy (HDP) are both common, and both associated with adverse maternal and child health outcomes. However, the relationship between them is unclear. This study aimed to investigate prevalence and symptom severity of depression, anxiety, and post-traumatic stress disorder (PTSD) 2-years postpartum in women with normal blood pressure (NBP) during pregnancy versus preeclampsia or gestational hypertension (GH). METHODS Two-years follow-up of the prospective Postpartum, Physiology, Psychology and Paediatric (P4) Cohort Study was conducted in metropolitan Australia. Prevalence and symptom severity of depression (Edinburgh Postnatal Depression Scale, EPDS > 12), anxiety (7-item Generalized Anxiety Disorder scale, GAD-7 ≥ 10) and PTSD (Posttraumatic stress Diagnostic Scale, PDS/PDS-5) were measured and calculated for women with NBP, preeclampsia and GH. RESULTS Among 365 participants (NBP: n = 271, preeclampsia: n = 75, GH: n = 19), 2-years postpartum depression prevalence was 3.9% (95% CI 2.3-6.4%): 4.4% after NBP, and 2.7% after preeclampsia (p = 0.53). Anxiety prevalence was higher after GH than NBP (15.8% versus 3.3%, p = 0.02). Prevalence of any mental illness (depression/anxiety/PTSD) was 5.9% (95% CI 3.8-8.8%); 5.6% after NBP, 4.1% after PE, and 15.8% after GH (p = 0.15). Although PTSD prevalence was low (1.4%), and similar between groups (p = 0.97), around 3 times more women after PE (8.1%), compared to NBP (2.5%), recalled childbirth as traumatic (p = 0.003). CONCLUSIONS Preeclampsia, although associated with persistent perceptions of traumatic childbirth, did not alter the risk of mental illnesses at 2-years postpartum. GH (albeit in a small subgroup) was associated with increased anxiety scores. Larger, multicentre studies are required to clarify relationships between HDP and postpartum mental illness. TRIAL REGISTRATION Retrospectively registered on 18/11/2013 with the Australian and New Zealand Clinical Trials Registry. REGISTRATION NUMBER ACTRN 12613 00,126 0718.
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Affiliation(s)
- Jie Shang
- Discipline of Women's Health, School of Clinical Medicine, Faculty of Medicine, and Health, University of New South Wales, Sydney, Australia; The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
| | - Maree L Hackett
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Katie Harris
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Mark Woodward
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia; The George Institute for Global Health, School of Public Health, Imperial College London, UK
| | - Lynne M Roberts
- Department of Women's and Children's Health, St George Hospital, Kogarah, NSW, Australia; St George and Sutherland Clinical Campus, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | | | - Amanda Henry
- Discipline of Women's Health, School of Clinical Medicine, Faculty of Medicine, and Health, University of New South Wales, Sydney, Australia; The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia; Department of Women's and Children's Health, St George Hospital, Kogarah, NSW, Australia.
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Rezaei M, Bagheri MMS. Clinical effects of anodal tDCS and identifying response markers in post-traumatic stress disorder (PTSD): An open-label study. Behav Brain Res 2024; 458:114751. [PMID: 37931705 DOI: 10.1016/j.bbr.2023.114751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/08/2023]
Abstract
Transcranial direct current stimulation (tDCS) is a promising treatment for post-traumatic stress disorder (PTSD). However, not all patients respond to this type of treatment. The first aim of present study was to examine efficacy of tDCS for PTSD, depression, anxiety, and anhedonia in patients with PTSD. The second aim of this study was to examine the demographic, clinical, and psychological factors that may predict response to tDCS. In this open-label study, 103 PTSD patients underwent 10 sessions of tDCS (2 mA, 20 min). The anodal and cathodal electrodes were placed over the left dorsolateral prefrontal cortex (DLPFC; F3) and right supra-orbital (FP2) Respectively. Clinical outcome measures included Posttraumatic the Stress Disorder Checklist for DSM-5 (PCL-5), the Beck Depression Inventory (BDI-II), the Beck Anxiety Inventory (BAI), and the Snaith-Hamilton Pleasure Scale (SHAPS). There was an overall significant improvement in symptoms of PTSD, depression, anxiety, and anhedonia from pre- to post-treatment. Results also revealed that non-responders had higher severity at baseline for depression, anxiety, and anhedonia. However, higher severity of depression and anhedonia at baseline predicted response status, with higher severity associated with greater likelihood of non-response. tDCS of the left dLPFC and right supra-orbital appears to have a positive effect in reducing PTSD and related symptoms. These initial results could have an important influence on the adoption of anodal tDCS over the left DLPFC for PTSD, by enabling the early identification of patients who respond to tDCS.
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Affiliation(s)
- Mehdi Rezaei
- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Birjand, Birjand, Iran.
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Parekh SV, Adams LO, Barkell GA, Paniccia JE, Reissner KJ, Lysle DT. Dorsal hippocampal astrocytes mediate the development of heroin withdrawal-enhanced fear learning. Psychopharmacology (Berl) 2024:10.1007/s00213-024-06562-4. [PMID: 38396195 DOI: 10.1007/s00213-024-06562-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/20/2024] [Indexed: 02/25/2024]
Abstract
There is a significant co-occurrence of opioid use disorder (OUD) and post-traumatic stress disorder (PTSD) in clinical populations. However, the neurobiological mechanisms linking chronic opioid use, withdrawal, and the development of PTSD are poorly understood. Our previous research has shown that proinflammatory cytokines, expressed primarily by astrocytes in the dorsal hippocampus (DH), play a role in the development of heroin withdrawal-enhanced fear learning (HW-EFL), an animal model of PTSD-OUD comorbidity. Given the role of astrocytes in memory, fear learning, and opioid use, our experiments aimed to investigate their involvement in HW-EFL. Experiment 1 examined the effect of withdrawal from chronic heroin administration on GFAP surface area and volume, and identified increased surface area and volume of GFAP immunoreactivity in the dentate gyrus (DG) following 24-hour heroin withdrawal. Experiment 2 examined astrocyte morphology and synaptic interactions at the 24-hour withdrawal timepoint using an astroglial membrane-bound GFP (AAV5-GfaABC1D-lck-GFP). Although we did not detect significant changes in surface area and volume of GfaABC1D-Lck-GFP labelled astrocytes, we did observe a significant increase in the colocalization of astrocyte membranes with PSD-95 (postsynaptic density protein 95) in the DG. Experiment 3 tested if stimulating astroglial Gi signaling in the DH alters HW-EFL, and our results demonstrate this manipulation attenuates HW-EFL. Collectively, these findings contribute to our current understanding of the effects of heroin withdrawal on astrocytes and support the involvement of astrocytes in the comorbid relationship between opioid use and anxiety disorders.
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Affiliation(s)
- Shveta V Parekh
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB#3720, Chapel Hill, NC, 27599-3270, USA
| | - Lydia O Adams
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB#3720, Chapel Hill, NC, 27599-3270, USA
| | - Gillian A Barkell
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB#3720, Chapel Hill, NC, 27599-3270, USA
| | - Jacqueline E Paniccia
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB#3720, Chapel Hill, NC, 27599-3270, USA
| | - Kathryn J Reissner
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB#3720, Chapel Hill, NC, 27599-3270, USA
| | - Donald T Lysle
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB#3720, Chapel Hill, NC, 27599-3270, USA.
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Beck-Hiestermann FML, Hartung LK, Richert N, Miethe S, Wiegand-Grefe S. Are 6 more accurate than 4? The influence of different modes of delivery on postpartum depression and PTSD. BMC Pregnancy Childbirth 2024; 24:118. [PMID: 38331809 PMCID: PMC10851577 DOI: 10.1186/s12884-024-06267-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/11/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Empirical evidence shows that 4.6-6.3% of all women develop a post-traumatic stress disorder (PTSD) and approximately 10-15% postpartum depression (PPD) following childbirth. This study explores the relationship between delivery mode and the occurrence of PTSD and PPD, specifically examining four distinct caesarean section (CS) modes: primary on maternal request (Grade 4), medically indicated primary (Grade 3), secondary CS from relative indication (Grade 2) and emergency secondary CS (Grade 1), compared to vaginal and assisted vaginal delivery (AVD). The research aims to understand how these six subcategories of delivery modes impact PPD and PTSD levels. Common predictors, including the need for psychological treatment before childbirth, fear of childbirth, planning of pregnancy, induction of labor, birth debriefing, and lack of social support after childbirth, will be analyzed to determine their association with postpartum mental health outcomes. METHODS The study was planned and carried out by a research team of the psychology department at the Medical School Hamburg, Germany. Within an online-study (cross-sectional design) N = 1223 German speaking women with a baby who did not die before, during or after birth were surveyed once between four weeks and twelve months postpartum via an anonymous online questionnaire on demographic and gynecological data, delivery mode, PTSD (PCL-5) and PPD (EPDS). RESULTS For both psychiatric disorders, ANOVA revealed significant differences between delivery mode and PPD and PTSD. With weak effects for PPD and medium to strong effects for PTSD. Post-hoc tests showed increased levels of PPD for two CS types (Grade 1, Grade 3) compared to vaginal delivery. For PTSD, secondary CS from relative indication (Grade 2), emergency secondary CS (Grade 1) and assisted vaginal delivery (AVD) were associated with elevated levels of PTSD. Regression analysis revealed delivery mode as a significant predictor of EPDS- (medium effect size) and PCL-5-Score (medium to high effect size). LIMITATION Delivery was considered as the potential traumatic event, and any previous traumas were not documented. Additionally, the categorization of delivery modes relied on subjective reports rather than medical confirmation. CONCLUSION The study highlights the influence of delivery mode on the mental health of postpartum mothers: different modes influence postpartum disorders in various ways. However, the definition of delivery mode was only stated subjectively and not medically confirmed. Further research should investigate which aspects of the different delivery modes affect maternal mental health and explore how the perception of childbirth may be influenced by specific delivery experiences.
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Affiliation(s)
- Franziska Marie Lea Beck-Hiestermann
- Department of Psychology, Medical School Hamburg, Hamburg, Germany.
- Department of Psychosomatic Medicine and Psychotherapy, Psychologische Hochschule Berlin, Berlin, Germany.
| | - Lisa Kathrin Hartung
- Department of Psychology, Medical School Hamburg, Hamburg, Germany
- Clinic of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Nadine Richert
- Department of Psychology, Medical School Hamburg, Hamburg, Germany
| | - Sandra Miethe
- Department of Psychology, Medical School Hamburg, Hamburg, Germany
- Institute for Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
| | - Silke Wiegand-Grefe
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Lorem GF, Næss ET, Løchen ML, Lillevoll K, Molund EM, Rösner A, Lindkvist S, Schirmer H. Post-traumatic stress disorder among heart disease patients: a clinical follow-up of individuals with myocardial infarction in the Tromsø Study. BMC Psychiatry 2023; 23:936. [PMID: 38087199 PMCID: PMC10714632 DOI: 10.1186/s12888-023-05431-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Myocardial infarction is likely to be experienced as a life-threatening and potentially traumatic event. Approximately one-third of patients with myocardial infarction experience clinically significant symptoms of anxiety/depression. However, it is unclear how many of these patients experience these symptoms because of post-traumatic stress disorder (PTSD). We conducted a clinical screening of individuals with a confirmed myocardial infarction diagnosis. Our goal was to examine the prevalence of PTSD in myocardial infarction patients and study how PTSD symptoms were associated with exposure to potentially traumatic events. METHOD This is epidemiological research with a cross-sectional design following up participants from the Tromsø Study with a confirmed diagnosis of myocardial infarction. We sent invitations to participants in the Tromsø Study with clinically significant self-reported anxiety or depression symptoms following myocardial infarction. A cross-sectional sample of N = 79 participants (61 men and 18 women) was collected. During an interview, participants completed the Stressful Life Events Screening Questionnaire and the PTSD checklist PCL-5. RESULTS We found nine participants (11.6%) with probable PTSD. This was significantly higher than the postulated population prevalence in Norway (p < 0.015). We found no direct association between myocardial infarction as illness trauma and symptom levels (p = 0.123). However, we found a significant linear trend (p = 0.002), indicating that symptom severity increased proportionately as the number of post-traumatic events increased. CONCLUSION PTSD prevalence in myocardial infarction patients was related to lifetime exposure to traumatic events, not the myocardial infarction event alone. More research is required to examine the interaction between myocardial infarction and PTSD. Clinicians should be aware that anxiety or depression symptoms after MI could be secondary symptoms of PTSD.
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Affiliation(s)
- Geir Fagerjord Lorem
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Eva T Næss
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Cardiology, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kjersti Lillevoll
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Else-Marie Molund
- Department of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Assami Rösner
- Department of Cardiology, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Henrik Schirmer
- Department of Cardiology, Akershus University Hospital, Nordbyhagen, Norway
- Department of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
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Xu H, Li M, Cai J, Yuan Y, He L, Liu J, Wang L, Wang W. Comparison of ACE-IQ and CTQ-SF for child maltreatment assessment: Reliability, prevalence, and risk prediction. Child Abuse Negl 2023; 146:106529. [PMID: 37931543 DOI: 10.1016/j.chiabu.2023.106529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/12/2023] [Accepted: 10/27/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Child maltreatment has profound effects on mental health. The Childhood Trauma Questionnaire Short Form (CTQ-SF) and the Adverse Childhood Experiences International Questionnaire (ACE-IQ) are commonly used retrospective assessment tools for evaluating child maltreatment. OBJECTIVE This study aims to conduct a comprehensive comparison of the CTQ-SF and ACE-IQ, encompassing internal consistency, prevalence, and the predictive efficacy of trauma-related outcomes. It also seeks to enhance the scoring method of ACE-IQ based on the established comparability between the two instruments. PARTICIPANTS AND SETTING 1484 college students from northern China were recruited, assessing demographic characteristics and outcomes related to traumatic experiences, including post-traumatic stress disorder (PTSD), complex post-traumatic stress disorder (CPTSD), borderline personality disorder (BPD), anxiety, and depression. METHODS A contingency correlation analysis was performed to evaluate the degree of agreement between the CTQ-SF and ACE-IQ. Binary logistic regression models were utilized to compare the predictive capabilities of distinct instruments. RESULTS CTQ-SF and ACE-IQ instruments display favorable internal consistency and notable correlations across shared categories. However, the predictive relationships between trauma type and adverse outcomes are inconsistent across instruments. The ACE-IQ, encompassing 13 trauma categories, demonstrate a lower AIC and BIC index, indicating a superior model fit for elucidating outcomes. CONCLUSION This study introduces a scoring methodology for ACE-IQ, improving the comparability of the two measures and emphasizing the importance of capturing the full range of maltreatment types a child may have experienced. These findings have significant implications for clinical and epidemiological research, providing valuable insights for understanding the impact of child maltreatment.
