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Turton, P., P. Hughes, C. D. H. Evans, and D. Fainman. "Incidence, correlates and predictors of post-traumatic stress disorder in the pregnancy after stillbirth." British Journal of Psychiatry 178, no. 6 (June 2001): 556–60. http://dx.doi.org/10.1192/bjp.178.6.556.
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BackgroundMany women may suffer psychological symptoms after stillbirth and in the subsequent pregnancy. Stillbirth has not been demonstrated previously to be a stressor for post-traumatic stress disorder (PTSD).AimsTo assess incidence, correlates and predictors of PTSD during and after the pregnancy following stillbirth.MethodA cohort study of pregnant women whose previous pregnancy ended in stillbirth.ResultsPTSD symptoms were prevalent in the pregnancy following stillbirth. Case-level PTSD was associated with depression, state-anxiety and conception occurring closer to loss. Symptomsgenerally resolved naturally by 1 year postpartum (birth of healthy baby).ConclusionsWomen are vulnerabe to PTSD in the pregnancy subsequent to stillbirth, particularly when conception occurs soon after the loss.
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Alcorn, K. L., A. O'Donovan, J. C. Patrick, D. Creedy, and G. J. Devilly. "A prospective longitudinal study of the prevalence of post-traumatic stress disorder resulting from childbirth events." Psychological Medicine 40, no. 11 (January 11, 2010): 1849–59. http://dx.doi.org/10.1017/s0033291709992224.
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BackgroundChildbirth has been linked to postpartum impairment. However, controversy exists regarding the onset and prevalence of post-traumatic stress disorder (PTSD) after childbirth, with seminal studies being limited by methodological issues. This longitudinal prospective study examined the prevalence of PTSD following childbirth in a large sample while controlling for pre-existing PTSD and affective symptomatology.MethodPregnant women in their third trimester were recruited over a 12-month period and interviewed to identify PTSD and anxiety and depressive symptoms during the last trimester of pregnancy, 4–6 weeks postpartum, 12 weeks postpartum and 24 weeks postpartum.ResultsOf the 1067 women approached, 933 were recruited into the study. In total, 866 (93%) were retained to 4–6 weeks, 826 (89%) were retained to 12 weeks and 776 (83%) were retained to 24 weeks. Results indicated that, uncontrolled, 3.6% of women met PTSD criteria at 4–6 weeks postpartum, 6.3% at 12 weeks postpartum and 5.8% at 24 weeks postpartum. When controlling for PTSD and partial PTSD due to previous traumatic events as well as clinically significant anxiety and depression during pregnancy, PTSD rates were less at 1.2% at 4–6 weeks, 3.1% at 12 weeks and 3.1% at 24 weeks postpartum.ConclusionsThis is the first study to demonstrate the occurrence of full criteria PTSD resulting from childbirth after controlling for pre-existing PTSD and partial PTSD and clinically significant depression and anxiety in pregnancy. The findings indicate that PTSD can result from a traumatic birth experience, though this is not the normative response.
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Fernández Ordóñez, Eloísa, Cristóbal Rengel Díaz, Isabel María Morales Gil, and María Teresa Labajos Manzanares. "Post-traumatic stress disorder after subsequent birth to a gestational loss: An observational study." Salud mental 43, no. 3 (May 1, 2020): 129–36. http://dx.doi.org/10.17711/sm.0185-3325.2020.018.
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Introduction. The loss of a pregnancy puts women at risk of suffering post-traumatic stress disorder. This circumstance can influence a subsequent pregnancy, and the link with the future baby. Objective. The main objective of this work was to identify the prevalence of post-traumatic stress disorder (PTSD) among post-partum women who give birth after having suffered a previous gestational loss and to identify possible relationships between PTSD and the variables studied. Method. An observational, descriptive, and cross-sectional study. A total of 115 puerperal women who had suffered a previous gestational loss completed questionnaires containing sociodemographic variables, obstetric history, and responses to the Davidson Trauma Scale. Results. A score of 40 was established as a cut-off point in the Davidson Trauma Scale for the identification of PTSD. 21.7% of the participants scored 40 or above. Significant differences were found related to age (p = .030), number of pregnancies (p = .033), and number of gestational losses (p = .001). The probability of PTSD increases significantly in relation to the number of losses. Respondents are 2.55 times (β = .94 p = .027) more likely to suffer PTSD the higher the number of gestational losses suffered. Discussion and conclusion. There are significant differences in the presence of PTSD among puerperal women in terms of age, number of pregnancies, and number of gestational losses. Post-partum women are more likely to suffer PTSD after a gestational loss the higher the number of gestational losses suffered.
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Hjort, Line, Feride Rushiti, Shr-Jie Wang, Peter Fransquet, Sebahate P Krasniqi, Selvi I Çarkaxhiu, Dafina Arifaj, et al. "Intergenerational effects of maternal post-traumatic stress disorder on offspring epigenetic patterns and cortisol levels." Epigenomics 13, no. 12 (June 2021): 967–80. http://dx.doi.org/10.2217/epi-2021-0015.
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Aim: To investigate the association between maternal post-traumatic stress disorder (PTSD) during pregnancy and offspring DNA methylation and cortisol levels. Materials & methods: Blood genome-wide DNA methylation and cortisol was measured in the youngest child of 117 women who experienced sexual violence/torture during the Kosovo war. Results: Seventy-two percent of women had PTSD symptoms during pregnancy. Their children had higher cortisol levels and differential methylation at candidate genes ( NR3C1, HTR3A and BNDF) . No methylation differences reached epigenome-wide corrected significance levels. Conclusion: Identifying the biological processes whereby the negative effects of trauma are passed across generations and defining groups at high risk is a key step to breaking the intergenerational transmission of the effects of mental disorders.
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Ayers, S., R. Bond, S. Bertullies, and K. Wijma. "The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework." Psychological Medicine 46, no. 6 (February 16, 2016): 1121–34. http://dx.doi.org/10.1017/s0033291715002706.
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There is evidence that 3.17% of women report post-traumatic stress disorder (PTSD) after childbirth. This meta-analysis synthesizes research on vulnerability and risk factors for birth-related PTSD and refines a diathesis–stress model of its aetiology. Systematic searches were carried out on PsycINFO, PubMed, Scopus and Web of Science using PTSD terms crossed with childbirth terms. Studies were included if they reported primary research that examined factors associated with birth-related PTSD measured at least 1 month after birth. In all, 50 studies (n = 21 429) from 15 countries fulfilled inclusion criteria. Pre-birth vulnerability factors most strongly associated with PTSD were depression in pregnancy (r = 0.51), fear of childbirth (r = 0.41), poor health or complications in pregnancy (r = 0.38), and a history of PTSD (r = 0.39) and counselling for pregnancy or birth (r = 0.32). Risk factors in birth most strongly associated with PTSD were negative subjective birth experiences (r = 0.59), having an operative birth (assisted vaginal or caesarean, r = 0.48), lack of support (r = −0.38) and dissociation (r = 0.32). After birth, PTSD was associated with poor coping and stress (r = 0.30), and was highly co-morbid with depression (r = 0.60). Moderator analyses showed that the effect of poor health or complications in pregnancy was more apparent in high-risk samples. The results of this meta-analysis are used to update a diathesis–stress model of the aetiology of postpartum PTSD and can be used to inform screening, prevention and intervention in maternity care.
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Greenberg, Y., N. Naor, P. Sirota, and L. Sirota. "When dreams become nightmares: Post traumatic stress disorder symptoms in mothers of NICU babies." European Psychiatry 26, S2 (March 2011): 1097. http://dx.doi.org/10.1016/s0924-9338(11)72802-4.
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IntroductionHaving a critically ill baby in the NICU is very difficult to cope with, and mothers may feel a whole host of emotions as they cope with the loss of the last part of pregnancy, the dream of a healthy birth, the loss of the first weeks or months of their baby's life. This distress may resemble posttraumatic stress disorder (PTSD).ObjectiveTo examine mothers’ responses to having a baby (preterm or full term) in neonatal intensive -care unit and to determine if they fulfill the criteria for PTSD or depression.MethodsForty nine mothers of pre term babies and ten mothers of full term babies who had been hospitalized in NICU of Schneider Children's Hospital, Israel, were interviewed at the follow up clinic between 4–17 months after birth. The evaluation was carried out by one senior psychiatrist and was based on diagnostic criteria for PTSD and depression according to DSM-4. Severity of PTSD was measured by PSS-sr and the severity of depression by HAMD-Distress factors in NICU setting were evaluated by Parental Stressor Scale (M&F&C Scale).Results1.50% of mothers of preterm babies and 40% of mothers of full term babies fulfill the criteria for PTSD (N.S.).2.25% (15/59) of the whole sample had moderate to severe PTSD.3.A strong correlation between PTSD and severity of stress during hospitalization in NICU was found.ConclusionThe development of later ptsd and depression can be predicted by maternal responses to hospitalization of her baby in nicu.
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Born, Leslie, Shauna Dae Phillips, Meir Steiner, and Claudio N. Soares. "Trauma & the reproductive lifecycle in women." Revista Brasileira de Psiquiatria 27, suppl 2 (October 2005): s65—s72. http://dx.doi.org/10.1590/s1516-44462005000600006.
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Women are at significantly higher risk for developing post-traumatic stress disorder (PTSD) than men, resulting in increased psychosocial burden and healthcare related costs. Recent research has shown complex interactions between the impact of traumatic experiences, and the reproductive lifecycle in women. For example, women suffering from premenstrual dysphoric disorder (PMDD) who also report a history of sexual or physical abuse are more likely to present with different neuroendocrine reactivity to stressors, when compared to premenstrual dysphoric disorder subjects without prior history of trauma or abuse or non-premenstrual dysphoric disorder subjects. In addition, women with a history of abuse or trauma may experience re-emergence of symptoms during pregnancy. Lastly, females who experience miscarriage may present with even higher prevalence rates of post-traumatic stress disorder symptoms. In this manuscript we examine the existing data on gender differences in post-traumatic stress disorder, with particular focus on psychological and physiological factors that might be relevant to the development of symptoms after exposure to traumatic events associated with the reproductive life cycle. Current options available for the treatment of such symptoms, including group and counselling therapies and debriefing are critically reviewed.
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River, Laura M., Angela J. Narayan, Victoria M. Atzl, Luisa M. Rivera, and Alicia F. Lieberman. "Romantic partner support during pregnancy: The discrepancy between self-reported and coder-rated support as a risk factor for prenatal psychopathology and stress." Journal of Social and Personal Relationships 37, no. 1 (May 21, 2019): 27–46. http://dx.doi.org/10.1177/0265407519850333.
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Romantic partner support from the father-to-be is associated with women’s mental health during pregnancy. However, most studies of partner support rely upon women’s responses to self-report questionnaires, which may be biased and should be corroborated by efficient, coder-rated measures of partner support. This study tested whether the Five-Minute Speech Sample (FMSS), adapted to assess expressed emotion about romantic partners, can provide information about partner support during pregnancy that is less prone to bias than self-report. Participants were 101 low-income, ethnically diverse pregnant women who completed self-report questions on partner support quality and the FMSS. Self-reported and coder-rated (FMSS) partner support were highly correlated and were each significantly associated with self-reported depressive and post-traumatic stress disorder (PTSD) symptoms, perceived stress, and partner victimization during pregnancy. Self-reported and coder-rated support corresponded in approximately 75% of cases; however, nearly 25% of women self-reported high support but received low FMSS support ratings. These women reported elevated PTSD symptoms, perceived stress, and victimization during pregnancy. While self-reported partner support may be valid for many respondents, the FMSS is less susceptible to reporting biases and may better identify women facing heightened psychopathology and stress during pregnancy, who would benefit from supportive intervention.
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Nath, Selina, Elizabeth G. Ryan, Kylee Trevillion, Debra Bick, Jill Demilew, Jeannette Milgrom, Andrew Pickles, and Louise M. Howard. "Prevalence and identification of anxiety disorders in pregnancy: the diagnostic accuracy of the two-item Generalised Anxiety Disorder scale (GAD-2)." BMJ Open 8, no. 9 (September 2018): e023766. http://dx.doi.org/10.1136/bmjopen-2018-023766.
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ObjectiveTo estimate the population prevalence of anxiety disorders during pregnancy and investigate the diagnostic accuracy of the two-item Generalised Anxiety Disorder scale (GAD-2) for a) GAD and b) any anxiety disorder.DesignCross-sectional survey using a stratified sampling design. Sampling weights were used in the analysis to adjust for the bias introduced by the stratified sampling.SettingInner-city maternity service, South London.Participants545 pregnant women were interviewed after their first antenatal appointment; 528 provided answers on the GAD-2 questions.Main outcome measuresDiagnosis generated by the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (SCID).ResultsPopulation prevalence of anxiety disorders was 17% (95% CI 12% to 21%): 5% (95% CI 3% to 6%) for GAD, 4% (95% CI 2% to 6%) for social phobia, 8% (95% CI 5% to 11%) for specific phobia and 2% (95% CI 1% to 4%) for obsessive-compulsive disorder. Post-traumatic stress disorder (PTSD) prevalence was unclear due to higher levels of reluctance to respond to PTSD interview questions but sensitivity analyses suggest population prevalence maybe up to 4% (95% CI 2% to 6%). Weighted sensitivity of GAD-2 for GAD (cut-off ≥3) was 69%, specificity 91%, positive predictive value 26%, negative predictive value 98% and likelihood ratio 7.35. For any anxiety disorder the weighted sensitivity was 26%, specificity 91%, positive predictive value 36%, negative predictive value 87% and likelihood ratio 2.92.ConclusionsAnxiety disorders are common but GAD-2 generates many false positives and may therefore be unhelpful in maternity services.
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Vukelic, Jelka, Aleksandra Kapamadzija, and Biljana Kondic. "Investigation of risk factors for acute stress reaction following induced abortion." Medical review 63, no. 5-6 (2010): 399–403. http://dx.doi.org/10.2298/mpns1006399v.