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Affiliation(s)
- Hang Xu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.
| | - Man Li
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China; Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China; Tianjin Social Science Laboratory of Students' Mental Development and Learning, Tianjin 300387, China
| | - Jinping Cai
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yidan Yuan
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Li He
- Teachers' College of Beijing Union University, Beijing, China
| | - Jing Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Weiwen Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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9
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Wiseman M, Hinks M, Hallett D, Blundell J, Sweeney E, Thorpe CM, Walling SG, Swift-Gallant A. Evidence that ovarian hormones, but not diet and exercise, contribute to the sex disparity in post-traumatic stress disorder. J Psychiatr Res 2023; 168:213-220. [PMID: 37918034 DOI: 10.1016/j.jpsychires.2023.10.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/04/2023]
Abstract
Females are twice as likely as males to receive a diagnosis of post-traumatic stress disorder (PTSD). One hypothesis for this sex disparity is that ovarian hormones, including estrogen and progesterone, contribute to PTSD risk. Alternatively, sex differences in lifestyle factors, such as diet and exercise, may play a role in PTSD risk. Using data from the Atlantic Partnership for Tomorrow's Health (PATH) cohort (n = 16,899), the relationship between endogenous hormone fluctuations (e.g., menarche, pregnancy, and menopause), exogenous hormone use (e.g., hormonal contraception and hormone replacement therapy (HRT)) and lifestyle variables (diet and exercise habits, as measured by the Mediterranean Diet Adherence Screener, Healthy Eating Index, and International Physical Activity Questionnaire) with PTSD diagnosis and treatment were analyzed. While several hormonal variables, including contraceptive use, higher total number of pregnancies, younger menarche age, and having undergone menopause increased the risk of PTSD, no lifestyle variables contributed to an increased risk of PTSD diagnosis. These findings support the theory that ovarian hormones contribute to the sex-linked disparity in PTSD diagnosis.
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Affiliation(s)
- Megan Wiseman
- Department of Psychology, Memorial University of Newfoundland, 242 Elizabeth Ave. St. John's, NL, A1B 3X9, Canada
| | - Meagan Hinks
- Department of Psychology, Memorial University of Newfoundland, 242 Elizabeth Ave. St. John's, NL, A1B 3X9, Canada
| | - Darcy Hallett
- Department of Psychology, Memorial University of Newfoundland, 242 Elizabeth Ave. St. John's, NL, A1B 3X9, Canada
| | - Jacqueline Blundell
- Department of Psychology, Memorial University of Newfoundland, 242 Elizabeth Ave. St. John's, NL, A1B 3X9, Canada
| | - Ellen Sweeney
- Atlantic PATH, Faculty of Medicine, Dalhousie University, 5849 University Ave, Halifax, NS, B3H 4R2, Canada
| | - Christina M Thorpe
- Department of Psychology, Memorial University of Newfoundland, 242 Elizabeth Ave. St. John's, NL, A1B 3X9, Canada
| | - Susan G Walling
- Department of Psychology, Memorial University of Newfoundland, 242 Elizabeth Ave. St. John's, NL, A1B 3X9, Canada
| | - Ashlyn Swift-Gallant
- Department of Psychology, Memorial University of Newfoundland, 242 Elizabeth Ave. St. John's, NL, A1B 3X9, Canada.
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10
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Chang CC, Hsu ST, Wang YY, Chou FHC. The impact of the COVID-19 pandemic on mental health in Taiwan. Asian J Psychiatr 2023; 88:103745. [PMID: 37625327 DOI: 10.1016/j.ajp.2023.103745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023]
Affiliation(s)
- Chih-Chieh Chang
- Department of Addiction Prevention, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Su-Ting Hsu
- Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Yu-Yuan Wang
- Department of Neuropsychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Frank Huang-Chih Chou
- Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan.
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11
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Dell'Aquila A, Berle D. Predictors of alcohol and substance use among people with post-traumatic stress disorder (PTSD): findings from the NESARC-III study. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1509-1522. [PMID: 37133523 PMCID: PMC10460312 DOI: 10.1007/s00127-023-02472-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/30/2023] [Indexed: 05/04/2023]
Abstract
PURPOSE The self-medication hypothesis suggests people may develop Alcohol Use Disorder (AUD) or Non-Alcohol Substance Use Disorder (NA-SUD) following PTSD as a maladaptive way of coping with PTSD symptoms. Given that an accumulation of trauma experiences and interpersonal trauma increase the likelihood and severity of PTSD, we sought to determine whether the number and type of traumas additionally predict AUD and NA-SUD following PTSD. METHODS We analysed data from 36,309 adult participants in the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) study (M = 45.63 years, SD = 17.53, 56.3% female) who were administered semi-structured diagnostic interviews of trauma exposure and PTSD, AUD and NA-SUD symptoms. RESULTS Individuals with PTSD were more likely to have an AUD or NA-SUD than those without PTSD. Endorsement of a greater number of traumas was associated with greater odds of having PTSD, AUD, or NA-SUD. Experience of interpersonal trauma was related to greater odds of having PTSD and subsequent AUD or NA-SUD than not experiencing interpersonal trauma. Multiple experiences of interpersonal trauma compared to one interpersonal trauma exposure also increased the odds of having PTSD followed by AUD or NA-SUD. CONCLUSIONS Interpersonal trauma and multiple experiences of interpersonal trauma may result in individuals turning to alcohol and substances as a way to alleviate intolerable PTSD symptomology, aligning with the self-medication hypothesis. Our findings highlight the importance of ensuring services and support for interpersonal trauma survivors and for those who have experienced multiple traumas given their increased for unfavourable outcomes.
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Affiliation(s)
- Adriana Dell'Aquila
- Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - David Berle
- Graduate School of Health, University of Technology Sydney, Sydney, Australia.
- School of Medicine and Psychology, Australian National University, Canberra, Australia.
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12
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Li W, Cheng P, Liu Z, Ma C, Liu B, Zheng W, Scarisbrick D, Lu J, Li L, Huang Y, Wang L, Yan Y, Xiao S, Zhang Y, Zhang T, Yan J, Yu Y, Xu X, Wang Z, Xu Y, Li T, Xu G, Xu X, Xue M, Li G, Jia F, Shi J, Zhang N, Du X, Sang H, Zhang C, Liu B. Post-traumatic stress disorder and traumatic events in China: a nationally representative cross-sectional epidemiological study. Psychiatry Res 2023; 326:115282. [PMID: 37290364 DOI: 10.1016/j.psychres.2023.115282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/10/2023]
Abstract
Post-traumatic stress disorder (PTSD) is one of the most severe sequelae of trauma. But a nationally representative epidemiological data for PTSD and trauma events (TEs) was unavailable in China. This article firstly demonstrated detailed epidemiological information on PTSD, TEs, and related comorbidities in the national-wide community-based mental health survey in China. A total of 9,378 participants completed the PTSD-related interview of the CIDI 3.0. Lifetime prevalence and 12-month prevalence of PTSD in total respondents were 0.3% and 0.2%. while the conditional lifetime and 12-month prevalence of PTSD after trauma exposure were 1.8% and 1.1%. The prevalence of exposure to any type of TE was 17.2%. Among individuals with the exposed to TEs, younger, without regular work (being a homemaker or retried), and intimate relationship breakdown (separated/Widowed/Divorced), living rurally were associated with either the lifetime PTSD or the 12-month PTSD, while the count of a specific TE, the unexpected death of loved one, was related to both. Alcohol dependence was the most common comorbidity among male participants with PTSD but major depressive disorder (MDD) for female counterparts. Our study can provide a reliable reference for future identification and intervention for people with PTSD.
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Affiliation(s)
- Weihui Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Peng Cheng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Zhaorui Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Chao Ma
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Bangshan Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Wanhong Zheng
- West Virginia University Department of Behavioral Medicine and Psychiatry, 930 Chestnut Ridge Road, Morgantown, WV 26505
| | - Dave Scarisbrick
- West Virginia University Department of Behavioral Medicine and Psychiatry, West Virginia University Department of Neuroscience 930 Chestnut Ridge Road, Morgantown, WV 26505
| | - Jin Lu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China
| | - Lingjiang Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Yueqin Huang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China.
| | - Limin Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yongping Yan
- Department of Epidemiology, the Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha 410078, Hunan, China
| | - Yan Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Tingting Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Jie Yan
- Institute of Social Science Survey, Peking University, Beijing 100871, China
| | - Yaqin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, Jilin, China
| | - Xiufeng Xu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China
| | - Zhizhong Wang
- Department of Epidemiology and Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan 750004, Ningxia, China
| | - Yifeng Xu
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Tao Li
- Mental Health Centre of West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Guangming Xu
- Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Xiangdong Xu
- The Fourth People's Hospital in Urumqi, Urumqi 830002, China
| | - Meihua Xue
- The Affiliated Wuxi Mental Health Center with Nanjing Medical University, Wuxi 214151, Jiangsu, China
| | - Guohua Li
- Chifeng Anding Hospital, Chifeng 024000, Inner Mongolia Autonomous Region, China
| | - Fujun Jia
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510120, Guangdong, China
| | - Jianfei Shi
- Department of Psychiatry, Hangzhou Seventh People's Hospital, Hangzhou 310013, Zhejiang, China
| | - Ning Zhang
- Nanjing Brain Hospital, Nanjing 210029, Jiangsu, China
| | - Xinbai Du
- The Third People's Hospital of Qinghai, Xining 810007, Qinghai, China
| | - Hong Sang
- Changchun Sixth Hospital, Changchun 130052, Jilin, China
| | - Congpei Zhang
- Harbin First Specialized Hospital, Harbin 150000, Heilongjiang, China
| | - Bo Liu
- Jingzhou Mental Health Center, Jingzhou 434000, Hubei China
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13
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Long G, Duo W, Man L, Haoning M, Ping Y, Mingsheng T, Yuxiang S. The impact of post-traumatic stress on the clinical outcome in a cohort of patients with knee osteoarthritis and knee arthroplasty: A prospective study. J Orthop Sci 2023:S0949-2658(23)00087-8. [PMID: 37055273 DOI: 10.1016/j.jos.2023.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 01/18/2023] [Accepted: 03/26/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND Knee osteoarthritis (KOA) is one of the most common musculoskeletal disorders and commonly occurs in older adults, predominantly female populations. Both populations have intimate links with trauma-related stress. Therefore, we intended to evaluate the prevalence of post-traumatic stress disorder (PTSD), which arises from KOA and determine its effects on the postoperative results in patients undergoing total knee arthroplasty (TKA). METHODS The patients who fulfilled the diagnosis of KOA from February 2018 to October 2020 were interviewed. Patients were interviewed by a senior psychiatrist about evaluating their overall experience during their most difficult or stressful situations. KOA patients who underwent TKA were further analyzed to investigate whether PTSD influences the postoperative results. The PTSD Checklist-Civilian Version (PCL-C) and Western Ontario McMaster Universities (WOMAC) Osteoarthritis Index were used to assess PTS symptoms and clinical outcomes after TKA, respectively. RESULTS 212 KOA patients completed this study with a mean follow-up of 16.7 months (7-36 months). The mean age was 62.5 ± 12.3 years, and 53.3% (113/212) were women. 64.6% of the sample (137/212) underwent TKA to relieve the symptoms of KOA. Patients with either PTS or PTSD tended to be younger (P < 0.05), female (P < 0.05) and undergo TKA (P < 0.05) than their counterparts. WOMAC-pain (P < 0.05), WOMAC-stiffness (P < 0.05), and WOMAC-physical function (P < 0.05) both before TKA and 6 months after TKA in the PTSD group is significantly higher compared to their counterparts. Logistic regression analysis showed that a history of OA-inducing trauma (adjusted OR = 2.0, 95% CI = 1.7-2.3, P = 0.003), posttraumatic KOA (adjusted OR = 1.7, 95% CI = 1.4-2.0, P < 0.001), and invasive treatment (adjusted OR = 2.0, 95% CI = 1.7-2.3, P = 0.032), were significantly associated with PTSD in KOA patients. CONCLUSIONS Patients with KOA, especially those undergoing TKA, are associated with PTS symptoms and PTSD, indicating the need to evaluate it and offer care for them.
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Affiliation(s)
| | - Wang Duo
- School of Music and Dance, Hubei Minzu University, China
| | - Li Man
- General Hospital of Enshi Tujia & Miao Autonomous Prefecture, China
| | | | - Yi Ping
- China-Japan Friendship Hospital, China
| | | | - Song Yuxiang
- Department of Anesthesiology, The First Medical Center of PLA General Hospital, Beijing, China.
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14
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Simkin DR. Post-Traumatic Stress Disorder/Developmental Trauma Disorder/Complex Post-Traumatic Stress Disorder and Complementary and Integrative Medicine/Functional Medicine. Child Adolesc Psychiatr Clin N Am 2023; 32:317-365. [PMID: 37147042 DOI: 10.1016/j.chc.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Response to PTSD treatments differ based on the age the abuse occurred, the type of abuse, and the chronicity of the abuse. Even when modifications to treatment are made based on the developmental age when the abuse occurred, therapies may be insufficient. In addition, when diagnostic criteria are modified to identify more children, some children continue to escape detection. Developmental Trauma Disorder, (akin to the RDoC), may be more suitable to identify epigenetic and inflammatory effects of early abuse that may be responsible for the nonresponsive to treatment. Complementary and Integrative Medicine interventions (meditation, EFT, EMDR, PUFAs, etc.) may reverse these effects.
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Affiliation(s)
- Deborah R Simkin
- Department of Psychiatry, Emory University School of Medicine, 8955 Highway 98 West, Suite 204, Miramar Beach, FL 32550, USA.
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15
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Lee BEC, Ling M, Boyd L, Olsson C, Sheen J. The prevalence of probable mental health disorders among hospital healthcare workers during COVID-19: A systematic review and meta-analysis. J Affect Disord 2023; 330:329-345. [PMID: 36931567 PMCID: PMC10017178 DOI: 10.1016/j.jad.2023.03.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 02/24/2023] [Accepted: 03/06/2023] [Indexed: 03/17/2023]
Abstract
OBJECTIVES The mental health impacts of the COVID-19 pandemic continue to be documented worldwide with systematic reviews playing a pivotal role. Here we present updated findings from our systematic review and meta-analysis on the mental health impacts among hospital healthcare workers during COVID-19. METHODS We searched MEDLINE, CINAHL, PsycINFO, Embase and Web Of Science Core Collection between 1st January 2000 to 17th February 2022 for studies using validated methods and reporting on the prevalence of diagnosed or probable mental health disorders in hospital healthcare workers during the COVID-19 pandemic. A meta-analysis of proportions and odds ratio was performed using a random effects model. Heterogeneity was investigated using test of subgroup differences and 95 % prediction intervals. RESULTS The meta-analysis included 401 studies, representing 458,754 participants across 58 countries. Pooled prevalence of depression was 28.5 % (95 % CI: 26.3-30.7), anxiety was 28.7 % (95 % CI: 26.5-31.0), PTSD was 25.5 % (95 % CI: 22.5-28.5), alcohol and substance use disorder was 25.3 % (95 % CI: 13.3-39.6) and insomnia was 24.4 % (95 % CI: 19.4-29.9). Prevalence rates were stratified by physicians, nurses, allied health, support staff and healthcare students, which varied considerably. There were significantly higher odds of probable mental health disorders in women, those working in high-risk units and those providing direct care. LIMITATIONS Majority of studies used self-report measures which reflected probable mental health disorders rather than actual diagnosis. CONCLUSIONS These updated findings have enhanced our understanding of at-risk groups working in hospitals. Targeted support and research towards these differences in mental health risks are recommended to mitigate any long-term consequences.
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Affiliation(s)
| | - Mathew Ling
- School of Psychology, Deakin University, Burwood, VIC, Australia; Neami National, Preston, VIC, Australia
| | | | - Craig Olsson
- School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Jade Sheen
- School of Psychology, Deakin University, Burwood, VIC, Australia
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16
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Usta Sağlam NG, Aksoy Poyraz C, Doğan D, Erhan B. Suicidal ideation, post-traumatic stress disorder, and depression in traumatic spinal cord injury: What resilience tells us. J Spinal Cord Med 2023; 46:309-316. [PMID: 35593735 PMCID: PMC9987751 DOI: 10.1080/10790268.2022.2039856] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE Identification of unmet psychiatric needs, protective and risk factors for suicide are crucial for people with traumatic spinal cord injury (SCI). In this study, we aimed to explore depression, post-traumatic stress disorder (PTSD) status (non-PTSD, partial-PTSD, full-PTSD), resilience, suicidal ideation (SI) and to examine predictors and clinical correlates of current SI in traumatic SCI. METHOD Sixty-three individuals with traumatic SCI who were at least 3 months post-injury were included in the study. The participants were evaluated in terms of PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5), depression, SI, and resilience using the PCL-5, the Patient Health Questionnaire-9, the Brief Resilience Scale, and sociodemographic measures. RESULTS 33% of our sample (n = 21) had SI over the past two weeks. 71.4% of the patients with SI (n = 15) had depression. A total of 52.4% of the patients with SI (n = 11) were diagnosed with full PTSD. Resilience was found to be significantly lower in individuals with depression and individuals with SI. While depression predicted SI in traumatic SCI, resilience stands as a protective factor against SI. CONCLUSION SI is quite common in individuals with traumatic SCI and is accompanied by substantial psychiatric comorbidities such as depression and PTSD. Along with depression and PTSD, resilience - which has protective and predictive values and is inversely associated with SI - constitutes a significant psychotherapeutic intervention and screening area.
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Affiliation(s)
- Nazife Gamze Usta Sağlam
- Department of Psychiatry, University of Health Sciences, Erenköy Training and Research Hospital for Psychiatry and Neurological Diseases, Istanbul, Turkey
| | - Cana Aksoy Poyraz
- Department of Psychiatry, Istanbul University- Cerrahpaşa, Cerrahpasa Medical School, Istanbul, Turkey
| | - Deniz Doğan
- Physical Medicine and Rehabilitation Department, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey
| | - Belgin Erhan
- Physical Medicine and Rehabilitation Department, İstanbul Medeniyet University, School of Medicine, Istanbul, Turkey
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17
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Hummel EM, Piovesan K, Berg F, Herpertz S, Kessler H, Kumsta R, Moser DA. Mitochondrial DNA as a marker for treatment-response in post-traumatic stress disorder. Psychoneuroendocrinology 2023; 148:105993. [PMID: 36462294 DOI: 10.1016/j.psyneuen.2022.105993] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/28/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a serious mental health condition thought to be mediated by a dysregulated stress response system. Stress, especially chronic stress, affects mitochondrial activity and their efficiency in duplicating their genomes. Human cells contain numerous mitochondria that harbor multiple copies of their own genome, which consist of a mixture of wild type and variant mtDNA - a condition known as mitochondrial heteroplasmy. Number of mitochondrial genomes in a cell and the degree of heteroplasmy may serve as an indicator of mitochondrial allostatic load. Changes in mtDNA copy number and the proportion of variant mtDNA may be related to mental disorders and symptom severity, suggesting an involvement of mitochondrial dysfunction also in PTSD. Therefore, we examined number and composition of mitochondrial DNA before and after six weeks of inpatient psychotherapy treatment in a cohort of 60 female PTSD patients. We extracted DNA from isolated monocytes before and after inpatient treatment and quantified cellular mtDNA using multiplex qPCR. We hypothesized that treatment would lead to changes in cellular mtDNA levels and that change in mtDNA level would be associated with PTSD symptom severity and treatment response. It could be shown that mtDNA copy number and the ratio of variant mtDNA decreased during therapy, however, this change did not correlate with treatment response. Our results suggest that inpatient treatment can reduce signs of mitochondrial allostatic load, which could have beneficial effects on mental health. The quantification of mtDNA and the determination of cellular heteroplasmy could represent valuable biomarkers for the molecular characterization of mental disorders in the future.
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Affiliation(s)
- E M Hummel
- Department of Genetic Psychology, Faculty of Psychology, Ruhr-University Bochum, Universitätsstraße 150, 44801 Bochum, Germany.
| | - K Piovesan
- Department of Genetic Psychology, Faculty of Psychology, Ruhr-University Bochum, Universitätsstraße 150, 44801 Bochum, Germany
| | - F Berg
- Department of Genetic Psychology, Faculty of Psychology, Ruhr-University Bochum, Universitätsstraße 150, 44801 Bochum, Germany
| | - S Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Germany
| | - H Kessler
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Germany; Department of Psychosomatic Medicine and Psychotherapy, Fulda Hospital, University Medicine Marburg Campus Fulda, Fulda, Germany
| | - R Kumsta
- Department of Genetic Psychology, Faculty of Psychology, Ruhr-University Bochum, Universitätsstraße 150, 44801 Bochum, Germany; Department of Behavioural and Cognitive Sciences, Laboratory for Stress and Gene-Environment nterplay, University of Luxemburg, Porte des Sciences, L-4366 Esch-sur-Alzette, Luxemburg
| | - D A Moser
- Department of Genetic Psychology, Faculty of Psychology, Ruhr-University Bochum, Universitätsstraße 150, 44801 Bochum, Germany.
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18
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Holter KM, Pierce BE, Gould RW. Metabotropic glutamate receptor function and regulation of sleep-wake cycles. Int Rev Neurobiol 2023; 168:93-175. [PMID: 36868636 DOI: 10.1016/bs.irn.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Metabotropic glutamate (mGlu) receptors are the most abundant family of G-protein coupled receptors and are widely expressed throughout the central nervous system (CNS). Alterations in glutamate homeostasis, including dysregulations in mGlu receptor function, have been indicated as key contributors to multiple CNS disorders. Fluctuations in mGlu receptor expression and function also occur across diurnal sleep-wake cycles. Sleep disturbances including insomnia are frequently comorbid with neuropsychiatric, neurodevelopmental, and neurodegenerative conditions. These often precede behavioral symptoms and/or correlate with symptom severity and relapse. Chronic sleep disturbances may also be a consequence of primary symptom progression and can exacerbate neurodegeneration in disorders including Alzheimer's disease (AD). Thus, there is a bidirectional relationship between sleep disturbances and CNS disorders; disrupted sleep may serve as both a cause and a consequence of the disorder. Importantly, comorbid sleep disturbances are rarely a direct target of primary pharmacological treatments for neuropsychiatric disorders even though improving sleep can positively impact other symptom clusters. This chapter details known roles of mGlu receptor subtypes in both sleep-wake regulation and CNS disorders focusing on schizophrenia, major depressive disorder, post-traumatic stress disorder, AD, and substance use disorder (cocaine and opioid). In this chapter, preclinical electrophysiological, genetic, and pharmacological studies are described, and, when possible, human genetic, imaging, and post-mortem studies are also discussed. In addition to reviewing the important relationships between sleep, mGlu receptors, and CNS disorders, this chapter highlights the development of selective mGlu receptor ligands that hold promise for improving both primary symptoms and sleep disturbances.
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Affiliation(s)
- Kimberly M Holter
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Bethany E Pierce
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Robert W Gould
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, United States.
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Leshem S, Keha E, Kalanthroff E. Post-traumatic stress in war veterans and secondary traumatic stress among parents of war veterans five years after the 2014 Israel-Gaza military conflict. Eur J Psychotraumatol 2023; 14:2235983. [PMID: 37497596 PMCID: PMC10375916 DOI: 10.1080/20008066.2023.2235983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/16/2023] [Accepted: 06/16/2023] [Indexed: 07/28/2023] Open
Abstract
Secondary traumatic stress (STS) has been studied in therapists, spouses, and mainly in children of traumatised individuals. To date, the relationship between children's posttraumatic stress disorder (PTSD) symptoms and their parents' mental health outcomes have been understudied, and specifically, long term STS symptoms of parents of war veterans were not investigated. The current study examined PTSD symptoms among veterans of the 2014 Israel-Gaza war and STS among their parents, five years after the war. The control group consisted of veterans from combat military units who were on active duty at the time of the war but did not actively participate in the war (stand-by units) - providing a natural experiment condition. We found that PTSD symptoms were almost twice as high in the directly active war veterans (DAV, N = 32) group compared to the indirectly active war veterans (IAV, N = 26) group. Results showed that mothers had higher STS symptoms in general, and DAV PTSD symptoms correlated with their fathers STS symptoms. The current study provides novel evidence for: (a) subclinical PTSD symptoms in war veterans 5 years after the war, and (b) transmission of trauma from war veterans to their parents. The overall negative effect of sending a child to war on the parents are also discussed.
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Affiliation(s)
- Shahaf Leshem
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Eldad Keha
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Psychology, Achva Academic College, Beer-Tuvia, Israel
| | - Eyal Kalanthroff
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
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20
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Shaw SB, Nicholson AA, Ros T, Harricharan S, Terpou B, Densmore M, Theberge J, Frewen P, Lanius RA. Increased top-down control of emotions during symptom provocation working memory tasks following a RCT of alpha-down neurofeedback in PTSD. Neuroimage Clin 2023; 37:103313. [PMID: 36669352 PMCID: PMC9868881 DOI: 10.1016/j.nicl.2023.103313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 12/31/2022] [Accepted: 01/02/2023] [Indexed: 01/05/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) has been found to be associated with emotion under-modulation from the prefrontal cortex and a breakdown of the top-down control of cognition and emotion. Novel adjunct therapies such as neurofeedback (NFB) have been shown to normalize aberrant neural circuits that underlie PTSD psychopathology at rest. However, little evidence exists for NFB-linked neural improvements under emotionally relevant cognitive load. The current study sought to address this gap by examining the effects of alpha-down NFB in the context of an emotional n-back task. METHODS We conducted a 20-week double-blind randomized, sham-controlled trial of alpha-down NFB and collected neuroimaging data before and after the NFB protocol. Participants performed an emotional 1-back and 2-back working memory task, with interleaved trauma-neutral and trauma-relevant cues in the fMRI scanner. Data from 35 participants with a primary diagnosis of PTSD were analyzed in this study (n = 18 in the experimental group undergoing alpha-down NFB, n = 17 in the sham-control group). RESULTS Firstly, within-group analyses showed clinically significant reductions in PTSD symptom severity scores at the post-intervention timepoint and 3-month follow-up for the experimental group, and not for the sham-control group. The neuroimaging analyses revealed that alpha-down NFB enhanced engagement of top-down cognitive and emotional control centers, such as the dorsolateral prefrontal cortex (dlPFC), and improved integration of the anterior and posterior parts of the default mode network (DMN). Finally, our results also indicate that increased alpha-down NFB performance correlated with increased activity in brain regions involved in top-down control and bodily consciousness/embodied processing of self (TPJ and posterior insula). CONCLUSION This is the first study to provide mechanistic insights into how NFB may normalize dysfunctional brain activity and connectivity in PTSD under cognitive load with simultaneous symptom provocation, adding to a growing body of evidence supporting the therapeutic neuromodulatory effects of NFB. This preliminary study highlights the benefits of alpha-down NFB training as an adjunctive therapy for PTSD and warrants further investigation into its therapeutic effects on cognitive and emotion control in those with PTSD.
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Affiliation(s)
- Saurabh Bhaskar Shaw
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Vector Institute, Toronto, Ontario, Canada; Homewood Research Institute (HRI), Guelph, Ontario, Canada.
| | - Andrew A Nicholson
- School of Psychology, University of Ottawa, Canada; Atlas Institute for Veterans and Families, Royal Ottawa Hospital, Canada; Department of Psychiatry and Behavioral Neuroscience, McMaster University, Hamilton, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Tomas Ros
- Departments of Neuroscience and Psychiatry, University of Geneva, Geneva, Switzerland
| | - Sherain Harricharan
- Homewood Research Institute (HRI), Guelph, Ontario, Canada; Department of Psychiatry and Behavioral Neuroscience, McMaster University, Hamilton, Ontario, Canada; St. Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Braeden Terpou
- Homewood Research Institute (HRI), Guelph, Ontario, Canada; Department of Psychiatry and Behavioral Neuroscience, McMaster University, Hamilton, Ontario, Canada
| | - Maria Densmore
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada
| | - Jean Theberge
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Department of Diagnostic Imaging, St. Joseph's Healthcare, London, Ontario, Canada
| | - Paul Frewen
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Ruth A Lanius
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Homewood Research Institute (HRI), Guelph, Ontario, Canada; St. Joseph's Healthcare, Hamilton, Ontario, Canada.
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21
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Abstract
BACKGROUND Although eye movement desensitization and reprocessing (EMDR) has been shown to be effective in the treatment of PTSD for years, it remains controversial due to the lack of understanding of its mechanisms of action. We examined whether the working memory (WM) hypothesis -the competition for limited WM resources induced by the dual task attenuates the vividness and emotionality of the traumatic memory - would provide an explanation for the beneficial effect induced by bilateral stimulation. METHODS We followed the Prisma guidelines and identified 11 articles categorized in two types of designs: studies involving participants with current PTSD symptoms and participants without PTSD diagnosis. RESULTS Regardless of the types of studies, the results showed a reduction of vividness and emotionality in the recall of traumatic stimuli under a dual-task condition compared to a control condition, such as recall alone. However, two studies used a follow-up test to show that this effect does not seem to last long. CONCLUSION Our results provide evidence for the WM hypothesis and suggest that recalling a traumatic memory while performing a secondary task would shift the individual's attention away from the retrieval process and result in a reduction in vividness and emotionality, also associated with the reduction of symptoms.