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Introduction. Termination of pregnancy - induced abortion is inevitable in family planning as the final solution in resolving unwanted pregnancies. It can be the cause of major physical and phychological concequences on women?s health. Diverse opinions on psychological consequences of induced abortion can be found in literature. Material and methods. A prospective study was performed in order to predict acute stress disorder (ASD) after the induced abortion and the possibility of post-traumatic stress disorder (PTSD). Seven days after the induced abortion, 40 women had to fill in: 1. a special questionnaire made for this investigation, with questions linked to some risk factors inducing stress, 2. Likert?s emotional scale and 3. Bryant?s acute stress reaction scale. Results. After an induced abortion 52.5% women had ASD and 32.5% women had PTSD. Women with ASD after the abortion developed more sense of guilt, irritability, shame, self-judgement, fear from God and self-hatred. They were less educated, had lower income, they were more religious, did not approve of abortion and had worse relationship with their partners after the abortion in comparison to women without ASD. Age, number of previous abortions and decision to abort did not differ between the two groups. Discussion and conclusion. Induced abortion represents a predisposing factor for ASD and PTSD in women. Some psychosocial factors contribute to the development of stress after abortion. Serbia has a task to reduce the number of abortions which is very high, in order, to preserve reproductive and phychological health of women.
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Rurangirwa, Akashi Andrew, Ingrid Mogren, Joseph Ntaganira, Kaymarlin Govender, and Gunilla Krantz. "Intimate partner violence during pregnancy in relation to non-psychotic mental health disorders in Rwanda: a cross-sectional population-based study." BMJ Open 8, no. 7 (July 2018): e021807. http://dx.doi.org/10.1136/bmjopen-2018-021807.
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ObjectivesTo investigate the prevalence of non-psychotic mental health disorders (MHDs) and the association between exposure to all forms of intimate partner violence (IPV) during pregnancy and MHDs.DesignCross-sectional population-based study conducted in the Northern Province of Rwanda and Kigali city.Participants and settingsTotally, 921 women who gave birth ≤13 months before being interviewed were included. Simple random sampling was done to select villages, households and participants. Community health workers helped to identify eligible participants and clinical psychologists, nurses or midwives conducted face-to-face interviews. The collected data were analysed using descriptive statistics and bivariable and multivariable logistic regression modellingResultsThe prevalence rates of generalised anxiety disorder, suicide ideation and post-traumatic stress disorder (PTSD) were 19.7%, 10.8% and 8.0%, respectively. Exposure to the four forms of IPV during pregnancy was highly associated with the likelihood of meeting diagnostic criteria for each of the non-psychotic MHDs investigated. Physical, psychological and sexual violence, showed the strongest association with PTSD, with adjusted ORs (aORs) of 4.5, 6.2 and 6.3, respectively. Controlling behaviour had the strongest association with major depressive episode in earlier periods with an aOR of 9.2.ConclusionIPV and MHDs should be integrated into guidelines for perinatal care. Moreover, community-based services aimed at increasing awareness and early identification of violence and MHDs should be instituted in all villages and health centres in Rwanda. Finally, healthcare providers need to be educated and trained in a consistent manner to manage the most challenging cases quickly, discreetly and efficiently.
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Logue, Omar C., Eric M. George, and Gene L. Bidwell. "Preeclampsia and the brain: neural control of cardiovascular changes during pregnancy and neurological outcomes of preeclampsia." Clinical Science 130, no. 16 (July 7, 2016): 1417–34. http://dx.doi.org/10.1042/cs20160108.
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Preeclampsia (PE) is a form of gestational hypertension that complicates ∼5% of pregnancies worldwide. Over 70% of the fatal cases of PE are attributed to cerebral oedema, intracranial haemorrhage and eclampsia. The aetiology of PE originates from abnormal remodelling of the maternal spiral arteries, creating an ischaemic placenta that releases factors that drive the pathophysiology. An initial neurological outcome of PE is the absence of the autonomically regulated cardiovascular adaptations to pregnancy. PE patients exhibit sympathetic overactivation, in comparison with both normotensive pregnant and hypertensive non-pregnant females. Moreover, PE diminishes baroreceptor reflex sensitivity (BRS) beyond that observed in healthy pregnancy. The absence of the cardiovascular adaptations to pregnancy, combined with sympathovagal imbalance and a blunted BRS leads to life-threatening neurological outcomes. Behaviourally, the increased incidences of maternal depression, anxiety and post-traumatic stress disorder (PTSD) in PE are correlated to low fetal birth weight, intrauterine growth restriction (IUGR) and premature birth. This review addresses these neurological consequences of PE that present in the gravid female both during and after the index pregnancy.
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Seng, Julia S., Mickey Sperlich, Heather Rowe, Heather Cameron, Anna Harris, Sheila A. M. Rauch, and Susan A. Bell. "The Survivor Moms’ Companion: Open Pilot of a Posttraumatic Stress Specific Psychoeducation Program for Pregnant Survivors of Childhood Maltreatment and Sexual Trauma." International Journal of Childbirth 1, no. 2 (2011): 111–21. http://dx.doi.org/10.1891/2156-5287.1.2.111.
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The Survivor Moms’ Companion (SMC) is a fully manualized, 10-module self-study psychoeducation program developed to address the pregnancy-specific needs of traumatic stress-affected abuse survivors. It aims to improve affect regulation, reduce interpersonal reactivity, and support posttraumatic stress disorder (PTSD) symptom management despite the presence of triggers. An open pilot enrolled “survivor moms” prior to 28 weeks gestation and they completed baseline diagnostic telephone interviews, fidelity measures, pretest and posttest, and self-report measures assessing the efficacy of the proposed mechanisms of intervention effect. Of 57 eligible women invited to participate, 32 took up the intervention, 9 completed at least the core 4 modules, and 18 completed all 10 modules. Participant scores showed improvements in anger expression, interpersonal reactivity, and PTSD symptom management, suggesting that participation in the SMC is beneficial. Results will inform the protocol for a cluster randomized trial of the SMC.
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Nair, Smriti, James E. McGreevy, Juana Hutchinson-Colas, Heather Turock, Frank Chervenak, and Gloria Bachmann. "Pregnancy in incarcerated women: need for national legislation to standardize care." Journal of Perinatal Medicine 49, no. 7 (June 25, 2021): 830–36. http://dx.doi.org/10.1515/jpm-2021-0145.
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Abstract Objectives This review examined prenatal care provided to incarcerated women to identify areas where improvement is needed, and examined current legislative gaps such that they can be addressed to ensure uniform templates of care be instituted at women’s prisons. Methods Data were compiled from 2000-2021 citations in PubMed and Google Scholar using the keywords: prison AND prenatal care AND pregnancy. Results Although the right to health care of inmates is protected under the Eight Amendment to the United States Constitution, the literature suggests that prenatal care of incarcerated individuals is variable and would benefit from uniform federal standards. Inconsistency in reporting requirements has created a scarcity of data for this population, making standardization of care difficult. Although incarceration may result in improved access to care that women may not have had in their community, issues of shackling, inadequate prenatal diet, lack of access to comprehensive mental health management, and poor availability of opioid use disorder (OUD) management such as Medication Assisted Therapy (MAT) amd Opioid Treatment Programs (OTP), history of post-traumatic stress disorder (PTSD) are just a few areas that must be focused on in prenatal care. After birth, mother-baby units (MBU) to enhance maternal-fetal bonding also should be a prison standard. Conclusions In addition to implementing templates of care specifically directed to this subgroup of women, standardized state and federal legislation are recommended to ensure that uniform standards of prenatal care are enforced and also to encourage the reporting of data regarding pregnancy and neonatal outcomes in correctional facilities.
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Ferreira, Elton C., Maria Laura Costa, Rodolfo C. Pacagnella, Carla Silveira, Carla B. Andreucci, Dulce Maria Toledo Zanardi, Juliana P. Santos, et al. "Multidimensional assessment of women after severe maternal morbidity: the COMMAG cohort study." BMJ Open 10, no. 12 (December 2020): e041138. http://dx.doi.org/10.1136/bmjopen-2020-041138.