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Affiliation(s)
- Dany Laure Wadji
- grid.8534.a0000 0004 0478 1713I-Reach Lab, Unit of Clinical and Health Psychology, Department of Psychology, University of Fribourg, Fribourg, Switzerland ,grid.8534.a0000 0004 0478 1713Department of Psychology, University of Fribourg, Rue P.-A.-de Faucigny 2, CH-1700 Fribourg, Switzerland
| | - C. Martin-Soelch
- grid.8534.a0000 0004 0478 1713I-Reach Lab, Unit of Clinical and Health Psychology, Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - V. Camos
- grid.8534.a0000 0004 0478 1713W-MOVE (Working meMOry deVElopment) lab, Department of Psychology, University of Fribourg, Fribourg, Switzerland CH-1700
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22
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Zai CC, Cheema SY, Zai GC, Tiwari AK, Kennedy JL. Post-traumatic stress disorder in the Canadian Longitudinal Study on Aging: A genome-wide association study. J Psychiatr Res 2022; 154:209-18. [PMID: 35952521 DOI: 10.1016/j.jpsychires.2022.07.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/06/2022] [Accepted: 07/20/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Canada exhibits one of highest lifetime prevalence for post-traumatic stress disorder (PTSD), but the etiology of this debilitating mental health condition still remains largely unknown. This study aims to examine the genetics of PTSD in the Canadian Longitudinal Study on Aging (CLSA) to identify potential genetic factors involved in the development of PTSD. METHOD The CLSA sample was screened for primary (PTSD status) and secondary outcomes (avoidance, detachment, guardedness, and nightmares) based on the Primary Care PTSD Screen Scale (PC-PTSD). After GWAS quality control and whole-genome imputation, single-marker, gene-based, and polygenic risk score (PRS) analyses were performed. RESULTS Based on available genotype and phenotype data, N = 16,535 individuals were selected for the analyses. While genome-wide analyses did not show significant findings for our primary and secondary outcomes, PRS analyses showed variable levels of association between PC-PTSD items with trauma, major depressive disorder, schizophrenia, bipolar disorder, educational attainment, and insomnia (p < 5e-4). CONCLUSION This is the first GWAS of PTSD status and individual PC-PTSD items in a population sample of older adults from Canada. This study was also able to replicate findings from previous studies. Genetic investigations into individual symptom components of PTSD may help untangle the complex genetic architecture of PTSD.
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23
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Straus LD, Dolsen EA, Nishimi K, Neylan TC, O'Donovan A. Worse sleep, worsening post-traumatic stress disorder (PTSD): Poor sleep quality associated with increases in PTSD symptoms amongst those experiencing high threat of the COVID-19 pandemic. J Sleep Res 2022; 31:e13568. [PMID: 35199399 PMCID: PMC9115198 DOI: 10.1111/jsr.13568] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 01/14/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is a global health crisis with the potential to elicit and worsen psychiatric symptoms, particularly post-traumatic stress disorder (PTSD) symptoms. Identifying modifiable protective factors is critical for preventing and treating PTSD symptoms both during and following the COVID-19 pandemic. The present study examined associations of self-reported sleep quality and anticipatory threat appraisals of the pandemic with PTSD symptoms 6 months later in a sample enriched for pre-pandemic trauma exposure and PTSD. The sample included 590 adults (mean age 38.2 years) who completed a baseline survey in August/September 2020 and follow-up survey in March/April 2021. The sample was recruited from a pool of participants interested in a prior study about traumatic stress. Participants self-reported sleep quality and pandemic-related anticipatory threat appraisals at baseline. PTSD symptoms were assessed at baseline and follow-up. Baseline sleep quality was associated with PTSD symptoms at follow-up controlling for baseline PTSD symptoms (B = -2.49, p = 0.001). Perceived anticipatory threat of the pandemic moderated this association such that worse sleep quality was related to more severe PTSD symptoms at follow-up for participants with higher (B = -4.07, p < 0.001) but not lower (B = -0.43, p = 0.679) anticipatory threat about the COVID-19 pandemic. These findings suggest that poor sleep quality may enhance vulnerability to later PTSD symptoms during the pandemic, particularly among those individuals who perceived the pandemic as threatening for their future. Treatments that address sleep problems may be beneficial for reducing trauma-related symptoms during and following the global health crisis.
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Affiliation(s)
- Laura D Straus
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
- Department of Psychiatry, University of California, San Francisco, California, USA
| | - Emily A Dolsen
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
- Department of Psychiatry, University of California, San Francisco, California, USA
- Mental Illness Research Education and Clinical Centers, San Francisco Veterans Affairs Health Care System, San Francisco, California, USA
| | - Kristen Nishimi
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
- Department of Psychiatry, University of California, San Francisco, California, USA
| | - Thomas C Neylan
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
- Department of Psychiatry, University of California, San Francisco, California, USA
| | - Aoife O'Donovan
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
- Department of Psychiatry, University of California, San Francisco, California, USA
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24
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Somers K, Spruit A, Stams GJ, Vandevelde S, Lindauer R, Assink M. Identifying effective moderators of cognitive behavioural trauma treatment with caregiver involvement for youth with PTSD: a meta-analysis. Eur Child Adolesc Psychiatry 2022:10.1007/s00787-022-02088-2. [PMID: 36178528 DOI: 10.1007/s00787-022-02088-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 09/17/2022] [Indexed: 11/24/2022]
Abstract
Children can develop post-traumatic stress disorder (PTSD) and mental health symptoms after traumatic events. This meta-analysis evaluated the influence of moderators of cognitive behavioural trauma treatment (CBTT) with caregiver involvement in traumatized children. A total of 28 studies were included, with 23 independent samples and 332 effect sizes, representing the data of 1931 children (M age = 11.10 years, SD = 2.36). Results showed a significant medium overall effect (d = 0.55, t = 2.478, p = 0.014), indicating CBTT with caregiver involvement was effective in treating PTSD (d = 0.70), with somewhat smaller effect sizes for internalizing, externalizing, social, cognitive and total problems (0.35 < d > 0.48). The positive treatment effect was robust; we found somewhat smaller effect sizes at follow-up (d = 0.49) compared to post-test (d = 0.57) assessments. Furthermore, several sample (i.e. child's age, gender, and trauma event), programme (i.e. the duration of treatment, number of sessions), study (i.e. control condition, type of instrument, informant, type of sample), and publication (i.e. publication year and impact factor) characteristics moderated the treatment outcomes of the child. In sum, the results of our meta-analysis might help to improve the effectiveness of cognitive behavioural trauma treatment for youth with PTSD, and guide the development of innovative trauma interventions that involve caregivers. Implications for theory and practice are discussed.
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Affiliation(s)
- Katalin Somers
- Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands.
| | - Anouk Spruit
- Basic Trust, Specialists in Attachment and Trauma, Amsterdam, The Netherlands
| | - Geert Jan Stams
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Stijn Vandevelde
- Department of Special Needs Education, Ghent University, Ghent, Belgium
| | - Ramon Lindauer
- Amsterdam UMC, Location AMC, Department of Child and Adolescent Psychiatry, University of Amsterdam, Amsterdam, The Netherlands
- Academic Centre for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | - Mark Assink
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
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25
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Fung HW, Chien WT, Ling HWH, Ross CA, Lam SKK. The mediating role of post-traumatic stress disorder symptoms in the relationship between childhood adversities and depressive symptoms in two samples. Child Abuse Negl 2022; 131:105707. [PMID: 35714440 DOI: 10.1016/j.chiabu.2022.105707] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Childhood adversities have been increasingly recognized as a significant risk factor for depression. However, the underlying mediating mechanism between childhood adversities and depression requires further investigation. The literature shows that childhood adversities are also closely associated with post-traumatic stress disorder (PTSD) symptoms and that PTSD symptoms can predict depressive symptoms. It remains unexplored whether PTSD symptoms can act as a mediator between childhood adversities and depression. OBJECTIVES The primary goal of this study was to examine whether PTSD symptoms would mediate the relationship between childhood adversities and depressive symptoms. PARTICIPANTS AND SETTING We examined in a convenience sample of Hong Kong adults aged 18 or above (N = 418) whether PTSD symptoms would mediate the relationship between childhood adversities and depressive symptoms. We then examined and compared the results with those in another convenience sample of Chinese-speaking young adults (mainly from Taiwan and Hong Kong) aged between 18 and 24 (N = 205). Participants in both samples completed online surveys that included measures of childhood adversities, PTSD symptoms and depressive symptoms. RESULTS Childhood adversities were significantly associated with depressive symptoms; and this relationship was mediated by PTSD symptoms in both samples. CONCLUSION This study is one of very few studies demonstrating that PTSD symptoms mediate the relationship between childhood adversities and depressive symptoms. Our findings suggest that addressing unresolved PTSD symptoms for adults with childhood adversities may help in preventing or treating depressive symptoms. Therefore, PTSD symptoms should be taken into account in the prevention and management of depression.
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Affiliation(s)
- Hong Wang Fung
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; The Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Henry Wai-Hang Ling
- The Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Colin A Ross
- The Colin A. Ross Institute for Psychological Trauma, Richardson, TX, United States
| | - Stanley Kam Ki Lam
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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26
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Johnson RJ, Antonaccio O, Botchkovar E, Hobfoll SE. War trauma and PTSD in Ukraine's civilian population: comparing urban-dwelling to internally displaced persons. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1807-1816. [PMID: 34596712 DOI: 10.1007/s00127-021-02176-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/22/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION War in Ukraine started in March 2014 when Russia annexed Crimea and continues today in the Donbass region of Eastern Ukraine. Over 1.5 million people in these regions have been displaced from their homes. We conducted this study 36 months after the conflict began and interviewed civilians residing in Ukraine. PURPOSE This study examines the prevalence of exposure to war trauma, rates of PTSD by symptom clusters, and whether socio-demographic factors are associated with positive scores for PTSD among civilian urban-dwelling and internally displaced persons in Ukraine during the ongoing conflict in its Donbass region. METHODS Face-to-face interviews were conducted using a multi-stage random sample of the general population in two large cities (Kharkiv and Lviv) in Ukraine (n = 1247) and a purposive sample of internally displaced persons (n = 300), half living in each city. Exposure to trauma, symptom clusters for Posttraumatic Stress Disorder (PTSD), and overall PTSD were assessed. RESULTS We found widespread direct exposure to conflict-related traumatic events (65%) among internally displaced people (IDPs) compared to a sizable minority (23%) of urban-dwelling people (UDPs). We found elevated prevalence of PTSD symptoms that were also uniformly spread within several socio-demographic factors. There were, however, significant differences in PTSD between (1) IDPs compared to UDPs and (2) those UDPs with Ukrainian compared to Russian ethnic identity, the former of each pair showing increased likelihoods of positive PTSD scores. CONCLUSIONS Ukraine's adult civilians, enduring the prolonged engagement in war with Russia and Russian separatists, have elevated rates of PTSD. Moreover, those who have been displaced by the ongoing conflict (IDPs) have significantly higher levels of PTSD compared to UDPs.
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Affiliation(s)
| | | | | | - Stevan E Hobfoll
- STAR-Stress, Anxiety, and Resilience Consultants, Salt Lake City, UT, USA
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27
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Yin JB, Liu HX, Shi W, Ding T, Hu HQ, Guo HW, Jin S, Wang XL, Zhang T, Lu YC, Cao BZ. Various BDNF administrations attenuate SPS-induced anxiety-like behaviors. Neurosci Lett 2022; 788:136851. [PMID: 36007708 DOI: 10.1016/j.neulet.2022.136851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 08/02/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022]
Abstract
Post-traumatic stress disorder (PTSD) has become epidemic following severely stressful incidents. Previous studies have shown that brain-derived neurotrophic factor (BDNF) has anxiolytic effects on various anxiety or depression disorders including PTSD. However, the detailed mechanisms of BDNF for treating PTSD were rarely investigated. In the current study, single-prolonged stress (SPS) was used as an animal model recapitulating specific aspects for a PTSD-like phenotype. The effects of BDNF on SPS-induced anxiety-like behaviors were investigated. We showed that the levels of BDNF in the cerebro-spinal fluid (CSF) were significantly reduced after the rats experienced SPS. The SPS-induced reductions of percentages of time spent in the central area to total time in the open field test, were dose-dependently mitigated after BDNF intracerebroventricular (i.c.v.) injections. BDNF i.c.v. administration also dose-dependently increased the preference of the light box in the light-dark box test. Both expressions of tyrosine kinase receptor B (TrkB) protein and mRNA in the prefrontal cortex (PFC) and amygdala were significantly increased after SPS challenges. BDNF i.c.v. administration attenuated these compensatory increases of TrkB. At last, the anxiolytic effects of BDNF on SPS model were also observed by using other two injection methods. These results inspired us to study that different administrations of BDNF were used in patients with PTSD in the future, in-depthly.
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Affiliation(s)
- Jun-Bin Yin
- Department of Neurology, The 960(th) Hospital of Joint Logistics Support, PLA, Jinan 250031, PR China; Department of Human Anatomy, Histology and Embryology, The Fourth Military Medical University, Xi'an 710032, PR China
| | - Hai-Xia Liu
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Jinan 250021, PR China
| | - Wei Shi
- Department of Neurosurgery, The 960th Hospital of Joint Logistics Force, PLA, Jinan 250031, PR China
| | - Tan Ding
- Department of Human Anatomy, Histology and Embryology, The Fourth Military Medical University, Xi'an 710032, PR China; Institute of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, PR China
| | - Huai-Qiang Hu
- Department of Neurology, The 960(th) Hospital of Joint Logistics Support, PLA, Jinan 250031, PR China
| | - Hong-Wei Guo
- Department of Neurology, The 960(th) Hospital of Joint Logistics Support, PLA, Jinan 250031, PR China
| | - Shan Jin
- Department of Neurology, The 960(th) Hospital of Joint Logistics Support, PLA, Jinan 250031, PR China
| | - Xiao-Ling Wang
- Department of Neurology, The 960(th) Hospital of Joint Logistics Support, PLA, Jinan 250031, PR China
| | - Ting Zhang
- Department of Human Anatomy, Histology and Embryology, The Fourth Military Medical University, Xi'an 710032, PR China
| | - Ya-Cheng Lu
- Department of Human Anatomy, Histology and Embryology, The Fourth Military Medical University, Xi'an 710032, PR China
| | - Bing-Zhen Cao
- Department of Neurology, The 960(th) Hospital of Joint Logistics Support, PLA, Jinan 250031, PR China.
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Lossada-Soto E, Pazik M, Horodyski MB, Vasilopoulos T, de Faria LB, Mathews C, Hagen J. Can fluoxetine mitigate mental health decline in musculoskeletal trauma patients: a pilot single-center randomized clinical trial. Pilot Feasibility Stud 2022; 8:184. [PMID: 35978446 PMCID: PMC9382753 DOI: 10.1186/s40814-022-01119-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 07/15/2022] [Indexed: 11/28/2022] Open
Abstract
Background Musculoskeletal trauma is one of the leading causes of disability in the USA and its negative quality of life impact extends beyond that of physical recovery. More than 50% of victims of musculoskeletal trauma suffer lasting mental health issues and post-traumatic stress disorder (PTSD) symptomology following their injury. These symptoms can develop across all spectrums of patients and are independent predictors of poor outcome. Access to mental health care is limited, expensive, and time intensive, and a large majority of the trauma population do not get to utilize this valuable resource. This leaves the burden of management on the orthopedic team, as they are often the only point of contact for the patient within the medical system. Methods This is a single-center, repeated measures, randomized controlled pilot study including up to 100 orthopedic trauma patients aged between 18 and 85 years of age. Subjects are approached during their index hospitalization and are randomized to one of two pharmaceutical interventions, fluoxetine (also known as Prozac) or calcium, for 9 months. Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) that is supported for the treatment of PTSD by the American Psychiatric Association. It is low-cost and has minimal side effects and withdrawal symptoms if stopped suddenly. Calcium is a supplement with minimal side effects that is used in our study for its bone-healing potential. Feasibility will be indexed by recruitment feasibility, randomization feasibility, medical adherence, anti-depressant side effects, and fracture union rate. Subjects will complete physical and mental health surveys at baseline, 2 weeks, 6 weeks, 3 months, 6 months, and 1 year. Discussion The goals of this exploratory clinical trial are to: develop a safe, feasible, and time-limited protocol effect of immediate (post-injury) treatment with fluoxetine for use by orthopedic providers and other non-mental health care providers treating victims of musculoskeletal trauma (Aim 1), and test the for preliminary effects of the protocol on development of PTSD symptomology and physical recovery in these patients (Aim 2). This study is novel in that it strives to prevent the development of symptomology from the time of injury and empowers surgeons to manage their patients in a more holistic manner. Trial registration ClinicalTrials.gov, NCT04850222. Registered on April 20, 2021.
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Affiliation(s)
- Elizabeth Lossada-Soto
- Department of Orthopaedic Surgery & Sports Medicine, University of Florida, PO Box 112727, Gainesville, FL, 32611-2727, USA
| | - Marissa Pazik
- Department of Orthopaedic Surgery & Sports Medicine, University of Florida, PO Box 112727, Gainesville, FL, 32611-2727, USA
| | - Mary Beth Horodyski
- Department of Orthopaedic Surgery & Sports Medicine, University of Florida, PO Box 112727, Gainesville, FL, 32611-2727, USA
| | - Terrie Vasilopoulos
- Department of Orthopaedic Surgery & Sports Medicine, University of Florida, PO Box 112727, Gainesville, FL, 32611-2727, USA.,Department of Anesthesiology, University of Florida, 1600 SW Archer Road, Gainesville, FL, 32610, USA
| | - Ludmila Barbosa de Faria
- Department of Psychiatry, University of Florida, 1149 Newell Drive, Suite L4-100, Gainesville, FL, 32610, USA
| | - Carol Mathews
- Department of Psychiatry, University of Florida, 1149 Newell Drive, Suite L4-100, Gainesville, FL, 32610, USA
| | - Jennifer Hagen
- Department of Orthopaedic Surgery & Sports Medicine, University of Florida, PO Box 112727, Gainesville, FL, 32611-2727, USA.
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Harper L, Jones A, Goodwin L, Gillespie S. Association between trait mindfulness and symptoms of post-traumatic stress: A meta-analysis. J Psychiatr Res 2022; 152:233-41. [PMID: 35753243 DOI: 10.1016/j.jpsychires.2022.05.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 05/08/2022] [Accepted: 05/20/2022] [Indexed: 11/22/2022]
Abstract
Mindfulness is characterized by skills such as heightened awareness and acceptance of internal experiences, which may be helpful for people who have experienced trauma. The consistency and strength of the relationship between trait mindfulness and PTSD symptomology, however, is unknown. Studies were included in this review if they were published in an English language peer-reviewed journal, reported on a correlational relationship between validated measures of mindfulness and PTSD, and all participants were over the age of 18. A random effects meta-analysis showed that there was a robust, pooled relationship between total mindfulness and PTSD (r+ = -0.39, 95% CI [-0.47 to -0.30]), based on 35 datasets with 13,370 participants, with low risk of publication bias. Sixteen articles reported on facets of mindfulness and PTSD symptomology [5,206 to 5,600 participants]: the strongest associations were with Act with Awareness (r+ = -0.37) and Non-judge (r+ = -0.37), followed by Describe (r+ = -0.22) and Non-react (r+ = -0.21). Observe was not significantly associated with PTSD symptoms. Results from this analysis suggest that people who are more mindful also report fewer symptoms of PTSD ; the strength of the relationship varies across mindfulness facets. There was high heterogeneity across studies.
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30
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Abstract
Since its establishment in 2014, Military Medical Research has come a long way in becoming a premier journal for scientific articles from various different specialties, with a special emphasis on topics with military relevance. The field of military medicine may be obscure, and may not be readily encountered by the typical clinician on a day-to-day basis. This journal aims not only to pursue excellence in military research, but also keep current with the latest advancements on general medical topics from each and every specialty. This editorial serves to recap and synthesize the existing progress, updates and future needs of military medical excellence, discussing foremostly the unique traits of literature published in this journal, and subsequently presenting the discourse regarding wartime and peacetime medicine, the role of the military in a public health emergency, as well as wound healing and organ regeneration. Special attention have been devoted to military topics to shed light on the effects of Chemical, Biological, Radiological and Explosive (CBRE) warfare, environmental medicine and military psychiatry, topics which rarely have a chance to be discussed elsewhere. The interconnectedness between military combat and soldier physical and mental well-being is intricate, and has been distorted by pandemics such as coronavirus disease 2019 (COVID-19). This journal has come a long way since its first article was published, steadily contributing to the existing knowledge pool on general medical topics with a military slant. Only with continuous research and sharing, can we build upon the work of the scientific community, with hopes for the betterment of patient care.
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Peters E, Hardy A, Dudley R, Varese F, Greenwood K, Steel C, Emsley R, Keen N, Bowe S, Swan S, Underwood R, Longden E, Byford S, Potts L, Heslin M, Grey N, Turkington D, Fowler D, Kuipers E, Morrison A. Multisite randomised controlled trial of trauma-focused cognitive behaviour therapy for psychosis to reduce post-traumatic stress symptoms in people with co-morbid post-traumatic stress disorder and psychosis, compared to treatment as usual: study protocol for the STAR (Study of Trauma And Recovery) trial. Trials 2022; 23:429. [PMID: 35606886 PMCID: PMC9125351 DOI: 10.1186/s13063-022-06215-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 03/26/2022] [Indexed: 11/18/2022] Open
Abstract
Background People with psychosis have high rates of trauma, with a post-traumatic stress disorder (PTSD) prevalence rate of approximately 15%, which exacerbates psychotic symptoms such as delusions and hallucinations. Pilot studies have shown that trauma-focused (TF) psychological therapies can be safe and effective in such individuals. This trial, the largest to date, will evaluate the clinical effectiveness of a TF therapy integrated with cognitive behaviour therapy for psychosis (TF-CBTp) on post-traumatic stress symptoms in people with psychosis. The secondary aims are to compare groups on cost-effectiveness; ascertain whether TF-CBTp impacts on a range of other meaningful outcomes; determine whether therapy effects endure; and determine acceptability of the therapy in participants and therapists. Methods Rater-blind, parallel arm, pragmatic randomised controlled trial comparing TF-CBTp + treatment as usual (TAU) to TAU only. Adults (N = 300) with distressing post-traumatic stress and psychosis symptoms from five mental health Trusts (60 per site) will be randomised to the two groups. Therapy will be manualised, lasting 9 months (m) with trained therapists. We will assess PTSD symptom severity (primary outcome); percentage who show loss of PTSD diagnosis and clinically significant change; psychosis symptoms; emotional well-being; substance use; suicidal ideation; psychological recovery; social functioning; health-related quality of life; service use, a total of four times: before randomisation; 4 m (mid-therapy); 9 m (end of therapy; primary end point); 24 m (15 m after end of therapy) post-randomisation. Four 3-monthly phone calls will be made between 9 m and 24 m assessment points, to collect service use over the previous 3 months. Therapy acceptability will be assessed through qualitative interviews with participants (N = 35) and therapists (N = 5–10). An internal pilot will ensure integrity of trial recruitment and outcome data, as well as therapy protocol safety and adherence. Data will be analysed following intention-to-treat principles using generalised linear mixed models and reported according to Consolidated Standards of Reporting Trials-Social and Psychological Interventions Statement. Discussion The proposed intervention has the potential to provide significant patient benefit in terms of reductions in distressing symptoms of post-traumatic stress, psychosis, and emotional problems; enable clinicians to implement trauma-focused therapy confidently in this population; and be cost-effective compared to TAU through reduced service use. Trial registration ISRCTN93382525 (03/08/20) Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06215-x.
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Affiliation(s)
- Emmanuelle Peters
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London & Maudsley NHS Foundation Trust, London, UK
| | - Amy Hardy
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. .,South London & Maudsley NHS Foundation Trust, London, UK.
| | - Robert Dudley
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK.,Newcastle University, London, UK
| | - Filippo Varese
- School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Kathryn Greenwood
- Research and Development, Sussex Partnership NHS Foundation Trust, Brighton, UK.,School of Psychology, University of Sussex, London, UK
| | - Craig Steel
- Oxford Centre for Psychological Health, Oxford Health NHS Foundation Trust, Oxford, UK.,Oxford Institute of Clinical Psychology Training and Research, University of Oxford, Oxford, UK
| | - Richard Emsley
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Nadine Keen
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London & Maudsley NHS Foundation Trust, London, UK
| | - Samantha Bowe
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Sarah Swan
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London & Maudsley NHS Foundation Trust, London, UK
| | - Raphael Underwood
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London & Maudsley NHS Foundation Trust, London, UK
| | - Eleanor Longden
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Sarah Byford
- Health Service & Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Laura Potts
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Margaret Heslin
- Health Service & Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Nick Grey
- Research and Development, Sussex Partnership NHS Foundation Trust, Brighton, UK.,School of Psychology, University of Sussex, London, UK
| | - Doug Turkington
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK.,Newcastle University, London, UK
| | - David Fowler
- Research and Development, Sussex Partnership NHS Foundation Trust, Brighton, UK.,School of Psychology, University of Sussex, London, UK
| | - Elizabeth Kuipers
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London & Maudsley NHS Foundation Trust, London, UK
| | - Anthony Morrison
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Liyanage-Don NA, Winawer MR, Hamberger MJ, Agarwal S, Trainor AR, Quispe KA, Kronish IM. Association of depression and COVID-induced PTSD with cognitive symptoms after COVID-19 illness. Gen Hosp Psychiatry 2022; 76:45-48. [PMID: 35361494 PMCID: PMC8889792 DOI: 10.1016/j.genhosppsych.2022.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/27/2022] [Accepted: 02/28/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Many patients recovering from COVID-19 report persistent psychological and cognitive symptoms months after viral clearance. We examined the association of depression and COVID-induced PTSD with cognitive symptoms following COVID-19 illness. METHODS Patients treated for COVID-19 between March 26 and May 27, 2020 were surveyed three months later. Cognitive symptoms were assessed by asking "Since your COVID-19 illness, do you now have more difficulty: 1) Remembering conversations a few days later? 2) Remembering where you placed familiar objects? 3) Finding the right words while speaking?" Patients endorsing at least one such complaint were coded positive for cognitive symptoms. Logistic regression was used to estimate the association of depression (PHQ-8 ≥ 10) and COVID-induced PTSD (PCL-5 ≥ 30) with cognitive symptoms, adjusting for demographic and clinical factors. RESULTS Among 153 participants, 44.4% reported at least one cognitive symptom, 18.3% were depressed, and 23.5% had COVID-induced PTSD. Adjusting for covariates, depression (OR 5.15, 95% CI 1.30-20.35, p = 0.02) and COVID-induced PTSD (OR 3.67, 95% CI 1.13-11.89, p = 0.03) were significantly associated with cognitive symptoms; self-reported history of mental illness was also associated (OR 4.90, 95% CI 1.24-19.41, p = 0.02). CONCLUSIONS Depression, COVID-induced PTSD, and prior mental illness were strongly associated with cognitive symptoms three months after acute COVID-19 illness.
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Affiliation(s)
- Nadia A Liyanage-Don
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, USA; Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, USA
| | - Melodie R Winawer
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, USA
| | - Marla J Hamberger
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, USA
| | - Sachin Agarwal
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, USA
| | - Alison R Trainor
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, USA
| | - Kristal A Quispe
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, USA
| | - Ian M Kronish
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, USA; Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, USA.
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33
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Zhang Y, Li Q, Hu W, Zhan N, Zou J, Wang J, Geng F. The relationships between screen time and mental health problems among Chinese adults. J Psychiatr Res 2022; 146:279-85. [PMID: 34785040 DOI: 10.1016/j.jpsychires.2021.11.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/03/2021] [Accepted: 11/05/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND This study aimed to examine the specific relationships between screen time and various mental health problems among community-dwelling adults in China. METHODS Self-reports of weekday and weekend screen time (TV, computer use and cell phone/tablet use), symptoms of PTSD, depression, and ADHD, and psychotic-like experiences (PLEs) were completed by 7121 Chinese adults. Logistic regression was used to examine specific relationships between screen time and mental health problems with demographics, physical activity, drinking, smoking, and sleep duration as covariates. RESULTS On weekdays, the participants spending at least 3 h on watching TV, computer use and cell phone/tablet use respectively accounted for 6.8%, 15.9% and 45.9%. On weekends, the proportions were 15.5%, 12.1% and 50.0%. Computer use on weekends was associated with higher risk of PTSD (OR = 1.81); cell phone/tablet use on weekdays and weekends was related to increased depression (OR = 1.38, OR = 1.28, respectively), while only computer use on weekends was related to depression (OR = 1.33); cell phone/tablet use both on weekdays and weekends was also connected to ADHD (OR = 1.56, OR = 1.48, respectively); on weekdays and weekends, more time TV viewing (OR = 1.76-1.79, OR = 1.46-1.71, respectively) and less cell phone/tablet use (OR = 0.66, OR = 0.65, respectively) were associated with higher numbers of PLEs. CONCLUSIONS The relationships between different types of screen time and mental health problems are variant. Future longitudinal studies should subdivide screen time on the basis of content and explore the specific causal relationship between screen time and mental health problems.