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ObjectivesTo perform a multidimensional assessment of women who experienced severe maternal morbidity (SMM) and its short-term and medium-term impact on the lives and health of women and their children.DesignA retrospective cohort study.SettingA tertiary maternity hospital from the southeast region of Brazil.ParticipantsThe exposed population was selected from intensive care unit admissions if presenting any diagnostic criteria for SMM. Controls were randomly selected among women without SMM admitted to the same maternity and same time of childbirth.Primary and secondary outcome variablesValidated tools were applied, addressing post-traumatic stress disorder (PTSD) and quality of life (SF-36) by phone, and then general and reproductive health, functioning (WHO Disability Assessment Schedule), sexual function (Female Sexual Function Index (FSFI)), substance abuse (Alcohol, Smoking and Substance Involvement Screening Test 2.0) and growth/development (Denver Developmental Screening Test) of children born in the index pregnancy in a face-to-face interview.ResultsAll instruments were applied to 638 women (315 had SMM; 323 were controls, with the assessment of 264 and 307 children, respectively). SF-36 score was significantly lower in the SMM group, while PTSD score was similar between groups. Women who had SMM became more frequently sterile, had more abnormal clinical conditions after the index pregnancy and a higher score for altered functioning, while proportions of FSFI score or any drug use were similar between groups. Furthermore, children from the SMM group were more likely to have weight (threefold) and height (1.5 fold) for age deficits and also impaired development (1.5-fold).ConclusionSMM impairs some aspects of the lives of women and their children. The focus should be directed towards monitoring these women and their children after birth, ensuring accessibility to health services and reducing short-term and medium-term repercussions on physical, reproductive and psychosocial health.
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Forgash, Carol, Andrew Leeds, Claire A. I. Stramrood, and Amy Robbins. "Case Consultation: Traumatized Pregnant Woman." Journal of EMDR Practice and Research 7, no. 1 (2013): 45–49. http://dx.doi.org/10.1891/1933-3196.7.1.45.
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Case consultation is a new regular feature in the Journal of EMDR Practice and Research in which a therapist requests assistance regarding a challenging case and responses are written by three experts. In this article, Amy Robbins, a certified eye movement desensitization and reprocessing (EMDR) therapist from Atlanta, Georgia, briefly describes a challenging case in which a pregnant woman seeks treatment for trauma suffered in a tornado. The clinician asks if it is advisable to provide EMDR treatment and what concerns she should be aware of. The first expert, Carol Forgash, provides some general information about pregnancy and psychotherapy and outlines considerations, concerns, and contraindications for proceeding with EMDR. She recommends that if treatment is chosen, the therapist proceed with a recent trauma protocol to specifically target the traumatic memories of the recent tornado. The second expert, Andrew Leeds, comments on the absence of randomized controlled trials (RCTs) or other scientific reports exploring the safety of EMDR treatment of pregnant women. He states that pregnant women with symptoms of posttraumatic stress should understand that there is a high probability that EMDR will improve maternal quality of life and that the risks of adverse effects on stability of pregnancy are probably low, but that these remain unknown. The third expert, Claire Stramrood, explains that the few case studies that evaluated EMDR during pregnancy have found positive effects but pertained to women with posttraumatic stress disorder (PTSD) following childbirth. She asserts that once obstetricians have been consulted, women have been informed about possible risks and benefits, and, given their informed consent, they should be able to choose to commence EMDR therapy during pregnancy.
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Flouri, Eirini. "Post-Traumatic Stress Disorder (PTSD)." Journal of Interpersonal Violence 20, no. 4 (April 2005): 373–79. http://dx.doi.org/10.1177/0886260504267549.
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Weintraub, Lisa. "Inner-city Post-traumatic Stress Disorder." Journal of Psychiatry & Law 25, no. 2 (June 1997): 249–86. http://dx.doi.org/10.1177/009318539702500203.
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For the first time, psychiatrists have explicitly recognized the connection between urban violence and Post-Traumatic Stress Disorder (PTSD), in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Using the new DSM-IV definition, this article reexamines the use of the PTSD insanity defense in inner-city criminal cases. After investigating the extent to which inner-city defendants meet the criteria of PTSD, the author outlines how the legal system has applied the PTSD insanity defense in criminal cases and explores the policy implications of those defenses. The author concludes that although many inner-city defendants can meet the medical and psychological criteria of PTSD, the legal system should not encourage such defenses. Instead, the author advocates using knowledge about inner-city PTSD to design creative crime-prevention strategies.
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Bleich, Avi, Meni Koslowsky, Aliza Dolev, and Bernard Lerer. "Post-traumatic stress disorder and depression." British Journal of Psychiatry 170, no. 5 (May 1997): 479–82. http://dx.doi.org/10.1192/bjp.170.5.479.
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BackgroundWe examined psychiatric morbidity following war-related psychic trauma, with a special focus on the depressive comorbidity of post-traumatic stress disorder (PTSD).MethodSubjects consisted of 60 Israeli veterans who sought psychiatric treatment 4–6 years after having been exposed to war trauma. PTSD and psychiatric comorbidity were diagnosed using the Structured Interview for PTSD and the Schedule for Affective Disorders and Schizophrenia.ResultsBoth lifetime (100%) and current (87%) PTSD were the most prevalent disorders. Comorbidity was extensive, with major depressive disorder (MDD) most prevalent (95% lifetime, 50% current), followed by anxiety disorders, minor affective disorders, and alcoholism or drug misuse.ConclusionsWithin post-traumatic psychiatric morbidity of combat origin, PTSD and MDD are the most prevalent disorders. In addition it appears that PTSD, although related to post-traumatic MDD beyond a mere sharing of common symptoms, is of the same time differentiated from it as an independent diagnostic category.
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Seedat, S. "Post-traumatic Stress Disorder." South African Journal of Psychiatry 19, no. 3 (August 30, 2013): 5. http://dx.doi.org/10.4102/sajpsychiatry.v19i3.952.
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<div style="left: 70.8662px; top: 324.72px; font-size: 15.45px; font-family: serif; transform: scaleX(1.01119);" data-canvas-width="421.07550000000003">Post-traumatic stress disorder (PTSD) is among the most prevalent</div><div style="left: 70.8662px; top: 344.72px; font-size: 15.45px; font-family: serif; transform: scaleX(0.979077);" data-canvas-width="419.514">anxiety disorders, both in terms of lifetime and 12-month prevalence</div>rates documented in epidemiological studies worldwide.
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Connor, Kathryn M., Suzanne M. Sutherland, Larry A. Tupler, Mary L. Malik, R. Jonathan, and T. Davidson. "Fluoxetine in post-traumatic stress disorder." British Journal of Psychiatry 175, no. 1 (July 1999): 17–22. http://dx.doi.org/10.1192/bjp.175.1.17.