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Jacquet-Smailovic M, Brennsthul MJ, Denis I, Kirche A, Tarquinio C, Tarquinio C. Relationship between Post-traumatic Stress Disorder and subsequent myocardial infarction: a systematic review and meta-analysis. J Affect Disord 2022; 297:525-535. [PMID: 34715167 DOI: 10.1016/j.jad.2021.10.056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 09/14/2021] [Accepted: 10/23/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Each year, nearly 790.000 new cases of myocardial infarction (MI) are recorded in the United States. Better knowledge of the modifiable risk factors for this cardiovascular disease remains a major public health issue. In this perspective, the aim of this systematic review and meta-analysis was to estimate the relationship between post-traumatic stress disorder (PTSD) and risk of subsequent myocardial infarction (MI). METHODS A systematic review using PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) guidelines was performed by searching four bibliographic databases (PubMed/Medline, PsycINFO, Science Direct and Proquest Dissertations and Theses). RESULTS A total of 14 articles were included. Nine of these included depression as a covariate. Among 13 studies (N = 848.903), the pooled HR for the magnitude of the relationship between PTSD and MI was 1.49 (95% CI 1.31-1.69) before adjustment for depression. The pooled HR estimate for the 9 depression-adjusted estimates (N = 814.441) was 1.32 (95% CI 1.12-1.56). LIMITATIONS These results should be considered with caution because there is high heterogeneity between studies and possible publication bias; thus, further research is required to support these results. CONCLUSIONS Further research is still needed to identify in more precise terms the mediating factors involved in the direct association between PTSD and the subsequent occurrence of ischemic heart disease.
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Affiliation(s)
- Murielle Jacquet-Smailovic
- Centre Hospitalier du Pays d'Avesnes, Route de Haut-Lieu, 59363 Avesnes-sur-Helpe, France; Université de Lorraine, Département de psychologie de la santé, APEMAC/EPSAM UE 4360, Ile du Saulcy, 57000 Metz, France.
| | - Marie-Jo Brennsthul
- Université de Lorraine, Département de psychologie de la santé, APEMAC/EPSAM UE 4360, Ile du Saulcy, 57000 Metz, France
| | - Ilona Denis
- Université de Lorraine, Département de psychologie de la santé, APEMAC/EPSAM UE 4360, Ile du Saulcy, 57000 Metz, France
| | - Amanda Kirche
- Université de Lorraine, Département de psychologie de la santé, APEMAC/EPSAM UE 4360, Ile du Saulcy, 57000 Metz, France
| | - Camille Tarquinio
- Université de Lorraine, Département de psychologie de la santé, APEMAC/EPSAM UE 4360, Ile du Saulcy, 57000 Metz, France
| | - Cyril Tarquinio
- Université de Lorraine, Département de psychologie de la santé, APEMAC/EPSAM UE 4360, Ile du Saulcy, 57000 Metz, France
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35
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Weiss A, Canetti L, David SB, Reuveni I, Ekstein D. Seizure phobia: A distinct psychiatric disorder among people with epilepsy. Seizure 2021; 95:26-32. [PMID: 34974230 DOI: 10.1016/j.seizure.2021.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE Epilepsy is characterized by unpredictable attacks. Hence, people with epilepsy (PWE) may develop anxious anticipation of upcoming seizures. Seizure phobia is an anxiety disorder wherein seizure anticipatory situations trigger fear, accompanied by avoidance behaviors. Research on seizure phobia among PWE is scarce. Therefore, we aimed to describe the diagnosis of seizure phobia and its association with demographic, psychiatric and neurological variables. METHODS This is a cross-sectional study of adult PWE in a tertiary epilepsy outpatient clinic. Data were collected from semi-structured interviews, demographic questionnaires and medical records. Patients with and without seizure phobia were compared in terms of sociodemographic, psychiatric, and neurological variables. A logistic regression analysis was performed to identify variables that predicted seizure phobia. RESULTS Among 69 PWE included in the study, 19 (27.5%) were diagnosed with seizure phobia. In comparison with PWE without seizure phobia, PWE with seizure phobia were predominantly female (84.2% vs 44.2%, p = 0.005), and had more comorbid anxiety disorders (84.2% vs 34.9%, p = 0.01), past major depressive episode (MDE) (63.2% vs 20.9%, p = 0.003), and post-traumatic stress disorder (26.3% vs 7%, p = 0.05). There was a significant association between seizure phobia and comorbid psychogenic non-epileptic seizures (36.8% vs 11.6%, p = 0.034). However, no significant association was found with epilepsy-related variables. A multivariate logistic regression model indicated anxiety and a past MDE as predictive factors for seizure phobia (R2 = 0.43). CONCLUSION Seizure phobia is a distinct psychiatric entity among PWE. Further research is required to understand its etiology, risk factors, and potential interventions for these patients.
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Affiliation(s)
- Aviva Weiss
- Psychiatric Hostels affiliated with Kidum Rehabilitation Projects, Jerusalem, Israel; Alma Center for Treatment of Sexually Abused Patients, Jerusalem, Israel
| | - Laura Canetti
- Department of Psychiatry, Hadassah Medical Center, Jerusalem, Israel; Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Shiri Ben David
- Neuropsychiatry Clinic, Hadassah Medical Center, Jerusalem, Israel; Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Inbal Reuveni
- Department of Psychiatry, Hadassah Medical Center, Jerusalem, Israel; Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dana Ekstein
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Neurology, Ginges Center for Neurogenetics, Hadassah Medical Center, Jerusalem, Israel.
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du Bois N, Bigirimana AD, Korik A, Kéthina LG, Rutembesa E, Mutabaruka J, Mutesa L, Prasad G, Jansen S, Coyle DH. Neurofeedback with low-cost, wearable electroencephalography (EEG) reduces symptoms in chronic Post-Traumatic Stress Disorder. J Affect Disord 2021; 295:1319-1334. [PMID: 34706446 DOI: 10.1016/j.jad.2021.08.071] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 07/19/2021] [Accepted: 08/25/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The study examines the effectiveness of both neurofeedback and motor-imagery brain-computer interface (BCI) training, which promotes self-regulation of brain activity, using low-cost electroencephalography (EEG)-based wearable neurotechnology outside a clinical setting, as a potential treatment for post-traumatic stress disorder (PTSD) in Rwanda. METHODS Participants received training/treatment sessions along with a pre- and post- intervention clinical assessment, (N = 29; control n = 9, neurofeedback (NF, 7 sessions) n = 10, and motor-imagery (MI, 6 sessions) n = 10). Feedback was presented visually via a videogame. Participants were asked to regulate (NF) or intentionally modulate (MI) brain activity to affect/control the game. RESULTS The NF group demonstrated an increase in resting-state alpha 8-12 Hz bandpower following individual training sessions, termed alpha 'rebound' (Pz channel, p = 0.025, all channels, p = 0.024), consistent with previous research findings. This alpha 'rebound', unobserved in the MI group, produced a clinically relevant reduction in symptom severity in NF group, as revealed in three of seven clinical outcome measures: PCL-5 (p = 0.005), PTSD screen (p = 0.005), and HTQ (p = 0.005). LIMITATIONS Data collection took place in environments that posed difficulties in controlling environmental factors. Nevertheless, this limitation improves ecological validity, as neurotechnology treatments must be deployable outside controlled environments, to be a feasible technological treatment. CONCLUSIONS The study produced the first evidence to support a low-cost, neurotechnological solution for neurofeedback as an effective treatment of PTSD for victims of acute trauma in conflict zones in a developing country.
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Affiliation(s)
- N du Bois
- Intelligent Systems Research Centre, Ulster University (UU), Magee Campus, NI, United Kingdom
| | - A D Bigirimana
- Intelligent Systems Research Centre, Ulster University (UU), Magee Campus, NI, United Kingdom
| | - A Korik
- Intelligent Systems Research Centre, Ulster University (UU), Magee Campus, NI, United Kingdom
| | - L Gaju Kéthina
- Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda (UR), Huye, Rwanda
| | - E Rutembesa
- Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda (UR), Huye, Rwanda
| | - J Mutabaruka
- Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda (UR), Huye, Rwanda
| | - L Mutesa
- Centre for Human Genetics, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda (UR), Huye, Rwanda
| | - G Prasad
- Intelligent Systems Research Centre, Ulster University (UU), Magee Campus, NI, United Kingdom
| | - S Jansen
- Department of Clinical Psychology, College of Medicine and Health Sciences, University of Rwanda (UR), Huye, Rwanda
| | - D H Coyle
- Intelligent Systems Research Centre, Ulster University (UU), Magee Campus, NI, United Kingdom.
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Taylor SS, Noor N, Urits I, Paladini A, Sadhu MS, Gibb C, Carlson T, Myrcik D, Varrassi G, Viswanath O. Complex Regional Pain Syndrome: A Comprehensive Review. Pain Ther 2021; 10:875-892. [PMID: 34165690 PMCID: PMC8586273 DOI: 10.1007/s40122-021-00279-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/03/2021] [Indexed: 12/22/2022] Open
Abstract
Complex regional pain syndrome (CRPS) is a chronic pain condition often involving hyperalgesia and allodynia of the extremities. CRPS is divided into CRPS-I and CRPS-II. Type I occurs when there is no confirmed nerve injury. Type II is when there is known associated nerve injury. Female gender is a risk factor for developing CRPS. Other risk factors include fibromyalgia and rheumatoid arthritis. Unfortunately, the pathogenesis of CRPS is not yet clarified. Some studies have demonstrated different potential pathways. Neuropathic inflammation, specifically activation of peripheral nociceptors of C-fibers, has been shown to play a critical role in developing CRPS. The autonomic nervous system (ANS) is involved. Depending on whether it is acute or chronic CRPS, norepinephrine levels are either decreased or increased, respectively. Some studies have suggested the importance of genetics in developing CRPS. More consideration is being given to the role of psychological factors. Some association between a history of depression and/or post-traumatic stress disorder (PTSD) and the diagnosis of CRPS has been demonstrated. Treatment modalities available range from physical therapy, pharmacotherapy, and interventional techniques. Physical and occupational therapies include mirror therapy and graded motor imagery. Medical management with non-steroidal anti-inflammatory drugs (NSAIDs) has not shown significant improvement. There have been supporting findings in the use of short-course steroids, bisphosphonates, gabapentin, and ketamine. Antioxidant treatment has also shown some promise. Other pharmacotherapies include low-dose naltrexone and Botulinum toxin A (BTX-A). Sympathetic blocks are routinely used, even if their short- and long-term effects are not clear. Finally, spinal cord stimulation (SCS) has been used for decades. In conclusion, CRPS is a multifactorial condition that still requires further studying to better understand its pathogenesis, epidemiology, genetic involvement, psychological implications, and treatment options. Future studies are warranted to better understand this syndrome. This will provide an opportunity for better prevention, diagnosis, and treatment of CRPS.
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Affiliation(s)
- Samantha-Su Taylor
- grid.134563.60000 0001 2168 186XUniversity of Arizona College of Medicine-Phoenix, Phoenix, AZ USA
| | - Nazir Noor
- Department of Anesthesiology, Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL, 33130, USA.
| | - Ivan Urits
- grid.492905.3Southcoast Physician Group Pain Medicine, Southcoast Health, North Dartmouth, MA USA ,grid.64337.350000 0001 0662 7451Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA
| | - Antonella Paladini
- grid.158820.60000 0004 1757 2611Department of MESVA, University of L’Aquila, 67100 L’Aquila, Italy
| | - Monica Sri Sadhu
- grid.134563.60000 0001 2168 186XUniversity of Arizona College of Medicine-Phoenix, Phoenix, AZ USA
| | - Clay Gibb
- grid.260024.2Midwestern University Chicago College of Osteopathic Medicine, Chicago, IL USA
| | - Tyler Carlson
- grid.134563.60000 0001 2168 186XUniversity of Arizona College of Medicine-Phoenix, Phoenix, AZ USA
| | - Dariusz Myrcik
- grid.411728.90000 0001 2198 0923Department of Internal Medicine, Medical University of Silesia, 42-600 Katowice, Bytom Poland
| | | | - Omar Viswanath
- grid.134563.60000 0001 2168 186XUniversity of Arizona College of Medicine-Phoenix, Phoenix, AZ USA ,grid.64337.350000 0001 0662 7451Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA USA ,Valley Pain Consultants-Envision Physician Services, Phoenix, AZ USA ,grid.254748.80000 0004 1936 8876Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE USA
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38
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Li L, Xu Z, Chen L, Suo X, Fu S, Wang S, Lui S, Huang X, Li L, Li SJ, Biswal BB, Gong Q. Dysconnectivity of the amygdala and dorsal anterior cingulate cortex in drug-naive post-traumatic stress disorder. Eur Neuropsychopharmacol 2021; 52:84-93. [PMID: 34311210 DOI: 10.1016/j.euroneuro.2021.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 02/05/2023]
Abstract
Convergent studies have highlighted the amygdala-based and dorsal anterior cingulate cortex (dACC)-based circuit or network dysfunction in post-traumatic stress disorder (PTSD). However, previous studies are often complicated by various traumatic types, psychiatric comorbidities, chronic illness duration, and medication effect on brain function. Besides, little is known whether the functional integration with amygdala-dACC interaction disrupted or not in PTSD. Here, we investigated effective connectivity (EC) between the amygdala-dACC and rest of the cortex by applying psycho-physiological interaction (PPI) approach to resting-state functional magnetic resonance imaging data of 63 drug-naive PTSD patients and 74 matched trauma-exposed non-PTSD controls. Pearson correlation analysis was performed between EC values extracted from regions with between-group difference and clinical profiles in PTSD patients. We observed distinct amygdala-dACC interaction pattern between PTSD group and the control group, which is composed primarily by positive EC in the former and negative in the latter. In addition, compared with non-PTSD controls, PTSD patients showed increased EC between amygdala-dACC and the prefrontal cortex, left inferior parietal lobule, and bilateral ventral occipital cortex, and decreased EC between amygdala-dACC and the left fusiform gyrus. The EC increase between amygdala-dACC and the right middle frontal gyrus was negatively correlated with the clinician-administered PTSD scale scores in PTSD patients. Aberrent communication between amgydala-dACC and brain regions involved in central executive network and visual systems might be associated with the pathophysiology of PTSD. Further, these findings suggested that dysconnectivity of the amygdala and dACC could be adapted as a relatively early course diagnostic biomarker of PTSD.
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Affiliation(s)
- Lei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Zhan Xu
- Department of Biophysics, Medical College of Wisconsin, 8701 West Watertown Plank Road, Milwaukee, WI 53226, United States; Department of Imaging Physics, Univ of Texas M D Anderson Cancer Center, Houston, TX 77054, United States
| | - Lizhou Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Xueling Suo
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Shiqin Fu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Lingjiang Li
- Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Shi-Jiang Li
- Department of Biophysics, Medical College of Wisconsin, 8701 West Watertown Plank Road, Milwaukee, WI 53226, United States.
| | - Bharat B Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark 07101, NJ, United States; The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China; Psychoradiology Research Unit of Chinese Academy of Medical Sciences, Chengdu, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China.
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Raza Z, Hussain SF, Ftouni S, Spitz G, Caplin N, Foster RG, Gomes RSM. Dementia in military and veteran populations: a review of risk factors-traumatic brain injury, post-traumatic stress disorder, deployment, and sleep. Mil Med Res 2021; 8:55. [PMID: 34645526 DOI: 10.1186/s40779-021-00346-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 09/26/2021] [Indexed: 12/13/2022] Open
Abstract
The military population face a unique set of risk factors that may increase the risk of being diagnosed with dementia. Traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) have a higher prevalence in this group in comparison to the civilian population. By delving into the individual relationships between TBI and dementia, and PTSD and dementia, we are able to better explore dementia in the military and veteran populations. While there are some inconsistencies in results, the TBI-dementia association has become more widely accepted. Moderate-to-severe TBI has been found to increase the risk of being diagnosed with Alzheimer's disease. A correlation between PTSD and dementia has been established, however, whether or not it is a causal relationship remains unclear. Factors such as blast, combat and chemical exposure may occur during a deployment, along with TBI and/or PTSD diagnosis, and can impact the risk of dementia. However, there is a lack of literature exploring the direct effects of deployment on dementia risk. Sleep problems have been observed to occur in those following TBI, PTSD and deployment. Poor sleep has been associated with possible dementia risk. Although limited studies have focused on the link between sleep and dementia in military and veteran populations, sleep is a valuable factor to study due to its association and interconnection with other military/veteran factors. This review aims to inform of various risk factors to the cognitive health of military members and veterans: TBI, PTSD, deployment, and sleep.
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Kekibiina A, Adong J, Fatch R, Emenyonu NI, Marson K, Beesiga B, Lodi S, Muyindike WR, Kamya M, Chamie G, McDonell MG, Hahn JA. Post-traumatic stress disorder among persons with HIV who engage in heavy alcohol consumption in southwestern Uganda. BMC Psychiatry 2021; 21:457. [PMID: 34535103 PMCID: PMC8449437 DOI: 10.1186/s12888-021-03464-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 09/01/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND We aimed to describe the prevalence of PTSD symptoms and its associated factors in persons living with HIV (PLWH) in Uganda who engage in heavy alcohol use. METHODS We analyzed baseline data from the Drinkers Intervention to Prevent Tuberculosis study which enrolls PLWH with latent tuberculosis who engage in heavy alcohol consumption. Using the primary care Post Traumatic Stress Disorder (PTSD) screening scale from the DSM-5 (PC-PTSD-5), probable PTSD was defined as reporting ≥3 of 5 assessed symptoms. We conducted the Alcohol Use Disorders Identification Test-Consumption and assessed demographics, smoking, symptoms of depression, and spirituality/religiosity. RESULTS Of 421 participants enrolled from 2018 through 2020, the majority (68.2%) were male, median age was 40 years (interquartile range [IQR]: 32-47), and median AUDIT-C score was 6 [IQR: 4-8]. Half (50.1%) of the participants reported ever experiencing a traumatic event, and 20.7% reported ≥3 symptoms of PTSD. The most commonly reported PTSD symptoms in the past 1 month in the entire sample were avoidance (28.3%), nightmares (27.3%), and being constantly on guard (21.6%). In multivariable logistic regression analyses, level of alcohol use was not associated with probable PTSD (adjusted odds ratio [AOR] for each AUDIT-C point: (1.02; 95% CI: 0.92-1.14; p = 0.69); however, lifetime smoking (AOR 1.89; 95% CI: 1.10-3.24) and reporting symptoms of depression (AOR 1.89; 95% CI: 1.04-3.44) were independently associated with probable PTSD. CONCLUSIONS AND RECOMMENDATIONS A history of traumatic events and probable PTSD were frequently reported among persons who engage in heavy drinking, living with HIV in Uganda. Level of alcohol use was not associated with probable PTSD in this sample of PLWH with heavy alcohol use, however other behavioral and mental health factors were associated with probable PTSD. These data highlight the high prevalence of PTSD in this group, and the need for screening and interventions for PTSD and mental health problems.
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Affiliation(s)
- Allen Kekibiina
- grid.33440.300000 0001 0232 6272Global Health Collaborative, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Julian Adong
- grid.33440.300000 0001 0232 6272Global Health Collaborative, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Robin Fatch
- grid.266102.10000 0001 2297 6811Department of Medicine, University of California, San Francisco, CA USA
| | - Nneka I. Emenyonu
- grid.266102.10000 0001 2297 6811Department of Medicine, University of California, San Francisco, CA USA
| | - Kara Marson
- grid.266102.10000 0001 2297 6811Department of Medicine, University of California, San Francisco, CA USA
| | - Brian Beesiga
- grid.463352.5Infectious Diseases Research Collaboration (IDRC), Kampala, Uganda
| | - Sara Lodi
- grid.189504.10000 0004 1936 7558Boston University School of Public Health, Boston, MA USA
| | - Winnie R. Muyindike
- grid.33440.300000 0001 0232 6272Global Health Collaborative, Mbarara University of Science and Technology, Mbarara, Uganda ,grid.459749.20000 0000 9352 6415Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Moses Kamya
- grid.463352.5Infectious Diseases Research Collaboration (IDRC), Kampala, Uganda
| | - Gabriel Chamie
- grid.266102.10000 0001 2297 6811Department of Medicine, University of California, San Francisco, CA USA
| | - Michael G. McDonell
- grid.30064.310000 0001 2157 6568Elson S Floyd College of Medicine, Washington State University, Spokane, WA USA
| | - Judith A. Hahn
- grid.266102.10000 0001 2297 6811Department of Medicine, University of California, San Francisco, CA USA ,grid.266102.10000 0001 2297 6811Department of Epidemiology and Biostatistics, University of California, San Francisco, CA USA
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Harrison EM, Easterling AP, Schmied EA, Hurtado SL, Glickman GL. Chronotype and self-reported sleep, alertness, and mental health in U.S. sailors. Mil Med Res 2021; 8:43. [PMID: 34376248 PMCID: PMC8353852 DOI: 10.1186/s40779-021-00335-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 07/29/2021] [Indexed: 11/24/2022] Open
Abstract
Service members are at risk for sleep and psychological conditions affecting their readiness. Chronotype ("morningness" or "eveningness") is strongly associated with sleep, health and performance. The objective of this study was to examine associations between validated measures of chronotype and sleep quality, daytime functioning, alertness, and symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD) in US service members (n = 298). Although predominantly young males (who skew toward eveningness in civilian populations), these Sailors skewed toward morningness (35.6% morning, 51.3% intermediate). Eveningness was associated with symptoms of depression and post-traumatic stress disorder (PTSD) (P < 0.01), less time in bed (P < 0.05), more sleep disruption (P < 0.01), and poorer daytime functioning and alertness (P < 0.05). Evening types were less likely to consider sleep important for performance (P < 0.05). To maximize service member readiness, schedules should be aligned with endogenous rhythms, whenever possible, and evening chronotypes may benefit from targeted interventions. Chronotype should be examined alongside health and readiness in service members.
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Affiliation(s)
- Elizabeth M Harrison
- Center for Circadian Biology, University of California San Diego, San Diego, USA. .,Leidos, Inc., San Diego, USA. .,Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, USA.
| | - Alexandra P Easterling
- Center for Circadian Biology, University of California San Diego, San Diego, USA.,Leidos, Inc., San Diego, USA.,Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, USA
| | - Emily A Schmied
- School of Public Health, San Diego State University, San Diego, USA
| | - Suzanne L Hurtado
- Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, USA
| | - Gena L Glickman
- Center for Circadian Biology, University of California San Diego, San Diego, USA.,Departments of Psychiatry and Neuroscience, Uniformed Services University of the Health Sciences, Bethesda, USA
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Malka M, Gropp C, Jaworowski S, Oberbaum M, Katz DE. Telepsychiatry for Patients with Post-traumatic Stress Disorder During the COVID-19 Outbreak. ACTA ACUST UNITED AC 2021;:1-8. [PMID: 34377626 DOI: 10.1007/s40501-021-00245-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 11/21/2022]
Abstract
Purpose The novel coronavirus, SARS-CoV-2, emerged from Wuhan, China, causing a pandemic. Access to outpatient psychiatric care was limited. We conducted a pilot study of telepsychiatry during a national shutdown. Adult patients with post-traumatic stress disorder (PTSD) participated via Zoom. Patient preference comparing televisits to face-to-face visits was assessed. Recent findings Telemedicine has emerged as new technological tool in the evolution of the patient-physician relationship, changing the way we interact. Physicians and patients now have access to the electronic medical record, remote point-of-care testing, and each other. The present epidemic allows us to test the limits of technology in combating limited access to care for patients with psychiatric illness. Summary Twenty (90% male) patients with PTSD participated. Most (90 %) were moderately to severely depressed, and 50% used medical cannabis and increased their dosage during the study period. Patients preferred face-to-face meetings for its ease of use (p < .01) and general satisfaction from therapy (p < .01). However, given continued outbreak-limiting access to care, most patients stated they would continue with telepsychiatry. While most patients preferred face-to-face visits, telepsychiatry can be used during times of outbreak-limiting access to care. Future research and development should be directed at improving technological ease of use.
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Moroni L, Mazzetti M, Ramirez GA, Farina N, Bozzolo EP, Guerrieri S, Moiola L, Filippi M, Di Mattei V, Dagna L. Beyond Neuropsychiatric Manifestations of Systemic Lupus Erythematosus: Focus on Post-traumatic Stress Disorder and Alexithymia. Curr Rheumatol Rep 2021; 23:52. [PMID: 34196907 DOI: 10.1007/s11926-021-01019-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE OF REVIEW To deepen the comprehension of the role of specific psychological conditions in the pathogenesis and in the treatment of systemic lupus erythematosus (SLE). Specifically, the present comprehensive review aims at examining the association between SLE, alexithymia (AT)-a personality construct referring to the inability to identify, describe, and express sensations, emotions, and physical state-and post-traumatic stress disorder (PTSD), to infer potential biological relationships between these psychopathological issues and disease course, and to draw up a research agenda on gray areas of these topics. RECENT FINDINGS Whereas several studies document the presence of neuropsychiatric symptoms in patients with SLE, psychological distress, alexithymia, and post-traumatic manifestations are usually neglected by healthcare professionals and poorly investigated in research contexts. However, the interplay of these aspects, which affect physiologic stress coping mechanisms, potentially plays an important role in SLE pathogenesis. In particular, research documents that cytokine repertoire pattern alteration and hypothalamic-pituitary-adrenal axis impairment leading to inflammation and pain represent the main links between emotional health and immunity. AT and PTSD seem to be common in patients with SLE and account for multiple aspects of SLE-related morbidity. Furthermore, abnormal processing of stressful stimuli as hallmarks of PTSD and AT might promote neuroendocrine dysfunction and dysregulated immunity, thus contributing to the pathogenesis of SLE. A comprehensive, multidisciplinary clinical approach, based on a cooperation between immunologists, rheumatologists, neurologists, and mental health professionals, is crucial to promote patients' global health.
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Omura J, Fuchikami M, Araki M, Miyagi T, Okamoto Y, Morinobu S. Chemogenetic activation of the mPFC alleviates impaired fear memory extinction in an animal model of PTSD. Prog Neuropsychopharmacol Biol Psychiatry 2021; 108:110090. [PMID: 32896603 DOI: 10.1016/j.pnpbp.2020.110090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 08/19/2020] [Accepted: 08/30/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND AIM Although impaired extinction of fear memory (EFM) is a hallmark symptom of posttraumatic stress disorder (PTSD), the mechanisms underlying the impairment are unknown. Activation of the infralimbic cortex (IL) in the medial prefrontal cortex (mPFC) has been reported to predict successful fear extinction, whereas functionally disrupting this region impairs extinction. We examined whether chemogenetic activation of the IL could alleviate impaired EFM in a single prolonged stress (SPS) rat model of PTSD. METHODS Chemogenetic activation of IL and prelimbic (PL) excitatory neurons was undertaken to evaluate EFM using a contextual fear conditioning paradigm. Neuronal activity in the IL was recorded using a 32-multichannel silicon electrode. To examine histological changes in the mPFC, apoptosis was measured by TUNEL staining. RESULTS Chemogenetic activation of excitatory neurons in the IL, but not the PL, enhanced EFM in sham rats and resulted in alleviation of EFM impairment in SPS rats. The alleviation of impaired EFM in SPS rats was observed during the extinction test session. Neuronal activity in the IL of SPS rats was lower than that of sham rats after clozapine-n-oxide administration. Increased apoptosis was found in the IL of SPS rats. CONCLUSIONS These findings suggest that a decreased excitatory response in the IL due, at least in part, to an increase in apoptosis in SPS rats leads to impaired EFM, and that neuronal activation during extinction training could be useful for the treatment of impaired EFM in PTSD patients.
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Affiliation(s)
- Jun Omura
- Department of Psychiatry and Neuroscience, Division of Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Manabu Fuchikami
- Department of Psychiatry and Neuroscience, Division of Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| | - Motoaki Araki
- Department of Psychiatry and Neuroscience, Division of Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tatsuhiro Miyagi
- Department of Psychiatry and Neuroscience, Division of Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasumasa Okamoto
- Department of Psychiatry and Neuroscience, Division of Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shigeru Morinobu
- Department of Occupational Therapy, School of Health Science and Social Welfare, Kibi International University, Takahashi, Japan
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Carmassi C, Dell'Oste V, Barberi FM, Pedrinelli V, Cordone A, Cappelli A, Cremone IM, Rossi R, Bertelloni CA, Dell'Osso L. Do somatic symptoms relate to PTSD and gender after earthquake exposure? A cross-sectional study on young adult survivors in Italy. CNS Spectr 2021; 26:268-74. [PMID: 32248878 DOI: 10.1017/S1092852920000097] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Increasing evidence confirms a strict relationship between mental disorders and physical health. Particularly, stressful life events and post-traumatic stress disorder (PTSD) have been closely correlated with various physical disorders and somatic symptoms, such as chronic pain, gastrointestinal disorders, and headaches. The aim of this study was to investigate the emergence of somatic symptoms in a sample of young adult survivors 21 months after exposure to the L'Aquila 2009 earthquake, with particular attention to PTSD and gender impact. METHODS Four hundred and fifty high-school senior students (253 male and 197 female) exposed to the 2009 L'Aquila earthquake, 21 months earlier, were enrolled and evaluated by the Trauma and Loss Spectrum Self-Report (TALS-SR), for symptomatological PTSD, and the Mood Spectrum Self-Report-Lifetime Version (MOODS-SR) "rhythmicity and vegetative functions" domain, for somatic symptoms. RESULTS Significantly higher rates of endorsement of the MOODS-SR somatic symptoms emerged in survivors with PTSD compared to those without. Females reported higher rates of endorsement of at least one MOODS-SR somatic symptom compared to males; however, a Decision Tree model and a two-way analysis of variance model confirmed a significant effect of PTSD only. A multivariate logistical regression showed a significant association between the presence of at least one MOOD-SR somatic symptom and re-experiencing and maladaptive coping TALS-SR domains. CONCLUSION This study corroborates a relevant impact of symptomatological PTSD, across both the genders, on somatic symptoms occurring in young adults after months from exposure to a massive earthquake.