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BackgroundMost pharmacotherapy trials in post-traumatic stress disorder (PTSD) have been conducted upon male combat veterans. Outcome studies relating to civilians are therefore needed.AimsTo demonstrate that fluoxetine is more effective than placebo in treating PTSD.MethodCivilians with PTSD (n=53) were treated for 12 weeks with fluoxetine (up to 60 mg/day) or placebo. Assessments of PTSD severity, disability, stress vulnerability, and high end-state function were obtained.ResultsFluoxetine was more effective than placebo on most measures at week 12, including global improvement (much or very much improved: fluoxetine 85%, placebo 62%, difference 0.24, 95% CI 0.01–0.47; very much improved: fluoxetine 59%, placebo 19%, difference 0.40, 95% CI 0.16–0.64), and high end-state function (fluoxetine 41%, placebo 4%, difference 0.37, 95% CI 0.17–0.57)ConclusionsFluoxetine was superior for measures of PTSD severity, disability, stress vulnerability, and high end-state function. The placebo-group response was low when viewed as a broad outcome based on a portfolio of ratings, but was higher with a traditional global rating criterion.
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Thomas, J. Ressler. "Post-Traumatic Stress Disorder: Vocational Considerations." Journal of Applied Rehabilitation Counseling 26, no. 1 (March 1, 1995): 9–13. http://dx.doi.org/10.1891/0047-2220.26.1.9.
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The article discusses the symptoms and treatments for post-traumatic stress disorder (PTSD). A case study is used throughout to clarify the counseling strategies discussed, including psychoanalytic therapy, behavioral-cognitive therapy, short term therapy, and psychodynamic therapy utilizing behavioral techniques. Finally, vocational implications for the client with PTSD are addressed.
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Freedman, Sara A., Dalia Brandes, Tuvia Peri, and Arieh Y. Shalev. "Predictors of chronic post-traumatic stress disorder." British Journal of Psychiatry 174, no. 4 (April 1999): 353–59. http://dx.doi.org/10.1192/bjp.174.4.353.
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BackgroundMost individuals who, shortly after trauma, express symptoms of post-traumatic stress disorder (PTSD) recover within one year of their traumatic experiences. In contrast, those who remain ill for one year rarely recover completely. The early identification of the latter is, therefore, very important.AimsTo prospectively evaluate predictors of PTSD at four months and one year.MethodWe followed 236 trauma survivors recruited from admissions to a general hospital's emergency room for four months, at which point 41 (17.4%) met diagnostic criteria for PTSD. Twenty-three of these individuals, and 39 individuals without PTSD at four months, were assessed again at one year.ResultsDepressive symptoms were the best predictors of PTSD at both time points. Intrusive symptoms and peri-traumatic dissociation were better at predicting four-month PTSD than one-year PTSD.ConclusionsThe occurrence of depression during the months that follow a traumatic event is an important mediator of chronicity in PTSD.
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Ballard, C. G., A. K. Stanley, and I. F. Brockington. "Post-Traumatic Stress Disorder (PTSD) after Childbirth." British Journal of Psychiatry 166, no. 4 (April 1995): 525–28. http://dx.doi.org/10.1192/bjp.166.4.525.
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BackgroundThere has been discussion about the possible occurrence of post-traumatic stress disorder (PTSD) in mothers after difficult childbirth.MethodFour cases with a symptom profile suggestive of PTSD commencing within 48 hours of childbirth are presented.ResultsThe PTSD was in each case associated with the delivery. In each case, there was an associated depressive illness. All four had persistent disorders, and two had difficulties with mother/infant attachment.ConclusionAs confirmed by other reports, the prevalence of PTSD associated with childbirth is a matter of concern.
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Bisson, Jonathan I. "Automatism and Post-traumatic Stress Disorder." British Journal of Psychiatry 163, no. 6 (December 1993): 830–32. http://dx.doi.org/10.1192/bjp.163.6.830.
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A soldier with post-traumatic stress disorder (PTSD) who committed a criminal act during a dissociative episode is described. This report and other published cases indicate that criminal acts can occur during dissociative episodes among people who suffer from PTSD. However, the evidence suggests that such incidents are rare and may be overemphasised. There often seems to be little relationship between the crimes committed by war veterans and their war experiences.
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Bisson, Jonathan I. "Pharmacological treatment of post-traumatic stress disorder." Advances in Psychiatric Treatment 13, no. 2 (March 2007): 119–26. http://dx.doi.org/10.1192/apt.bp.105.001909.
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Post-traumatic stress disorder (PTSD) causes significant distress and is often associated with markedly reduced functioning. Recent reviews have consistently recommended trauma-focused psychological therapies as a first-line treatment for PTSD. Pharmacological treatments have also been recommended but not as consistently. This article reviews the available trials of the pharmacological treatment of PTSD and discusses their implications.
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Adshead, Gwen. "Psychological therapies for post-traumatic stress disorder." British Journal of Psychiatry 177, no. 2 (August 2000): 144–48. http://dx.doi.org/10.1192/bjp.177.2.144.
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BackgroundAfter exposure to traumatic stressors, a subgroup of survivors (20–30%) will develop post-traumatic stress disorder (PTSD).AimsSince the incidence and prevalence rates for PTSD in the community are significant, it is important that general practitioners and psychiatrists be familiar with possible therapeutic options. In this review we shall look at the published evidence about the effectiveness of psychological treatments for PTSD.MethodThe psychopathological mechanisms involved in PTSD are discussed. Studies of the effectiveness of different psychological therapies are reviewed.ResultsThe review suggests that persistent fear or shame reactions are key aspects of PTSD. Evidence from systematic reviews suggests that psychotherapeutic treatments are effective in the therapy of reactions based on fear, and may increase the effectiveness of pharmacological therapy. There is less systematic evidence for the efficacy of interventions for symptoms based on shame.ConclusionsAlthough a proportion of patients with complex or chronic PTSD may require specialist interventions, most patients can be treated effectively by a general psychiatric service which can offer both pharmacological and psychological interventions.
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SPIVAK, B., M. SEGAL, R. MESTER, and A. WEIZMAN. "Lateral preference in post-traumatic stress disorder." Psychological Medicine 28, no. 1 (January 1998): 229–32. http://dx.doi.org/10.1017/s0033291797005837.
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Background. We assessed lateral preference in 80 male patients with combat-related post-traumatic stress disorder (PTSD) and in 100 healthy age-matched male controls.Methods. Hand, foot, eye and ear preferences were examined, using the Edinburgh Handedness Inventory-Modified and the Coren Inventory of Lateral Preference.Results. Mixed lateral preference was noted in significantly more PTSD patients than controls (65 v. 43%, P<0·005).Conclusions. These results indicate a possible hemispheric imbalance (less lateralization) in PTSD patients, with the right hemisphere playing a more active role in perceptual and cognitive processing and in the regulation of biological responses in these patients. This imbalance may be relevant to the pathophysiology of PTSD.
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Ahmed, Ayesha S. "Post-traumatic stress disorder, resilience and vulnerability." Advances in Psychiatric Treatment 13, no. 5 (September 2007): 369–75. http://dx.doi.org/10.1192/apt.bp.106.003236.
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Post-traumatic stress disorder (PTSD), recognised as a diagnostic entity in 1980, was originally associated with combat or war experiences. It has since been recognised that it is prevalent in any population exposed to traumatic events. Although much has been written about the management of PTSD, the concepts of resilience and vulnerability have not received the same attention. This article reviews the conceptualisation, epidemiology and comorbidities of PTSD and highlights the factors underlying vulnerability and conveying resilience.
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Davidson, J., Vivette Glover, Angela Clow, H. Kudler, K. Meador, and M. Sandler. "Tribulin in post-traumatic stress disorder." Psychological Medicine 18, no. 4 (November 1988): 833–36. http://dx.doi.org/10.1017/s0033291700009764.