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Thakur A, Choudhary D, Kumar B, Chaudhary A. A review on post-traumatic stress disorder (PTSD): "Symptoms, Therapies and Recent Case Studies". Curr Mol Pharmacol 2021; 15:502-516. [PMID: 34036925 DOI: 10.2174/1874467214666210525160944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/21/2021] [Accepted: 03/22/2021] [Indexed: 11/22/2022]
Abstract
Post-traumatic stress disorder (PTSD), previously known as battle fatigue syndrome or shell shock, is a severe mental disturbance condition that is normally triggered by the experience of some frightening/scary events or trauma where a person undergoes some serious physical or mental harm or threatened. PTSD is a long-life effect of the continuous occurrence of traumatic conditions which, leading the production of feelings of helplessness, intense fear, and horror in the person. There are various examples of events that can cause PTSD, such as physical, mental, or sexual assault at home or working place by others, unexpected death of a loved one, an accidental event, war, or some kind of natural disaster. Treatment of PTSD includes the removal or reduction of these emotional feelings or symptoms with the aim to improve the daily life functioning of a person. Problems which are needed to be considered in case of PTSD like ongoing trauma, abusive or bad relationships. Various drugs which are used for the treatment of PTSD include selective serotonin reuptake inhibitors (SSRIs) (citalopram, fluvoxamine, fluoxetine, etc.); tricyclic antidepressants (amitriptyline and isocarboxazid); mood stabilizers (Divalproex and lamotrigine); atypical antipsychotics (aripiprazole and quetiapine), etc. In this review, we have covered the different risk factors, case studies related to various treatment options with different age group peoples in PTSD and their effects on them. We have also covered the symptoms and associated disorders which can play a key role in the development of PTSD.
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Affiliation(s)
- Amandeep Thakur
- School of Pharmacy, College of Pharmacy, Taipei Medical University, 250 Wuxing Street, Taipei 11031. Taiwan
| | - Diksha Choudhary
- Department of School of Pharmacy, Abhilashi University, Chail Chowk, tehsil Chachyot, Mandi, Himachal Pradesh 175028, India
| | - Bhupinder Kumar
- Department of Pharmaceutical Chemistry, ISF College of Pharmacy, Ghal Kalan, G.T Road, Moga, Punjab, India
| | - Amit Chaudhary
- Department of School of Pharmacy, Abhilashi University, Chail Chowk, tehsil Chachyot, Mandi, Himachal Pradesh 175028, India
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Ke Y, Zhu H, Huang Y, Cheng L, Wu X, Chen N. Correlation between monoamine neurotransmitter and cytokine levels and the occurrence of post-traumatic stress disorder among operating room nurses. Ann Palliat Med 2021; 9:3947-3956. [PMID: 33302657 DOI: 10.21037/apm-20-1829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/17/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND The aim of the present study was to investigate the correlation between monoamine neurotransmitter and cytokine levels and the occurrence of post-traumatic stress disorder (PTSD) among operating room nurses. METHODS A total of 131 nursing staff were selected and assigned into the PTSD, non-PTSD, and control group. Enzyme-linked immunosorbent assay was applied to determine the monoamine neurotransmitters in plasma and serum cytokines. Receiver-operating characteristic curve analysis was conducted to assess the sensitivity and specificity of neurotransmitters and cytokines in the clinical detection of PTSD among operating room nurses. Addenbrooke's Cognitive Examination-Revised and the Connor-Davidson Resilience Scale were used to evaluate the correlation between neurotransmitter and cytokine levels and the clinical characteristics of operating room nurses with PTSD. RESULTS Our study found that the monoamine neurotransmitters and cytokines among nurses in the PTSD group were significantly higher than those in the non-PTSD and control group. Neurotransmitter and cytokine levels as clinical predictors of PTSD among operating room nurses have good sensitivity and specificity, and were negatively correlated with cognitive function and resilience. CONCLUSIONS The findings of the present study confirm that monoamine neurotransmitter and cytokine levels are correlated with the occurrence of PTSD among operating room nurses.
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Affiliation(s)
- Yajuan Ke
- Department of Operating Room, Hainan General Hospital, Haikou, China
| | - Hongying Zhu
- Department of Operating Room, Hainan General Hospital, Haikou, China
| | - Yi Huang
- Department of Operating Room, Hainan General Hospital, Haikou, China
| | - Liurong Cheng
- Department of Operating Room, Hainan General Hospital, Haikou, China
| | - Xiaofang Wu
- Department of Operating Room, the Second Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Nanyao Chen
- Department of Operating Theater, The Fourth People's Hospital of Haikou, Haikou, China
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Vlake JH, Van Bommel J, Wils EJ, Korevaar TIM, Hellemons ME, Schut AFC, Labout JAM, Schreuder LLH, Gommers D, Van Genderen ME. Effect of intensive care unit-specific virtual reality (ICU-VR) to improve psychological well-being and quality of life in COVID-19 ICU survivors: a study protocol for a multicentre, randomized controlled trial. Trials 2021; 22:328. [PMID: 33952318 PMCID: PMC8097671 DOI: 10.1186/s13063-021-05271-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/15/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The SARS-CoV-2 outbreak has resulted in a tremendous increase in hospital and intensive care unit (ICU) admissions all over the world. Patients with severe coronavirus disease 2019 (COVID-19) warranting ICU treatment usually have prolonged mechanical ventilation and are expected to be prone to develop psychological impairments, such as post-traumatic stress disorder (PTSD), anxiety and depression, which negatively impact quality of life. To date, no effective treatment strategy is available. In the current trial, we aim to assess the effect of an ICU-specific virtual reality (ICU-VR) intervention on psychological well-being and quality of life after COVID-19 ICU treatment. METHODS In this multicentre, randomized controlled trial, we aim to examine whether COVID-19-specific ICU-VR, offered 3 months after hospital discharge, improves psychological well-being and quality of life. Secondary objectives are, firstly, to examine the intra-group changes in psychological well-being and quality of life and the inter-group differences in psychological well-being and quality of life during follow-up, up to 12 months after hospital discharge, and secondly, to examine patients' satisfaction with and rating of ICU care and aftercare and patients' perspectives on ICU-VR. Eighty adult patients treated for COVID-19 in the mixed-surgical ICUs of four hospitals in Rotterdam, the Netherlands, will be included and randomized (1:1) to either early or late ICU-VR between June 29 and December 31, 2020. Patients randomized to early ICU-VR will receive the ICU-VR intervention during an outpatient clinic visit 3 months after hospital discharge, whereas patients randomized to late ICU-VR will receive ICU-VR 6 months after hospital discharge. Primary outcomes of this study are psychological well-being, assessed using the Impact of Event Scale-Revised (IES-R) and the Hospital Anxiety and Depression Scale (HADS), and quality of life, assessed using the European Quality of Life 5 Dimensions (EQ-5D) and RAND-36 questionnaires, up to 6 months after hospital discharge. DISCUSSION Currently, an effective treatment for psychological sequelae after ICU treatment for specific illnesses is unavailable. Results from this study will provide insight whether virtual reality is a modality that can be used in ICU aftercare to improve psychological well-being and quality of life, or satisfaction, after ICU treatment for specific illnesses such as COVID-19. TRIAL REGISTRATION This trial has been retrospectively registered on the Netherlands Trial Register on August 14, 2020 ( NL8835 ).
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Affiliation(s)
- Johan H. Vlake
- Department of Intensive Care, Erasmus MC, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
- Department of Intensive Care, Franciscus Gasthuis & Vlietland, Kleiweg 500, 3045 PM Rotterdam, The Netherlands
| | - Jasper Van Bommel
- Department of Intensive Care, Erasmus MC, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Evert-Jan Wils
- Department of Intensive Care, Franciscus Gasthuis & Vlietland, Kleiweg 500, 3045 PM Rotterdam, The Netherlands
| | - Tim I. M. Korevaar
- Department of Internal Medicine, Academic Centre for Thyroid Diseases, Erasmus MC, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Merel E. Hellemons
- Department of Pulmonology, Erasmus MC, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Anna F. C. Schut
- Department of Intensive Care, Ikazia Hospital, Montessoriweg 1, 3083 AN Rotterdam, The Netherlands
| | - Joost A. M. Labout
- Department of Intensive Care, Maasstad Hospital, Maasstadweg 21, 3079 DZ Rotterdam, The Netherlands
| | - Lois L. H. Schreuder
- Department of Intensive Care, Erasmus MC, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Diederik Gommers
- Department of Intensive Care, Erasmus MC, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Michel E. Van Genderen
- Department of Intensive Care, Erasmus MC, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
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Krause-Utz A, Frost R, Chatzaki E, Winter D, Schmahl C, Elzinga BM. Dissociation in Borderline Personality Disorder: Recent Experimental, Neurobiological Studies, and Implications for Future Research and Treatment. Curr Psychiatry Rep 2021; 23:37. [PMID: 33909198 PMCID: PMC8081699 DOI: 10.1007/s11920-021-01246-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW The aim of this review article is to give an overview over recent experimental neurobiological research on dissociation in borderline personality disorder (BPD), in order to inform clinicians and to stimulate further research. First, we introduce basic definitions and models that conceptualize dissociation from a transdiagnostic perspective. Then, we discuss recent findings in BPD. RECENT FINDINGS Stress-related dissociation is a key symptom of BPD, closely linked to other core domains of the disorder (emotion dysregulation, identity disturbances, and interpersonal disturbances). The understanding of neurobiological correlates of dissociation across different psychiatric disorders (e.g., dissociative disorders, post-traumatic stress disorder) is steadily increasing. At the same time, studies explicitly focusing on dissociation in BPD are still scarce. There is evidence for adverse effects of dissociation on affective-cognitive functioning (e.g., interference inhibition), body perception, and psychotherapeutic treatment response in BPD. On the neural level, increased activity in frontal regions (e.g., inferior frontal gyrus) and temporal areas (e.g., inferior and superior temporal gyrus) during symptom provocation tasks and during resting state was observed, although findings are still diverse and need to be replicated. Conceptual differences and methodological differences in study designs and sample characteristics (e.g., comorbidities, trauma history) hinder a straightforward interpretation and comparison of studies. Given the potentially detrimental impact of dissociation in BPD, more research on the topic is strongly needed to deepen the understanding of this complex clinical condition.
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Affiliation(s)
- Annegret Krause-Utz
- Institute of Clinical Psychology, Leiden University, Leiden, The Netherlands.
- Leiden Institute for Brain and Cognition (LIBC), Leiden, The Netherlands.
| | - Rachel Frost
- Department of Psychology, King's College London, Institute of Psychiatry Psychology & Neuroscience, London, UK
| | - Elianne Chatzaki
- Institute of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Dorina Winter
- Pain and Psychotherapy Research Lab, University of Koblenz-Landau, Landau, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Bernet M Elzinga
- Institute of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden, The Netherlands
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Uwizeye G, Thayer ZM, DeVon HA, McCreary LL, McDade TW, Mukamana D, Park C, Patil CL, Rutherford JN. Double Jeopardy: Young adult mental and physical health outcomes following conception via genocidal rape during the 1994 genocide against the Tutsi in Rwanda. Soc Sci Med 2021; 278:113938. [PMID: 33905987 DOI: 10.1016/j.socscimed.2021.113938] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/08/2021] [Accepted: 04/11/2021] [Indexed: 11/15/2022]
Abstract
Rwandans conceived by rape during the 1994 genocide against the Tutsi have endured a violent beginning and a troubled childhood. Given compelling evidence of the influence of prenatal environments and adverse childhood experiences (ACEs) on future health, these individuals are at high risk of poor mental and physical health outcomes. The purpose of the study was to characterize mental and physical health outcomes in young adults who were exposed prenatally to maternal stress due to the genocide in general and those conceived by genocidal rape, and to determine whether ACEs compound these effects. Ninety-one 24-year-old Rwandans - 30 conceived by genocidal rape, 31 born of genocide survivors not raped, and a control group of 30 born of women with neither exposure - completed the Adverse Childhood Experiences International Questionnaire and measures of multiple physical and mental health characteristics. Data were collected from March 7 to April 6, 2019. Findings demonstrated that 1) individuals conceived during the genocide had poorer mental function (p = 0.002) and higher scores in post-traumatic stress disorder (PTSD), anxiety, depression, physical function, pain intensity, and sleep disturbance compared to young adults who were not exposed to genocide (all p < 0.033); 2) individuals conceived by genocidal rape reported more depression, PTSD, and pain interference compared to those prenatally exposed to maternal genocide stress only (all p < 0.008); and 3) among the group conceived via genocidal rape, the effects of prenatal exposures on depression, physical function, pain intensity and pain interference were exacerbated by ACEs (all p < 0.041). Being conceived during genocide, especially through genocidal rape, is associated with poor adult physical and mental health. The role of ACEs in exacerbating prenatal genocide exposure highlights opportunities for interventions to reduce these effects.
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Affiliation(s)
- Glorieuse Uwizeye
- Department of Human Development Nursing Science, College of Nursing, University of Illinois at Chicago, 845 S. Damen Ave., MC 802, Chicago, IL, 60612, USA; Society of Fellows, Dartmouth College, Hanover, NH, 03755, USA; Department of Anthropology, Dartmouth College, 3 Tuck Drive, Silsby Hall, Hanover, NH, 03755, USA.
| | - Zaneta M Thayer
- Society of Fellows, Dartmouth College, Hanover, NH, 03755, USA; Department of Anthropology, Dartmouth College, 3 Tuck Drive, Silsby Hall, Hanover, NH, 03755, USA.
| | - Holli A DeVon
- School of Nursing, University of California Los Angeles, 700 Tiverton Ave., Los Angeles, CA, 90095, USA.
| | - Linda L McCreary
- Department Health Systems Science, College of Nursing University of Illinois at Chicago, 845 S. Damen Ave., MC 802, Chicago, Ilinois, 60612, USA.
| | - Thomas W McDade
- Department of Anthropology and Institute for Policy Research, Northwestern University, 1810 Hinman Avenue, Evanston, IL, 60208, USA.
| | - Donatilla Mukamana
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda.
| | - Chang Park
- Department Health Systems Science, College of Nursing University of Illinois at Chicago, 845 S. Damen Ave., MC 802, Chicago, Ilinois, 60612, USA.
| | - Crystal L Patil
- Department of Human Development Nursing Science, College of Nursing, University of Illinois at Chicago, 845 S. Damen Ave., MC 802, Chicago, IL, 60612, USA.
| | - Julienne N Rutherford
- Department of Human Development Nursing Science, College of Nursing, University of Illinois at Chicago, 845 S. Damen Ave., MC 802, Chicago, IL, 60612, USA.
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