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SynopsisTribulin (endogenous monoamine oxidase inhibitor/benzodiazepine receptor binding inhibitor) output was measured in the urine of 18 patients with post-traumatic stress disorder (PTSD) and 13 controls. The level of the two inhibitory activities was highly significantly correlated in the group as a whole. There was no difference between output of either inhibitor in patients and controls. However, when the PTSD group was subdivided according to various psychometric ratings, a pattern of output did emerge. Levels of both inhibitory activities were higher in agitated compared with non-agitated subjects, and lower in extroverts compared with introverts. This finding supports the view that tribulin output is raised in conditions of greater arousal.
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Pietrzak, Robert H., Frances G. Javier, John H. Krystal, and Steven M. Southwick. "Subthreshold post-traumatic stress disorder as a risk factor for post-traumatic stress disorder: results from a sample of USA veterans." British Journal of Psychiatry 219, no. 2 (March 19, 2021): 456–59. http://dx.doi.org/10.1192/bjp.2021.17.
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Subthreshold post-traumatic stress disorder (PTSD) is more prevalent than PTSD, yet its role as a potential risk factor for PTSD is unknown. To address this gap, we analysed data from a 7-year, prospective national cohort of USA veterans. Of veterans with subthreshold PTSD at wave 1, 34.3% developed PTSD compared with 7.6% of trauma-exposed veterans without subthreshold PTSD (relative risk ratio 6.4). Among veterans with subthreshold PTSD, specific PTSD symptoms, greater age, cognitive difficulties, lower dispositional optimism and new-onset traumas predicted incident PTSD. Results suggest that preventive interventions targeting subthreshold PTSD and associated factors may help mitigate risk for PTSD in USA veterans.
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Davidson, Jonathan. "Drug Therapy of Post-traumatic Stress Disorder." British Journal of Psychiatry 160, no. 3 (March 1992): 309–14. http://dx.doi.org/10.1192/bjp.160.3.309.
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Post-traumatic stress disorder (PTSD) is a recently introduced diagnosis. The disorder is quite common, yet often unrecognised, and leads to significant morbidity or mortality. Effective treatment often entails use of psychotropic medication. Only recently has this become apparent, and awareness of the role of drug therapy in PTSD remains limited. A number of studies have indicated efficacy for antidepressant, mood-stabilising, anticonvulsant and antianxiety medications. This review describes the role of pharmacotherapy, by examining issues of diagnosis and recognition of PTSD, the theoretical basis for drug use, goals of drug treatment, dose ranges, and clinical application of psychotropic drugs.
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Michaels, AJ, CH Moon, &NA; Michaels, JS Smith, &NA; Zimmerman, &NA; Taheri, and C. Peterson. "POST TRAUMATIC STRESS DISORDER (PTSD) FOLLOWING INJURY." Journal of Trauma: Injury, Infection, and Critical Care 45, no. 6 (December 1998): 1108. http://dx.doi.org/10.1097/00005373-199812000-00034.
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Gluff, Jeffrey A., Marilyn G. Teolis, Ashley A. Moore, and Dorothy R. Kelly. "Post-traumatic Stress Disorder (PTSD): A Webliography." Journal of Consumer Health on the Internet 21, no. 4 (October 2, 2017): 389–401. http://dx.doi.org/10.1080/15398285.2017.1377539.
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Crumlish, Niall. "Post-traumatic stress disorder: present and future." Irish Journal of Psychological Medicine 27, no. 3 (September 2010): i—vi. http://dx.doi.org/10.1017/s0790966700001439.
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Post-traumatic stress disorder (PTSD) and acute stress disorder (ASD) differ from almost every other psychiatric diagnosis in that they may only be diagnosed with reference to an aetiological event – an external traumatic stressor. ASD occurs immediately after the stressor and is comparatively short-lived, while PTSD is a prolonged abnormal response that may take months to develop. The types of stressor leading to ASD and PTSD are identical and were intended to be tightly defined, involving a perceived threat of death, serious injury or loss of physical integrity.It is useful initially to distinguish ASD and PTSD from adjustment disorders, which are also diagnosed only after an observable life event. An adjustment disorder may be thought of as a gradual and prolonged response to stressful changes in a person's life. The range of stressors precipitating an adjustment disorder is potentially much broader than that precipitating ASD or PTSD, as a threat of death or injury is not needed.Indeed, a ‘threat’ as such is not needed, as the event may be a loss. Events such as job loss or the breakup of a relationship may lead to an adjustment disorder, as well as threats such as accidents or assaults. The diagnostic criteria for adjustment disorder do not specify what the immediate response, if any, to the precipitating stressor must be.
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Meewisse, Marie-Louise, Johannes B. Reitsma, Giel-Jan De Vries, Berthold P. R. Gersons, and Miranda Olff. "Cortisol and post-traumatic stress disorder in adults." British Journal of Psychiatry 191, no. 5 (November 2007): 387–92. http://dx.doi.org/10.1192/bjp.bp.106.024877.
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BackgroundPost-traumatic stress disorder (PTSD) has inconsistently been associated with lower levels of cortisol.AimsTo compare basal cortisol levels in adults with current PTSD and in people without psychiatric disorder.MethodSystematic review and meta-analysis. Standardised mean differences (SMD) in basal cortisol levels were calculated and random-effects models using inverse variance weighting were applied.ResultsAcross 37 studies, 828 people with PTSD and 800 controls did not differ in cortisol levels (pooled SMD = −0.12, 95% C1= −0.32 to 0.080). Subgroup analyses revealed that studies assessing plasma or serum showed significantly lower levels in people with PTSD than in controls not exposed to trauma. Lower levels were also found in people with PTSD when females were included, in studies on physical or sexual abuse, and in afternoon samples.ConclusionsLow cortisol levels in PTSD are only found under certain conditions. Future research should elucidate whether low cortisol is related to gender or abuse and depends on the measurement methods used.
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Sumpter, Ruth E., and Tom M. McMillan. "Misdiagnosis of post-traumatic stress disorder following severe traumatic brain injury." British Journal of Psychiatry 186, no. 5 (May 2005): 423–26. http://dx.doi.org/10.1192/bjp.186.5.423.
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BackgroundThe incidence of post-traumatic stress disorder (PTSD) after traumatic brain injury is unclear. One issue involves the validity of diagnosis using self-report questionnaires.AimsTo compare PTSD ‘caseness' arising from questionnaire self-report and structured interview.MethodParticipants (n=34) with traumatic brain injury were recruited. Screening measures and self-report questionnaires were administered, followed by the structured interview.ResultsUsing questionnaires, 59% fulfilled criteria for PTSD on the Post-traumatic Diagnostic Scale and 44% on the Impact of Events Scale, whereas using structured interview (Clinician-Administered PTSD Scale) only 3% were ‘cases'. This discrepancy may arise from confusions between effects of PTSD and traumatic brain injury.ConclusionsAfter traumatic brain injury, PTSD self-report measures might be used for screening but not diagnosis.
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Tobin, John P. "Post traumatic stress disorder and the adrenal gland." Irish Journal of Psychological Medicine 18, no. 1 (March 2001): 27–29. http://dx.doi.org/10.1017/s0790966700006194.
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AbstractLow serum and urinary Cortisol has been a consistent finding in post traumatic stress disorder (PTSD). Glucocorticoid receptor numbers are increased. PTSD patients have a significantly lower adrenocorticotropic hormone (ACTH) in response to corticotrophin releasing hormone (CRH) when compared to a control group of normal volunteers. The dexamethasone suppression test exhibits an exaggerated suppression response of Cortisol to dexamethasone, when the dose utilised is lower than that utilised to test patients with depression. Increased urine levels of noradrenaline and dopamine has been noted in patients with PTSD. This is believed to be related to the hyperarousal state of PTSD.
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Abo Hamza, Eid G., Majd A. Gharib A. M., Rami A. Gharib, and Ahmed A. Moustafa. "THE SYRIAN WAR AND POST-TRAUMATIC STRESS DISORDER." Humanities & Social Sciences Reviews 8, no. 2 (August 22, 2020): 870–76. http://dx.doi.org/10.18510/hssr.2020.8296.
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Purpose of the Study: The purpose of this study is to investigate the prevalence of posttraumatic distress disorder (PTSD) amongst Syrian whom lived in under the war.
Methodology: The study has utilized a survey to observe the prevalence of post-traumatic stress disorder (PTSD) among Syrian people who lived inside Syria during the Syrian conflict The survey uses the PTSD checklist for civilians (PCL-C), which measures both the severity of PTSD and the 3 symptoms of it in accordance with “The Diagnostic and Statistical Manual of Mental Disorders” (DSM-IV) that are re-experiencing; avoidance; and hyperarousal. A sample of 600 random Syrian people participated in the current study.
Findings: The PTSD test results show a widespread of the trauma in Syria based on the result of the test as 53percent of the participants had symptoms corresponding to the recommended diagnosis, which is expected due to horrors of war and terrorism-related events.
Implications: Results suggest that it is imperative to provide intervention programs to treat PTSD symptoms among people who live in Syria. The participants' cultural and religious backgrounds should be taken into account in these programs.
The originality of the Study: This Syrian war research has contributed to a spike in symptoms of PTSD and depression among children in Syria.
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BRYANT, RICHARD A., MARK CREAMER, MEAGHAN O’DONNELL, DERRICK SILOVE, C. RICHARD CLARK, and ALEXANDER C. MCFARLANE. "Post-traumatic amnesia and the nature of post-traumatic stress disorder after mild traumatic brain injury." Journal of the International Neuropsychological Society 15, no. 6 (November 2009): 862–67. http://dx.doi.org/10.1017/s1355617709990671.
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AbstractThe prevalence and nature of post-traumatic stress disorder (PTSD) following mild traumatic brain injury (MTBI) is controversial because of the apparent paradox of suffering PTSD with impaired memory for the traumatic event. In this study, 1167 survivors of traumatic injury (MTBI: 459, No TBI: 708) were assessed for PTSD symptoms and post-traumatic amnesia during hospitalization, and were subsequently assessed for PTSD 3 months later (N = 920). At the follow-up assessment, 90 (9.4%) patients met criteria for PTSD (MTBI: 50, 11.8%; No-TBI: 40, 7.5%); MTBI patients were more likely to develop PTSD than no-TBI patients, after controlling for injury severity (adjusted odds ratio: 1.86; 95% confidence interval, 1.78–2.94). Longer post-traumatic amnesia was associated with less severe intrusive memories at the acute assessment. These findings indicate that PTSD may be more likely following MTBI, however, longer post-traumatic amnesia appears to be protective against selected re-experiencing symptoms. (JINS, 2009, 15, 862–867.)
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Smith, Patrick, Sean Perrin, and William Yule. "Cognitive Behaviour Therapy for Post Traumatic Stress Disorder." Child Psychology and Psychiatry Review 4, no. 4 (February 1999): 177–82. http://dx.doi.org/10.1017/s1360641799002087.
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It is only relatively recently that Post Traumatic Stress Disorder (PTSD) has been recognised in children. Controlled treatment outcome studies of childhood PTSD are scarce, but those that exist indicate that Cognitive Behaviour Therapy (CBT) is an effective intervention. In this article, we briefly describe PTSD in children and outline some behavioural and cognitive models of the disorder. Derived from these models, prolonged therapeutic exposure and cognitive restructuring as part of a CBT package are then described. In practice, effective therapy will include more than exposure-based work, and additional procedures, including work with parents, are highlighted. While CBT is the treatment of choice of PTSD in childhood, there is an urgent need for further treatment outcome studies.
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Striefel, Sebastian “Seb.” "A Post Traumatic Stress Disorder Ethical Update." Biofeedback 37, no. 1 (March 1, 2009): 3–6. http://dx.doi.org/10.5298/1081-5937-37.1.3.
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Abstract Post traumatic stress disorder (PTSD) is a complex condition with a variety of potential causes and symptoms, and it requires multifaceted treatment. Practitioners are cautioned to take great care in the informed consent process to ensure that clients know their treatment options, the level of support, and pros and cons of each option before giving consent. Practitioners need to be familiar with both the clinical and research data when developing a rationale and treatment approach that is individualized for the specific client. Moreover, practitioners should be competent in diagnosing a wide variety of conditions that are comorbid with PTSD and should ensure that they can legally make such a diagnosis and provide treatment for the specific conditions from which the client suffers. In addition, it is strongly recommended, if not legally required, that practitioners have an appropriate background in a mental health discipline so they are competent to help a client work through the traumas, symptoms, and side effects experienced by the client before undertaking the treatment of those suffering from PTSD.
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Watson, I. P. Burges, L. Hoffman, and G. V. Wilson. "The Neuropsychiatry of Post-traumatic Stress Disorder." British Journal of Psychiatry 152, no. 2 (February 1988): 164–73. http://dx.doi.org/10.1192/bjp.152.2.164.
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The publication of DSM-III introduced the diagnosis Post-Traumatic Stress Disorder (PTSD), thus providing, for the first time, a framework for studying the consequences of extremely stressful events. Previously, traumatic neuroses had attracted a wide variety of labels – as wide as the experiences that produced them. Competing explanations in psychological and biological terms have characterised the approach to these disorders, and social and legal issues have added to the confusion. In recent years, psychosocial issues have tended to dominate the literature in relation to PTSD. While acknowledging the importance of such phenomenological and psychosocial approaches, this paper seeks to redress the balance by focusing on a biological perspective.
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Hull, Alastair M. "Neuroimaging findings in post-traumatic stress disorder." British Journal of Psychiatry 181, no. 02 (August 2002): 102–10. http://dx.doi.org/10.1017/s000712500016180x.
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Chang, Min Cheol, and Donghwi Park. "Incidence of Post-Traumatic Stress Disorder after Coronavirus Disease." Healthcare 8, no. 4 (September 30, 2020): 373. http://dx.doi.org/10.3390/healthcare8040373.
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Background: The coronavirus disease (COVID-19) emerged from China and rapidly spread to many other countries. In this study, we investigated the prevalence of post-traumatic stress disorder (PTSD) among patients with COVID-19 who were treated and discharged from a university hospital in Daegu, Korea. Methods: In total, 64 patients who were diagnosed with COVID-19 and then hospitalized, treated and discharged from the university hospital between February and April 2020 participated in our study. We conducted telephone interviews with the participants and evaluated the presence of PTSD using the Post-Traumatic Stress Disorder Checklist-5 (PCL-5) based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; score range: 0–80). If a score of ≥33 was obtained, then a diagnosis of PTSD was made. We analyzed the association between PTSD and demographic and clinical characteristics using the Mann–Whitney U and chi-square tests. Results: In total, 13 patients had a PCL-5 score of ≥33, which indicated that 20.3% (n = 64) of the patients had PTSD. No significant differences were observed in demographic characteristics, including, sex, age, hospitalization time and duration after discharge, between patients with PTSD and those without PTSD. Conclusions: The prevalence rate of PTSD was 20.3% in patients with COVID-19 who had been hospitalized, treated and discharged. Accordingly, clinicians should be aware of the high possibility of PTSD among COVID-19 patients. Mental health interventions supporting the mental health of patients should be provided to affected patients.
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Breslau, N., and L. Schultz. "Neuroticism and post-traumatic stress disorder: a prospective investigation." Psychological Medicine 43, no. 8 (November 30, 2012): 1697–702. http://dx.doi.org/10.1017/s0033291712002632.
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BackgroundNeuroticism has been consistently correlated with the post-traumatic stress disorder (PTSD) response to traumatic events. Interpretation of these findings is limited by the retrospective nature of these findings: neuroticism was measured after the trauma had occurred. The prospective association of neuroticism with PTSD has not been examined (the relationship of neuroticism with PTSD symptoms was examined in a few prospective studies). We evaluate prospectively the relationship of neuroticism, measured at baseline, with the cumulative occurrence of PTSD during the subsequent 10 years, using data from a longitudinal epidemiological study of young adults.MethodA sample of 1007 young adults randomly selected from the membership of a large health maintenance organization in southeast Michigan was assessed at baseline and followed up at 3, 5 and 10 years later. We conducted a series of multinomial logistic regressions to estimate the relative risk (RR) of exposure to trauma and PTSD by neuroticism at baseline, adjusting for history of major depression (n = 990).ResultsDuring the 10-year follow-up, 50.2% of the sample experienced traumatic events and 5.2% developed PTSD. Neuroticism score at baseline increased significantly the RR of PTSD response to trauma. Additional analysis revealed that, among persons with history of major depression at baseline, RR for PTSD associated with neuroticism was equal to the null value of 1, but was increased significantly among those with no history of major depression.ConclusionsThe results confirm the role of neuroticism as diathesis in the PTSD response to traumatic experiences.
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Bisson, Jonathan I., Amy Baker, William Dekker, and Mathew D. Hoskins. "Evidence-based prescribing for post-traumatic stress disorder." British Journal of Psychiatry 216, no. 3 (February 28, 2020): 125–26. http://dx.doi.org/10.1192/bjp.2020.40.
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SummaryThere is strong research evidence to support the pharmacological treatment of post-traumatic stress disorder (PTSD) as a second line to trauma-focused psychological interventions. Fluoxetine, paroxetine, sertraline and venlafaxine are the best-evidenced drugs, with lower-level evidence for other medications. It is important that prescribing for PTSD is evidence-based.
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Vazquez, Danny A., Shoshana M. Rosenberg, Shari I. Gelber, Kathryn Jean Ruddy, Evan Morgan, Christopher J. Recklitis, Steven E. Come, Lidia Schapira, and Ann H. Partridge. "Post-traumatic stress disorder in young breast cancer survivors." Journal of Clinical Oncology 34, no. 3_suppl (January 20, 2016): 202. http://dx.doi.org/10.1200/jco.2016.34.3_suppl.202.
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202 Background: Posttraumatic stress disorder (PTSD) is associated with morbidity and mortality in affected populations. Cancer survivors experience PTSD at a rate higher than the general population, with young age and female gender identified as risk factors. While young women with breast cancer experience greater psychosocial distress in general following diagnosis (dx), little is known about PTSD in this population. Methods: Women dx’d with Stage I-III breast cancer at age ≤ 40 were surveyed as a part of a multi-site cohort study. Demographic, treatment, psychosocial characteristics (including self-reported psychiatric conditions and use of psychiatric medications prior to dx), anxiety and depression (Hospital Anxiety and Depression Scale), fear of recurrence (Lasry Scale), and social support (Medical Outcomes Study) were assessed within 1 year after dx. PTSD was measured at 30 months post-dx using the PTSD Checklist – Civilian Version; a score ≥ 50 was considered positive for PTSD. Univariable and stepwise multivariable logistic regression were used to evaluate factors associated with PTSD. Results: 572 women were eligible for this analysis; median age at dx was 37 (range: 17-40); 87% had Stage I or II cancer. 37/572 women (6.5%) met criteria for PTSD at 30 months. Lower educational attainment, less financial comfort, less social support, stage 2 (vs. 1) disease, receipt of chemotherapy, fear of recurrence, anxiety and depression, and psychiatric comorbidities were associated (p ≤ 0.05) with PTSD in univariable analyses. Chemotherapy (OR = 3.48, 95% CI = 1.09-11.06), anxiety by HADS (OR = 20.29, 95% CI = 7.83-52.53), and psychiatric comorbidities (OR = 4.22, 95% CI = 1.40-12.74) were associated with increased likelihood of PTSD, whereas college education (OR = 0.25, 95% CI = 0.10-0.59) and greater social support (OR = 0.41, 95% CI = 0.17-0.99) appeared to be protective in multivariable analyses. Conclusions: PTSD affects a minority of young breast cancer survivors, with the prevalence in our cohort similar to that seen in other breast cancer populations. Early identification of those at risk for developing PTSD is essential for the adequate treatment of affected women and for the improvement of health outcomes and quality of life in cancer survivors.
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Neria, Y., A. Nandi, and S. Galea. "Post-traumatic stress disorder following disasters: a systematic review." Psychological Medicine 38, no. 4 (September 6, 2007): 467–80. http://dx.doi.org/10.1017/s0033291707001353.
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BackgroundDisasters are traumatic events that may result in a wide range of mental and physical health consequences. Post-traumatic stress disorder (PTSD) is probably the most commonly studied post-disaster psychiatric disorder. This review aimed to systematically assess the evidence about PTSD following exposure to disasters.MethodA systematic search was performed. Eligible studies for this review included reports based on the DSM criteria of PTSD symptoms. The time-frame for inclusion of reports in this review is from 1980 (when PTSD was first introduced in DSM-III) and February 2007 when the literature search for this examination was terminated.ResultsWe identified 284 reports of PTSD following disasters published in peer-reviewed journals since 1980. We categorized them according to the following classification: (1) human-made disasters (n=90), (2) technological disasters (n=65), and (3) natural disasters (n=116). Since some studies reported on findings from mixed samples (e.g. survivors of flooding and chemical contamination) we grouped these studies together (n=13).ConclusionsThe body of research conducted after disasters in the past three decades suggests that the burden of PTSD among persons exposed to disasters is substantial. Post-disaster PTSD is associated with a range of correlates including sociodemographic and background factors, event exposure characteristics, social support factors and personality traits. Relatively few studies have employed longitudinal assessments enabling documentation of the course of PTSD. Methodological limitations and future directions for research in this field are discussed.
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Michaels, AJ, &NA; Michaels, &NA; Zimmerman, JS Smith, CH Moon, and C. Peterson. "POST TRAUMATIC STRESS DISORDER (PTSD) IN INJURED ADULTS." Journal of Trauma: Injury, Infection, and Critical Care 46, no. 1 (January 1999): 207. http://dx.doi.org/10.1097/00005373-199901000-00067.
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